A COMPARATIVE EFFICACY TRIAL ON THE ANAEMIA REDUCTION EFFECT OF THREE DIFFERENT HOME FORTIFICATION PRODUCTS AMONG YOUNG CHILDREN IN URBAN SLUM OF NORTHERN JAKARTA

(A RANDOMIZED CONTROLLED FIELD TRIAL)

 Background: Sprinkles containing multiple micronutrients have been extensively used for supplementation to reduce anemia among young children. Several products have been introduced but their efficacy studies have not been widely known.

Objective: To assess the efficacy of 3 different multiple micronutrients home fortification (sprinkles) formulation: Vitalita, Anuka and Taburin1 on the prevalence of anemia among youg children living in an urban poor environment in Northern Jakarta.

Method: A randomized controlled field trial involving 599 children 6-18 months of age for 4 different sprinkles: Vitalita, Anuka, Taburin1 and control. The Control sprinkles contained iron only plus citric acid and maltodextrin filler. Trial was conducted in two urban villages within one kecamatan in Northern Jakarta Municipality for a 4 month intervention from May-September 2007. One of the sprinkles had a distinctive color and taste that has prevented the blinding of the intervention allocation. Randomization of the allocation was based on cluster of Growth Monitoring Promotion Groups for under-five children called Posyandu. The main outcome was hemoglobin detected by Hemocue Hb Meter from blood specimen taken from venous blood for analyzing serum ferritin, soluble transferring receptor and serum zinc. Other confounding factors were controlled through measurement and recording including basic socio-economic-demography data, anthropometry, food intakes, compliance and side effects for sprinkles consumption, and morbidity.

Result: The cure-rate and the relative risks for anemia cases has significantly differentiated the effect size of the 4 tested sprinkles and showed that the best efficacious sprinkles was Vitalita followed by Anuka, Control sprinkles and Taburin1.

All sprinkles has successfully cured about 40% of the anemia cases at the baseline but still left about 30% children anemic at the end of the study.