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The effect of a micronutrient powder home fortification program on anemia and cognitive outcomes among young children in rural China: a cluster randomized trial
Luo, Renfu1; Yue, Ai2; Zhou, Huan3; Shi, Yaojiang2; Zhang, Linxiu4; Martorell, Reynaldo5; Medina, Alexis6; Rozelle, Scott6; Sylvia, Sean7
2017-09-25
Source PublicationBMC PUBLIC HEALTH
ISSN1471-2458
Volume17Pages:16
Corresponding AuthorYue, Ai(yueai@163.com)
AbstractBackground: Anemia early in life has been associated with delayed cognitive and motor development. The WHO recommends home fortification using multiple micronutrient powders (MNPs) containing iron as a strategy to address anemia in children under two. We evaluated the effects of a program freely distributing MNP sachets to caregivers of infants in rural China. Methods: We conducted a cluster-randomized controlled trial in Shaanxi province, enrolling all children aged 6-11 months in target villages. Following a baseline survey, investigators randomly assigned each village/cluster to a control or treatment group. In the treatment group, caregivers were instructed to give MNPs daily. Follow-up was after 6, 12, and 18 months of intervention. Primary outcomes were hemoglobin concentrations and scores on the Bayley Scales of Infant Development. Results: One thousand, eight hundred and-two eligible children and their caregivers were enrolled. At baseline 48% (870) of children were anemic and 29% (529) were developmentally delayed. Six hundred and-ten children (117 villages) were assigned to the control group and 1192 children (234 villages) were assigned to the treatment group. Assignment to the treatment group was associated with an improvement in hemoglobin levels (marginal effect 1.77 g/L, 95% CI 0.017-3.520, p-value = 0.048) and cognitive development (marginal effect 2.23 points, 95% CI 0.061-4.399, p-value = 0.044) after 6 months but not thereafter. There were no significant effects on motor development. Zero effects after the first 6 months were not due to low compliance, low statistical power, or changes in feeding behavior. Hemoglobin concentrations improved in both the treatment and control groups over the course of the study; however, 22% (325) of children remained anemic at endline, and 48% (721) were cognitively delayed. Conclusions: Providing caregivers with MNP sachets modestly hastened improvement in hemoglobin levels that was occurring absent intervention; however, this improvement did not translate into improved developmental outcomes at endline.
KeywordMicronutrient supplementation Anemia Cognition Early childhood
DOI10.1186/s12889-017-4755-0
WOS KeywordIRON-DEFICIENCY ANEMIA ; DEVELOPMENTAL TEST-PERFORMANCE ; MIDDLE-INCOME COUNTRIES ; EARLY-CHILDHOOD ; MENTAL-DEVELOPMENT ; MOTOR DEVELOPMENT ; SHAANXI PROVINCE ; WESTERN CHINA ; INFANTS ; SUPPLEMENTATION
Indexed BySCI
Language英语
Funding ProjectInternational Initiative for Impact Evaluation (3ie) ; National Natural Science Foundation of China[71473239] ; National Natural Science Foundation of China[71703083] ; UBS Optimus Foundation ; China Medical Board ; Bank of East Asia ; Huaqiao Foundation ; Bill & Melinda Gates Foundation-HBGDki Initiative ; Noblesse ; H.J. Heinz Company Foundation
Funding OrganizationInternational Initiative for Impact Evaluation (3ie) ; National Natural Science Foundation of China ; UBS Optimus Foundation ; China Medical Board ; Bank of East Asia ; Huaqiao Foundation ; Bill & Melinda Gates Foundation-HBGDki Initiative ; Noblesse ; H.J. Heinz Company Foundation
WOS Research AreaPublic, Environmental & Occupational Health
WOS SubjectPublic, Environmental & Occupational Health
WOS IDWOS:000412110200002
PublisherBIOMED CENTRAL LTD
Citation statistics
Document Type期刊论文
Identifierhttp://ir.igsnrr.ac.cn/handle/311030/62184
Collection中国科学院地理科学与资源研究所
Corresponding AuthorYue, Ai
Affiliation1.Peking Univ, Sch Adv Agr Sci, China Ctr Agr Policy, Beijing, Peoples R China
2.Shaanxi Normal Univ, Ctr Expt Econ Educ, 620 Changan Rd West, Xian 710119, Shaanxi, Peoples R China
3.Sichuan Univ, West China Sch Publ Hlth, Chengdu, Sichuan, Peoples R China
4.Chinese Acad Sci, Ctr Chinese Agr Policy, Beijing, Peoples R China
5.Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA
6.Stanford Univ, Freeman Spogli Inst Int Studies, Stanford, CA 94305 USA
7.Univ North Carolina Chapel Hill, Gillings Sch Global Publ Hlth, Chapel Hill, NC USA
Recommended Citation
GB/T 7714
Luo, Renfu,Yue, Ai,Zhou, Huan,et al. The effect of a micronutrient powder home fortification program on anemia and cognitive outcomes among young children in rural China: a cluster randomized trial[J]. BMC PUBLIC HEALTH,2017,17:16.
APA Luo, Renfu.,Yue, Ai.,Zhou, Huan.,Shi, Yaojiang.,Zhang, Linxiu.,...&Sylvia, Sean.(2017).The effect of a micronutrient powder home fortification program on anemia and cognitive outcomes among young children in rural China: a cluster randomized trial.BMC PUBLIC HEALTH,17,16.
MLA Luo, Renfu,et al."The effect of a micronutrient powder home fortification program on anemia and cognitive outcomes among young children in rural China: a cluster randomized trial".BMC PUBLIC HEALTH 17(2017):16.
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