Multiple micronutrients in powder delivered through primary health care reduce iron and vitamin A deficiencies in young Amazonian children

Objective: We evaluated the effect of home fortification with multiple micronutrient powder (MNP) on anaemia and micronutrient status of young Amazonian children. Design: A pragmatic controlled trial was performed. A control group (CG) of children aged 11-14 months was recruited in the routine of primary health-care centres for assessing anaemia and micronutrient status. At the same time, an intervention group (IG) of infants aged 6-8 months was recruited in the same health centres to receive MNP daily in complementary feeding for 2 months. The IG children were assessed 4-6 months after enrolment (n 112) when they had reached the age of the CG participants (n 128) for comparisons. Setting: Primary health centres in Rio Branco city, Brazilian Amazon. Subjects: A total of 240 children aged < 2 years. Results: In the CG, the prevalence of anaemia (Hb < 110 g/l), iron deficiency (ID; plasma ferritin < 12 mu g/l or soluble transferrin receptor > 8.3 mg/l) and vitamin A deficiency (VAD; serum retinol < 0.70 mu mol/l) was 20.3%, 72.4% and 18.6%, respectively. Among the IG participants (aged 11-14 months), the prevalence of anaemia, ID and VAD was 15.2%, 25.2% and 4.7%, respectively. The IG had a lower likelihood of ID (prevalence ratio (95% CI): 0.34 (0.24, 0.49)) and VAD (0.25 (0 . 09, 0 . 64)). Conclusions: Home fortification of complementary feeding delivered through primary health care was effective in reducing iron and vitamin A deficiencies among young Amazonian children.