Iron Fortified Complementary Foods Containing a Mixture of Sodium Iron EDTA with Either Ferrous Fumarate or Ferric Pyrophosphate Reduce Iron Deficiency Anemia in 12- to 36-Month-Old Children in a Malaria Endemic Setting: A Secondary Analysis of a Cluster-Randomized Controlled Trial

Nutrients

Victorine G. Diakité¹  Grant J. Aaron²  Lukas G. Adiossan³  Dominik Glinz⁴  Rita Wegmüller⁴  Richard F. Hurrell⁴  Michael B. Zimmermann⁴  Lorenz Hofer⁵  Eliézer K. N’Goran⁶  Mamadou Ouattara⁶  Jürg Utzinger⁷ 

[1] Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303 Abidjan, Côte d’Ivoire;Global Alliance for Improved Nutrition, CH-1202 Geneva, Switzerland;Hôpital Général de Taabo, Taabo Cité, BP 700 Toumodi, Côte d’Ivoire;Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zurich, CH-8092 Zurich, Switzerland;Swiss Tropical and Public Health Institute, CH-4051 Basel, Switzerland;Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 01 BP V34 Abidjan, Cote d’Ivoire;University of Basel, CH-4003 Basel, Switzerland;

关键词: anemia;    cluster-randomized controlled trial;    complementary food;    Côte d’Ivoire;    infant cereal;    iron deficiency;    iron fortification;    Plasmodium falciparum;    sodium iron EDTA;   

DOI  :  10.3390/nu9070759

来源: DOAJ

【 摘 要 】

Iron deficiency anemia (IDA) is a major public health problem in sub-Saharan Africa. The efficacy of iron fortification against IDA is uncertain in malaria-endemic settings. The objective of this study was to evaluate the efficacy of a complementary food (CF) fortified with sodium iron EDTA (NaFeEDTA) plus either ferrous fumarate (FeFum) or ferric pyrophosphate (FePP) to combat IDA in preschool-age children in a highly malaria endemic region. This is a secondary analysis of a nine-month cluster-randomized controlled trial conducted in south-central Côte d’Ivoire. 378 children aged 12–36 months were randomly assigned to no food intervention (n = 125; control group), CF fortified with 2 mg NaFeEDTA plus 3.8 mg FeFum for six days/week (n = 126; FeFum group), and CF fortified with 2 mg NaFeEDTA and 3.8 mg FePP for six days/week (n = 127; FePP group). The outcome measures were hemoglobin (Hb), plasma ferritin (PF), iron deficiency (PF < 30 μg/L), and anemia (Hb < 11.0 g/dL). Data were analyzed with random-effect models and PF was adjusted for inflammation. The prevalence of Plasmodium falciparum infection and inflammation during the study were 44–66%, and 57–76%, respectively. There was a significant time by treatment interaction on IDA (p = 0.028) and a borderline significant time by treatment interaction on iron deficiency with or without anemia (p = 0.068). IDA prevalence sharply decreased in the FeFum (32.8% to 1.2%, p < 0.001) and FePP group (23.6% to 3.4%, p < 0.001). However, there was no significant time by treatment interaction on Hb or total anemia. These data indicate that, despite the high endemicity of malaria and elevated inflammation biomarkers (C-reactive protein or α-1-acid-glycoprotein), IDA was markedly reduced by provision of iron fortified CF to preschool-age children for 9 months, with no significant differences between a combination of NaFeEDTA with FeFum or NaFeEDTA with FePP. However, there was no overall effect on anemia, suggesting most of the anemia in this setting is not due to ID. This trial is registered at clinicaltrials.gov (NCT01634945).

【 授权许可】

Unknown