Treatment of anemia with microencapsulated ferrous fumarate plus ascorbic acid supplied as sprinkles to complementary (weaning) foods

Zlotkin, Stanley; Arthur, Paul; Antwi, Kojo Yeboah; Yeung, George

doi:10.1093/ajcn/74.6.791

Cited by 150 publications

(151 citation statements)

References 19 publications

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“…However, all mothers were instructed not to give more than one sachet a day. The content of Sprinkles sachets was identical for all groups and included 12.5 mg elemental iron as microencapsulated ferrous fumarate, 5 mg zinc as zinc gluconate, 300 mg retinol equivalents as retinol acetate, 160 mg folic acid and 50 mg vitamin C. The rationale for delivering 60 sachets to all children was based on the demonstrated efficacy of a twomonth daily supply of Sprinkles (Zlotkin et al, 2001(Zlotkin et al, , 2003Hirve et al, 2007;Hyder et al, 2007).…”

Section: Methodsmentioning

confidence: 99%

“…The efficacy, bioavailability and safety of Sprinkles have been demonstrated in many diverse settings (Zlotkin et al, 2001(Zlotkin et al, , 2003Tondeur et al, 2004;Giovannini et al, 2006;Sharieff et al, 2006). For example, a recent field trial in India showed that a daily iron dose of 12.5 mg given as Sprinkles over a two-month period significantly increased haemoglobin concentrations and successfully treated anaemia (Hirve et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

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Improved adherence and anaemia cure rates with flexible administration of micronutrient Sprinkles: a new public health approach to anaemia control

Hyder

Haseen

et al. 2007

Eur J Clin Nutr

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Background/Objectives: Despite repeated public commitments and availability of various forms of iron supplements, rates of anaemia in developing countries remain high. A major reason for this lack of success has been poor adherence. The objective of this study was to compare the effectiveness of daily and flexible administration of micronutrient Sprinkles on adherence, acceptability and haematological status among young children in rural Bangladesh. Subjects/Methods: A sample of 362 children (haemoglobin (Hb)X70 g l À1 ) aged 6-24 months were cluster-randomized to receive 60 sachets of Sprinkles either (i) daily over 2 months; (ii) flexibly over 3 months; or (iii) flexibly over 4 months. With a flexible regimen, mothers/caregivers decided how frequently to use Sprinkles without exceeding one sachet per day. Adherence was assessed monthly by counting the number of sachets used and acceptability was evaluated through focus group discussions. Haemoglobin was measured at baseline, at the end of each intervention period and 6 months post-intervention. Results: Mean percent adherence was significantly higher in the flexible-4-month group (98%) compared to the flexible-3-month (93%) and daily-2-month (88%) groups (Po0.01). Most mothers found flexible administration to be more acceptable than daily due to perceived benefits of use. Hb at the end of intervention was significantly higher in the flexible-4-month group compared to the daily group (P ¼ 0.03). Anaemia prevalence decreased by 65% in the flexible-4-month group compared to 54% in the flexible-3-month and 51% in the daily-2-month groups. Percent of cured children who maintained a non-anaemic status 6 months post-intervention was significantly higher in the flexible-4-month (82%) and flexible-3-month (80%) groups than the daily-2-month (53%) group (Po0.05). Conclusions: The adherence, acceptability and haematological response to flexible administration over 4 months were found preferable to daily.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improved adherence and anaemia cure rates with flexible administration of micronutrient Sprinkles: a new public health approach to anaemia control

Hyder

Haseen

et al. 2007

Eur J Clin Nutr

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“…7,8 Sprinkles berupa zat besi yang dienkapsulasi yaitu zat besi dalam bentuk ferrous fumarate dilapisi dengan lipid untuk mencegah zat besi berinteraksi dengan makanan sehingga tidak terjadi perubahan warna, rasa, dan tekstur makanan. Sprinkles berbentuk serbuk yang ditabur dan dicampurkan langsung ke dalam makanan yang telah disiapkan oleh ibu atau pengasuh anak.…”

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“…Micronutrien sprinkles merupakan terobosan dalam memenuhi tantangan global untuk mengurangi anemia masa kanak-kanak akibat defisiensi besi dan mikronutrien lainnya. 7 Studi efikasi di Ghana, Afrika Barat tahun 1998-2001 pada anak anemia umur 6-18 bulan selama 2 bulan pengobatan membuktikan bahwa sprinkles (80 mg elemental Fe dalam bentuk ferrous fumarate) sama efektifnya dengan sirup besi (40 mg elemental Fe dalam bentuk Fe sulfat) untuk mengatasi anemia pada 60% sampai 75% bayi anemia di daerah endemik malaria. Persentase kesembuhan dari iron ferrous fumarate sprinkles pada anemia (58%) tidak berbeda dengan sirup iron sulphate drops (56%) (p = 0,51).…”

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“…Persentase kesembuhan dari iron ferrous fumarate sprinkles pada anemia (58%) tidak berbeda dengan sirup iron sulphate drops (56%) (p = 0,51). 7 Defisiensi zat besi biasanya terjadi bersamaan dengan defisiensi zat gizi mikro lainnya sehingga dilakukan studi lanjutan di Ghana melihat efikasi dari Fe sprinkles ditambahkan Zn (80 mg elemental Fe dan 10 mg Zn). Hasil penelitian tersebut memperlihatkan angka kesembuhan anemia lebih tinggi pada kelompok Fe dibandingkan dengan kelompok FeZn.…”

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Sprinkles: Strategi Baru Pengendalian Defisiensi Zat Besi dan Anemia pada Bayi dan Anak di Negara Berkembang

Umniyati

2011

Kesmas: National Public Health Journal

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AbstrakAnemia defisiensi besi pada bayi dan anak-anak merupakan masalah gizi di negara-negara berkembang termasuk di Indonesia, sementara program suplementasi dengan sirup atau tetes besi folat tidak efektif sehingga kepatuhannya rendah akibat keluhan rasa logam, pewarnaan gigi, gangguan lambung, dan potensi overdosis. Untuk meningkatkan kepatuhan suplementasi, telah dikembangkan formula micronutrient sprinkles, suatu metode baru fortifikasi zat besi yang dienkapsulasi dalam bentuk serbuk pada makanan tambahan berisi multi vitamin dan mineral. Studi kepustakaan ini bertujuan untuk mengetahui efektivitas pengobatan anemia pada bayi dan anak dengan formula sprinkles. Studi ini didasarkan pada rangkaian studi efikasi di Ghana dan beberapa negara lainnya. Hasil studi membuktikan bahwa suplementasi besi dengan sprinkles mempunyai efektivitas yang sama dengan sirup atau tetes besi dalam mengobati anemia dengan tingkat kepatuhannya sangat tinggi. Di Indonesia, sprinkles besi telah banyak digunakan, termasuk untuk meningkatkan status gizi anak-anak pada saat bencana. Kementerian Kesehatan RI melalui Badan Penelitian dan Pengembangan Gizi Bogor telah mengembangkan sprinkles dengan nama Taburia yang telah diuji efikasi di Jakarta. Saat ini Taburia digunakan di Provinsi Sumatera Selatan, Sumatera Utara, Nusa Tenggara Barat, Nusa Tenggara Timur, Sulawesi Selatan, dan Kalimantan Barat.Kata kunci: Anemia, bayi, anak-anak, defisiensi besi, sprinkles Abstract Iron deficiency anemia in infants and children is one of nutritional problems in developing countries including Indonesia, where supplementation program using iron folic acid syrup or drops is not effective with low compliance due to complaint in metallic taste, teeth staining, stomach disorders, and potential overdose. To improve the supplementation compliance, micronutrient sprinkles formula, a new encapsulated iron fortification in powder form containing multivitamins and minerals has been developed. The objective of this literature study is to know the affectivity of sprinkles formula for anemia cure Sprinkles: Strategi Baru Pengendalian Defisiensi Zat Besi dan Anemia pada Bayi dan Anak di Negara Berkembang Sprinkles: New Strategy to Control Iron Deficiency and Anemia in Infants and Children in Developing CountriesHelwiah Umniyati 195 in infants and children. This study was based on series of efficacy in Ghana and other countries. It shows that the sprinkles formula is effective as the syrup or drop formula in curing infants and children anemia with very high level of compliance. In Indonesia, iron sprinkles have been used widely including for improving nutritional status of children during disaster. Indonesian Ministry of Health through Bogor Nutritional Agency for Research and Development has developed sprinkles formula Taburia that already tested in Jakarta. Currently, Taburia is used in Province of South Sumatra, North Sumatra, West Nusa Tenggara (NTB), East Nusa Tenggara (NTT), South Sulawesi, and West Kalimantan.Key words: Anemia, infant, children, iron deficienc...

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Effect of Micronutrient Sprinkles on Reducing Anemia

Jack¹,

Ou²,

Chea³

et al. 2012

Arch Pediatr Adolesc Med

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To evaluate the effectiveness of Sprinkles alongside infant and young child feeding (IYCF) education compared with IYCF education alone on anemia, deficiencies in iron, vitamin A, and zinc, and growth in Cambodian infants.Design: Cluster-randomized effectiveness study.Setting: Cambodian rural health district.Participants: Among 3112 infants aged 6 months, a random subsample (n = 1350) was surveyed at baseline and 6-month intervals to age 24 months.Intervention: Daily micronutrient Sprinkles alongside IYCF education vs IYCF education alone for 6 months from ages 6 to 11 months.Main Outcome Measures: Prevalence of anemia; iron, vitamin A, and zinc deficiencies; and growth via biomarkers and anthropometry.Results: Anemia prevalence (hemoglobin level Ͻ11.0 g/dL [to convert to grams per liter, multiply by 10.0]) was reduced in the intervention arm compared with the control arm by 20.6% at 12 months (95% CI, 9.4-30.2; P = .001), and the prevalence of moderate anemia (hemoglobin level Ͻ10.0 g/dL) was reduced by 27.1% (95% CI, 21.0-31.8; PϽ .001). At 12 and 18 months, iron deficiency prevalence was reduced by 23.5% (95% CI, 15.6-29.1; PϽ.001) and 11.6% (95% CI, 2.6-17.9; P=.02), respectively. The mean serum zinc concentration was increased at 12 months (2.88 µg/dL [to convert to micromoles per liter, multiply by 0.153]; 95% CI, 0.26-5.42; P =.03). There was no statistically significant difference in the prevalence of zinc and vitamin A deficiencies or in growth at any time.Conclusions: Sprinkles reduced anemia and iron deficiency and increased the mean serum zinc concentration in Cambodian infants. Anemia and zinc effects did not persist beyond the intervention period.

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Treatment of anemia with microencapsulated ferrous fumarate plus ascorbic acid supplied as sprinkles to complementary (weaning) foods

Cited by 150 publications

References 19 publications

Improved adherence and anaemia cure rates with flexible administration of micronutrient Sprinkles: a new public health approach to anaemia control

Improved adherence and anaemia cure rates with flexible administration of micronutrient Sprinkles: a new public health approach to anaemia control

Sprinkles: Strategi Baru Pengendalian Defisiensi Zat Besi dan Anemia pada Bayi dan Anak di Negara Berkembang

Effect of Micronutrient Sprinkles on Reducing Anemia

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