Menu ENN Search

The long-term impacts of multiple micronutrient supplementation in children aged 24 to 59 months in Pakistan

View this article as a pdf

This is a summary of the following paper: Khan A, Ul-Haq Z, Fatima S et al. (2023) Long-Term Impact of Multiple Micronutrient Supplementation on Micronutrient Status, Haemoglobin Level, and Growth in Children 24 to 59 Months of Age: A Non-Randomized Community-Based Trial from Pakistan. Nutrients, 15, 7, 1690. https://doi.org/10.3390/nu15071690

This non-randomised, community-based clinical trial evaluated the effect of a locally produced micronutrient powder (Vita-Mixe) on micronutrient status (zinc, vitamin A, and vitamin D), haemoglobin level, and growth parameters in children aged 24–59 months. The trial took place in a low-resource, rural area in Kurram, Pakistan between January 2018 and June 2019 as part of a broader clinical trial, ‘Ready to Use Supplementary Foods to Prevent Stunting Among Children Under Five Years in Kurram Agency’. Children aged 24–48 months were recruited and assigned to either an intervention or control arm. One sachet of micronutrient powder (1g) was given to the 111 enrolled children in the intervention arm (n=58) every other day for 12 months. The intervention provided an additional 50% of the reference nutrient intake per day for each micronutrient. Using blood samples taken at baseline and one year after the intervention, micronutrient and haemoglobin levels were assessed.

The study compared changes in the intervention group and control group. Results showed that children in the intervention arm had an average 7.52 ng/mL (p <0.001) increase in plasma vitamin A, a 4.80 ng/mL (p <0.002) increase in vitamin D, and a 33.85 µg/dL (p <0.001) increase in zinc, as well as a 2.0g/dL (p <0.001) increase in haemoglobin count. Significant improvements were observed in weight-for-height z-scores and weight-for-age z-scores in the intervention group (p <0.001), although no statistically significant changes were observed in height-for-age z-scores in the intervention group (p = 0.93).

The researchers concluded that one-year supplementation of micronutrient powder is a cost-effective and scalable intervention for food-insecure areas/households to address the alarming rates of undernutrition in Pakistan and other developing countries. The authors highlighted that uninterrupted micronutrient powder supply, compliance, and no loss to follow-up were among the strengths of their study.

The non-random allocation of participants may have introduced selection bias into the study. This was done to prevent contamination between intervention and control arms – as participants were allocated by distinct regions – so, on balance, this approach was appropriate. We also need to consider that children with various comorbidities and severely malnourished children were excluded. This produced appropriate study conditions; however, in a real-world setting where the intervention may be delivered as a blanket supplementary feeding programme to all, sicker children may not recover as readily as those featured in this study. Additionally, growth data were only measured at two time points, which prevents us from determining recovery trajectories over the study period. Nevertheless, the results remain compelling.

More like this

FEX: Fortified maize meal improves vitamin A and iron status in refugees

Summary of published field trial1 Premixing at the refugee camp site Nangweshi refugee camp was opened in 2000 in response to the influx of refugees fleeing the Angolan civil...

FEX: Micronutrient powders v iron-folic acid tablets in controlling anaemia in pregnancy

Summary of research1 The major cause of anaemia in pregnancy is iron deficiency, which is preventable. It is estimated that 56% of pregnant women in developing countries...

FEX: Effect of adding RUSF to ageneral food distribution on child nutritional status and morbidity: a cluster randomised controlled trial

Summary of research1 Child during appetite test at a health facility offering treatment in Monrovia, Liberia The authors of a recent study hypothesized that including a daily...

FEX: Fighting long-term nutritional deprivation among the Sarahawi refugees

Summary of report1 The Saharawi refugee population (approximately 150,000) living in south Algeria have been in crisis since 1975 when conflict over the status of Western...

FEX: Impact of an integrated agriculture and nutrition and health behaviour change communication programme for women in Burkina Faso

Summary of research1 Location: Burkina Faso What we know: The agricultural sector has great potential to contribute to improving nutrition.; However, current evidence of...

FEX: Prebiotics for severe wasting: Evidence from a randomised controlled trial in Pakistan

View this article as a pdf This is a summary of the following paper: Batool M, Saleem, J, Zakar R et al. (2023) Double-blind parallel treatment randomized controlled trial of...

FEX: The REFANI Project in Pakistan: adapting research to a multi-sectoral programme for impact measurement

By Zvia Shwirtz, Bridget Fenn, Riccardo Mioli, Ghulam Murtaza Sangrasi and Maureen Gallagher Zvia Shwirtz is currently the REFANI Communications and Research Uptake Officer,...

FEX: A cluster RCT to measure the effectiveness of cash-based interventions on nutrition status, Sindh Province, Pakistan

View this article as a pdf By Bridget Fenn Bridget Fenn is an epidemiologist with a background in nutrition. She is currently a consultant for the Emergency Nutrition Network...

en-net: Does Low MUAC treated with RUTF result in children becoming obese?

Using MUAC to identify SAM cases tends to identify more younger and stunted children compared to WHZ. Concerns have been expressed that stunted children with low MUAC may have...

FEX: Acceptability trial of a novel RUTF based on soy, lentils and rice

By Filippo Dibari, Valid International Filippo Dibari studied Food Science and Technology and more recently Public Health Nutrition at the London School of Hygiene Tropical...

FEX: Nutritional Status of HIV+ Pre-School Children in South Africa

Summary of unpublished research Nursing health professional doing clinical investigation at Livningstone Hospital By Liana Steenkamp, Dr Jill von der Marwitz, and Charlene...

FEX: Cambodia: Vitamin A and iron status remain unaffected by ready-to-use therapeutic food

View this article as a pdf This is a summary of the following paper: Sigh S, Roos N, Chhoun C et al. (2023) Ready-to-use therapeutic foods fail to improve vitamin A and iron...

FEX: Diet and nutrition status among school-age children and adolescents in Tanzania

View this article as a pdf By Sauli John, Geofrey Mchau, Heavenlight Ayubu, Stanslaus Mafung'a, Samafilan Ainan, Wiggins Kyatikila, Elizabeth Lyimo, Frank Chacky, Fatoumata...

FEX: A growth reference for MUAC-for-age among school age children and adolescents and validation for mortality

Summary of research1 Location: Kenya, Uganda and Zimbabwe What we know: An internationally accepted reference for mid-upper arm circumference (MUAC) does not exist for...

FEX: Non-nutrition interventions to prevent anaemia in school-age children and adolescents

View this article as a pdf Lisez cet article en français ici By Natalie Roschnik, Andrew Hall, Moussa Sacko and Sian Clarke Natalie Roschnik is Senior Nutrition...

FEX: Critical analysis of MICAH programme

Summary of published research1 The efficacy of some single nutrition interventions has been frequently and thoroughly evaluated, e.g. iron supplementation, vitamin A...

FEX: Local versus industrially produced therapeutic milks in managing severe malnutrition

By A Ould Sidi Mohamed, M. Diagana, Federica Riccardi, Abimbola Lagunju, Jean-Pierre Papart and Rebecca Norton. A Ould Sidi Mohamed is a paediatrician and chief of the...

FEX: Effect of supplementation during pregnancy and lactation on the nutritional status of infants in Pakistan

View this article as a pdf Research snapshot1 Despite economic and social development, malnutrition remains a major public health problem in Pakistan, especially low...

FEX: Household-based food fortification for anaemia control in Sudan

By Erin Tansey and Dr. Ibrahim Bani Erin Tansey started work as a programme officer for CARE in Bosnia in 1996. She moved on to work for UNHCR in Asia and Africa and has been...

FEX: Effect of short-term supplementation with ready-to-use therapeutic food or micronutrients for children after illness for prevention of malnutrition: a randomised controlled trial in Uganda

Summary of research1 Location: Uganda What we know: The potential for nutritional supplementation of sick children as a strategy for preventing malnutrition has not been...

Close

Reference this page

The long-term impacts of multiple micronutrient supplementation in children aged 24 to 59 months in Pakistan. Field Exchange 70, September 2023. p33. www.ennonline.net/fex/70/the-long-term-impacts-of-multiple-micronutrient-supplementation-in-children-aged-24-to-59-months-in-pakistan

(ENN_7674)

Close

Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.