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Table 1 Clinical trials assessing adherence to and acceptability of home fortification with multiple micronutrients in powder (MNP) in complementary feeding

From: Adherence to and acceptability of home fortification with vitamins and minerals in children aged 6 to 23 months: a systematic review

Source study (n = 14) Setting Prevalence of nutritional disorders Study aim Study design Sample at baseline Intervention
Soofi et al. (2013) [20] Sindh, Pakistan (urban and rural areas) Stunting = 23.3 %, 30.1 %, and 26.9 %; anaemia = 17.1 %, 26.6 %, and 24.9 %, in control, MNP with zinc, and MNP without zinc groups, respectively. To assess the effects of provision of two MNP formulations, with or without zinc, on children’s growth, micronutrient status, and morbidity. Cluster-randomized trial.
Three groups: non-supplemented control, MNP without zinc, and MNP with 10 mg of zinc.
n = 2746 children, aged 6 months. Frequency of MNP: daily
Intervention duration: 1 year
Total sachets prescribed: 360
Iron dosage in MNP: no data given
Jack et al. (2012) [17] Cambodia Stunting = 11.3 % and 13.3 %; anaemia = 83.7 % and 84.4 %, in control and intervention groups, respectively. To evaluate the effect of MNP alongside infant and young child feeding education program compared with feeding education alone on anaemia, iron deficiency, vitamin A, zinc, and growth in Cambodian infants. Cluster-randomized effectiveness trial.
Two groups: non-supplemented control received infant and young child feeding education alone; supplemented group received MNP alongside education.
n = 1350 children, aged 6 months. Frequency: daily
Intervention duration: 6 months
Total sachets prescribed: 180
Iron dosage in MNP: 12.5 mg
Inayati et al. (2012) [15] Nias Island, Indonesia Stunting = 34.1 %; anaemia = 51.7 %. To assess the impact of intensive nutrition education with or without the provision of MNP on the nutritional status of mildly wasted children. Cluster-randomized trial.
Four groups: MNP plus intensive education; intensive nutritional education alone; supplemented MNP plus monthly non-intensive nutrition education program; non-intensive education program alone.
n = 215 children, aged 6 to 60 months. Frequency: daily
Intervention duration: 1 year (or until child reached a weight-for-height z score ≥ -1)
Total sachets prescribed: 360
Iron dosage in MNP: 10 mg
Sampaio et al. (2012) [7] Bahia, Brazil Stunting = 5.3 % and 7.4 %, respectively, in intervention and control groups. To evaluate the incidence of diarrheal disease and acute respiratory infection in children undergoing supplementation with zinc and other micronutrients through the use of MNP. Randomized clinical trial, double blind.
Two groups: supplemented control with MNP without zinc; intervention group supplemented with MNP with zinc.
n = 143 children, aged 6 to 48 months. Frequency: daily
Intervention duration: 90 days
Total sachets prescribed: 90
Iron dosage in MNP: 12.5 mg
Avula et al. (2011) [13] Rajasthan, India Stunting = 48.0 % in India. To assess the impact of the existing Supplemental Nutrition Program with local production of supplemental food, home fortification with MNP, and monitoring. Quasi-experimental.
Two groups: control group received the usual Supplementation Nutrition Program; intervention group received the enhanced program.
n = 1128 children, aged 6 to 30 months. Frequency: five times weekly
Intervention duration: 6 months
Total sachets prescribed: ≈ 120
Iron dosage in MNP: 12 mg
Kounnavong et al. (2011) [18] Rural community in Lao People’s Democratic Republic Stunting = 44.5 %, 42.3 %, and 40.4 % in control, twice weekly, and daily groups, respectively. Anaemia = 63.5 %. To compare the effect of twice weekly versus daily supplementation with MNP on anaemia prevalence, haemoglobin concentration, and growth in infants and young children. Randomized trial.
Three groups: non-supplemented control, twice weekly supplementation, and daily supplementation.
n = 336 children, aged 6 to 52 months. Frequency: daily or twice weekly.
Intervention duration: 24 weeks
Total sachets prescribed: 168 (daily group) or 48 (twice weekly)
Iron dosage in MNP: 10 mg
Tripp et al. (2011) [23] Niger Stunting = 49.0 %; Anaemia = 91.0 %. To assess the acceptability of an MNP and a lipid-based nutrient supplement (Nutributter), and to explore people’s willingness to pay for these products. Qualitative study.
Two groups: 1. Supplemented with MNP or Nutributter for 4 weeks; 2. Supplemented with MNP and Nutributter for 2 weeks each.
n = 83 children, aged 6 to 23 months. Frequency: daily
Intervention duration: 4 weeks
Total sachets prescribed: 28 or 14
Iron dosage in MNP: 6 mg
Lundeen et al. (2010) [19] Kyrgyz Republic Anaemia = 50.0 %. To test the effectiveness of a 2-month intervention with daily home fortification of complementary food using MNP in reducing anaemia among children 6 to 36 months of age. Cluster-randomized trial.
Two groups: non-supplemented control and intervention supplemented with multiple micronutrients.
n = 2193 children, 6 to 36 months. Frequency: daily
Intervention duration: 2 months
Total sachets prescribed: 60
Iron dosage in MNP: 12.5 mg
Rosado et al. (2010) [12] Querétaro, México No data given. To evaluate the efficacy and children’s acceptance of several recognized strategies to treat anaemia. Randomized clinical trial.
Five groups: 1. Iron supplement, 2. Iron + folic acid supplement, 3. MNP, 4. Micronutrient-fortified complementary food as porridge powder, and 5. Zinc + iron + ascorbic acid-fortified water.
n = 266 children, aged 6 to 43 months. Frequency: daily.
Intervention duration: 4 months
Total sachets prescribed: 120
Iron dosage in MNP: 10 mg
Geltman et al. (2009) [11] United States Iron deficiency = 15.0–35.0 %. To determine whether low-income infants’ adherence to MNP was better than to ferrous sulfate drops. Randomized clinical trial.
Two groups: Supplemented with MNP, supplemented with iron syrup.
n = 150 children, aged 6 months. Frequency: daily
Intervention duration: 3 months
Total sachets prescribed: 90
Iron dosage in MNP: 12.5 mg
Iron dosage in ferrous sulphate drops: 10 mg of elemental iron
Adu-Afarwuah et al. (2008) [21] Ghana Anaemia = 23.0–30.0 % in both groups. To compare the efficacy and acceptability of MNP, Nutritabs, and fat-based Nutributter, which provide 6, 16, and 19 vitamins and minerals, respectively, when used for home fortification of complementary foods. Randomized trial.
Four groups: non-supplemented; supplemented with MNP; supplemented with Nutritabs; supplemented with Nutributter.
n = 313 children, aged 6 months. Frequency: daily
Intervention duration: 6 months
Total sachets prescribed: 180
Iron dosage in MNP: 12.5 mg
Ip et al. (2007) [16] Bangladesh Anaemia = 75.8 %, 81.7 %, and 73.0 %, in daily for 2 months, flexible for 3 months, and flexible for 4 months groups, respectively. To compare the effects of daily versus flexible administration of MNP on adherence, acceptability, and haematological status among young children in rural Bangladesh. Cluster-randomized trial
Three groups: supplemented daily with MNP for 2 months; supplemented with MNP with a flexible regimen for 3 months; supplemented with MNP with a flexible regimen for 4 months.
n = 362 children, aged 6 to 24 months. Frequency: Depended on the treatment regimen. The children received 60 sachets each.
Intervention duration: 2, 3, or 4 months.
Total sachets prescribed: 60
Iron dosage in MNP: 12.5 mg
Menon et al. (2007) [9] Haiti Anaemia = 52.0 % and 37.0 % in groups 1 and 2, respectively. To evaluate the effectiveness of 2-months treatment with MNP in reducing anaemia among children 9–24 months. Cluster-randomized pre-post intervention trial.
Two groups: group 1 supplemented with MNP plus fortified food; group 2 supplemented with fortified food alone.
n = 41 children, aged 9 to 24 months. Frequency: daily
Intervention duration: 2 months
Total sachets prescribed: 60
Iron dosage in MNP: 12.5 mg
Christofides
et al. (2005) [10]
Aboriginal communities in Canada Anaemia = 36.0 %. To determine the acceptability and safety of MNP as a strategy for delivering iron to infants and young children Double-blinded randomized controlled trial.
Two groups: control; supplemented with MNP.
n = 102 children, aged 4 to 18 months. Frequency: daily
Intervention duration: 6 months
Total sachets prescribed: 180
Iron dosage in MNP: 30 mg