Effectiveness of Selling Micronutrient Sprinkles in Rural Kenya
Condition: Anemia, Iron-deficiency
MeSH terms: Anemia; Anemia, Iron-Deficiency; Iron Deficiencies
Study type: Interventional
Phase: Phase 4

Summary: 
      The purpose of the study is to evaluate the effectiveness of household-based distribution of
      evidence-based health products and to measure the health impact of these combined
      interventions on a population basis.
    

Detailed description: 
      Nyanza Province has the highest mortality rates for infants and children under 5 years of age
      and the highest HIV prevalence rates in Kenya. Burden of disease in western Kenya is further
      characterized by endemic malaria transmission, diarrheal diseases due to poor access to safe
      water, and iron deficiency anemia (IDA) in over 60% of children. Access to health
      interventions in rural Nyanza Province is poor due to limited transportation and
      communication infrastructure. Delivery of household-based interventions through local
      institutions offers the potential for increased utilization and improved health outcomes in
      rural areas. The Centers for Disease Control and Prevention (CDC) in partnership with the
      Rotary-supported Safe Water and AIDS Project (SWAP), initiated a program in 2007 that
      combines household, clinic, school, and local commercial distribution approaches to increase
      access to various evidence-based health products (WaterGuard(TM) and PuR(TM) water
      disinfectant products, water storage containers, soap, insecticide treated bednets,
      micronutrient Sprinkles(TM), and albendazole) and measures the health impact of these
      combined interventions on a population basis.

      Evaluation of the intervention will take place over 36 months and will include: 1) baseline
      and follow-up cross sectional surveys among households in communities visited by SWAP for
      purchase of products; 2) active household surveillance of diarrhea, febrile illness and
      Sprinkles(TM) usage; 3) testing of hemoglobin and iron status and anthropometry measurement
      among children aged 6-35 months; 4) focus groups and targeted interviews to assess the
      acceptability of health products; and 5) other program evaluation methods.

      During the baseline and follow-up surveys, demographic information, water, sanitation,
      hygiene, and health information, dietary intake history, and other data will be collected by
      questionnaire. A blood specimen collected by fingerstick will be used to test for hemoglobin
      concentration, malaria parasitemia, and iron status. Follow-up surveys 12 and 24 months after
      baseline data collection will include collection of similar data to assess the effectiveness
      of product distribution. Anthropometry will be measured at baseline, 12, and 24 months.
      Qualitative information on user preferences will be obtained using ongoing focus groups,
      observations and targeted interviews. The results of these evaluations will be published in
      reports distributed to SWAP, the Kenyan government, and local NGO's and in peer-reviewed
      journals.
    

Intervention name(s): Micronutrient powders (Sprinkles)
Intervention type(s): Dietary Supplement
Intervention description(s): Sprinkles were developed in 1996 by Stanley Zlotkin's research group at the Hospital for Sick Children, University of Toronto as a novel approach for delivering iron and other micronutrients. They come in 1g sachets of dry powder that is then added to any home-prepared semi-solid food, intended for daily consumption by children aged 6-59 months. Formulation includes:
Iron (Ferrous fumarate) 12.5 mg, Folic acid 150 µg, Vitamin A 375 µg, Vitamin C 35 mg, Zinc 5 mg, Vitamin B1 0.5 mg, Vitamin B2 0.5 mg, Vitamin B6 0.5 mg, Vitamin B12 0.9 µg, Vitamin D3 5 µg, Vitamin E 6.0 mg, Niacin 6.0 mg, Copper 0.6 mg, Iodine 50 µg
Intervention MeSH terms: Micronutrients; Trace Elements
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Kenya; Child Nutrition Disorders; Social marketing