Cargando…

Combined infant and young child feeding with small-quantity lipid-based nutrient supplementation is associated with a reduction in anemia but no changes in anthropometric status of young children from Katanga Province of the Democratic Republic of Congo: a quasi-experimental effectiveness study

BACKGROUND: Small-quantity lipid-based nutrient supplements (SQ-LNS) are efficacious in controlled settings; data are scarce on the effectiveness utilizing health care delivery platforms. OBJECTIVE: We evaluated the impact of an infant young child feeding (IYCF)–SQ-LNS intervention on anemia and gro...

Descripción completa

Detalles Bibliográficos
Autores principales: Addo, O Yaw, Locks, Lindsey M, Jefferds, Maria Elena, Nanama, Simeon, Albert, Bope, Sandalinas, Fanny, Nanema, Ambroise, Whitehead, R Donnie, Mei, Zuguo, Clayton, Heather B, Garg, Aashima, Kupka, Roland, Tripp, Katie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458772/
https://www.ncbi.nlm.nih.gov/pubmed/32710737
http://dx.doi.org/10.1093/ajcn/nqaa170
_version_ 1783576263531692032
author Addo, O Yaw
Locks, Lindsey M
Jefferds, Maria Elena
Nanama, Simeon
Albert, Bope
Sandalinas, Fanny
Nanema, Ambroise
Whitehead, R Donnie
Mei, Zuguo
Clayton, Heather B
Garg, Aashima
Kupka, Roland
Tripp, Katie
author_facet Addo, O Yaw
Locks, Lindsey M
Jefferds, Maria Elena
Nanama, Simeon
Albert, Bope
Sandalinas, Fanny
Nanema, Ambroise
Whitehead, R Donnie
Mei, Zuguo
Clayton, Heather B
Garg, Aashima
Kupka, Roland
Tripp, Katie
author_sort Addo, O Yaw
collection PubMed
description BACKGROUND: Small-quantity lipid-based nutrient supplements (SQ-LNS) are efficacious in controlled settings; data are scarce on the effectiveness utilizing health care delivery platforms. OBJECTIVE: We evaluated the impact of an infant young child feeding (IYCF)–SQ-LNS intervention on anemia and growth in children aged 6–18 mo in the Democratic Republic of Congo following a quasi-experimental effectiveness design. METHODS: An intervention health zone (HZ) received enhanced IYCF including improved counseling on IYCF during pregnancy until 12 mo after birth and daily use of SQ-LNS for infants 6–12 mo; the control HZ received the standard IYCF package. We analyzed data from 2995 children, collected in repeated cross-sectional surveys. We used adjusted difference-in-difference analyses to calculate changes in anemia, iron and vitamin A deficiencies, stunting, wasting, and underweight. RESULTS: Of mothers, 70.5% received SQ-LNS at least once in the intervention HZ, with 99.6% of their children consuming SQ-LNS at least once. The mean number of batches of SQ-LNS (28 sachets per batch, 6 batches total) received was 2.3 ± 0.8 (i.e., 64.4 ± 22.4 d of SQ-LNS). The enhanced program was associated with an 11.0% point (95% CI: −18.1, −3.8; P < 0.01) adjusted relative reduction in anemia prevalence and a mean +0.26-g/dL (95% CI: 0.04, 0.48; P = 0.02) increase in hemoglobin but no effect on anthropometry or iron or vitamin A deficiencies. At endline in the intervention HZ, children aged 8–13 mo who received ≥3 monthly SQ-LNS batch distributions had higher anthropometry z scores [length-for-age z score (LAZ): +0.40, P = 0.04; weight-for-age z score (WAZ): +0.37, P = 0.04] and hemoglobin (+0.65 g/dL, P = 0.007) and a lower adjusted prevalence difference of stunting (−16.7%, P = 0.03) compared with those who received none. CONCLUSIONS: The enhanced IYCF–SQ-LNS intervention using the existing health care delivery platform was associated with a reduction in prevalence of anemia and improvement in mean hemoglobin. At endline among the subpopulation receiving ≥3 mo of SQ-LNS, their LAZ, WAZ, and hemoglobin improved. Future research could explore contextual tools to maximize coverage and intake adherence in programs using SQ-LNS.
format Online
Article
Text
id pubmed-7458772
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-74587722020-09-04 Combined infant and young child feeding with small-quantity lipid-based nutrient supplementation is associated with a reduction in anemia but no changes in anthropometric status of young children from Katanga Province of the Democratic Republic of Congo: a quasi-experimental effectiveness study Addo, O Yaw Locks, Lindsey M Jefferds, Maria Elena Nanama, Simeon Albert, Bope Sandalinas, Fanny Nanema, Ambroise Whitehead, R Donnie Mei, Zuguo Clayton, Heather B Garg, Aashima Kupka, Roland Tripp, Katie Am J Clin Nutr Original Research Communications BACKGROUND: Small-quantity lipid-based nutrient supplements (SQ-LNS) are efficacious in controlled settings; data are scarce on the effectiveness utilizing health care delivery platforms. OBJECTIVE: We evaluated the impact of an infant young child feeding (IYCF)–SQ-LNS intervention on anemia and growth in children aged 6–18 mo in the Democratic Republic of Congo following a quasi-experimental effectiveness design. METHODS: An intervention health zone (HZ) received enhanced IYCF including improved counseling on IYCF during pregnancy until 12 mo after birth and daily use of SQ-LNS for infants 6–12 mo; the control HZ received the standard IYCF package. We analyzed data from 2995 children, collected in repeated cross-sectional surveys. We used adjusted difference-in-difference analyses to calculate changes in anemia, iron and vitamin A deficiencies, stunting, wasting, and underweight. RESULTS: Of mothers, 70.5% received SQ-LNS at least once in the intervention HZ, with 99.6% of their children consuming SQ-LNS at least once. The mean number of batches of SQ-LNS (28 sachets per batch, 6 batches total) received was 2.3 ± 0.8 (i.e., 64.4 ± 22.4 d of SQ-LNS). The enhanced program was associated with an 11.0% point (95% CI: −18.1, −3.8; P < 0.01) adjusted relative reduction in anemia prevalence and a mean +0.26-g/dL (95% CI: 0.04, 0.48; P = 0.02) increase in hemoglobin but no effect on anthropometry or iron or vitamin A deficiencies. At endline in the intervention HZ, children aged 8–13 mo who received ≥3 monthly SQ-LNS batch distributions had higher anthropometry z scores [length-for-age z score (LAZ): +0.40, P = 0.04; weight-for-age z score (WAZ): +0.37, P = 0.04] and hemoglobin (+0.65 g/dL, P = 0.007) and a lower adjusted prevalence difference of stunting (−16.7%, P = 0.03) compared with those who received none. CONCLUSIONS: The enhanced IYCF–SQ-LNS intervention using the existing health care delivery platform was associated with a reduction in prevalence of anemia and improvement in mean hemoglobin. At endline among the subpopulation receiving ≥3 mo of SQ-LNS, their LAZ, WAZ, and hemoglobin improved. Future research could explore contextual tools to maximize coverage and intake adherence in programs using SQ-LNS. Oxford University Press 2020-09 2020-07-25 /pmc/articles/PMC7458772/ /pubmed/32710737 http://dx.doi.org/10.1093/ajcn/nqaa170 Text en Copyright © The Author(s) on behalf of the American Society for Nutrition 2020. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Research Communications
Addo, O Yaw
Locks, Lindsey M
Jefferds, Maria Elena
Nanama, Simeon
Albert, Bope
Sandalinas, Fanny
Nanema, Ambroise
Whitehead, R Donnie
Mei, Zuguo
Clayton, Heather B
Garg, Aashima
Kupka, Roland
Tripp, Katie
Combined infant and young child feeding with small-quantity lipid-based nutrient supplementation is associated with a reduction in anemia but no changes in anthropometric status of young children from Katanga Province of the Democratic Republic of Congo: a quasi-experimental effectiveness study
title Combined infant and young child feeding with small-quantity lipid-based nutrient supplementation is associated with a reduction in anemia but no changes in anthropometric status of young children from Katanga Province of the Democratic Republic of Congo: a quasi-experimental effectiveness study
title_full Combined infant and young child feeding with small-quantity lipid-based nutrient supplementation is associated with a reduction in anemia but no changes in anthropometric status of young children from Katanga Province of the Democratic Republic of Congo: a quasi-experimental effectiveness study
title_fullStr Combined infant and young child feeding with small-quantity lipid-based nutrient supplementation is associated with a reduction in anemia but no changes in anthropometric status of young children from Katanga Province of the Democratic Republic of Congo: a quasi-experimental effectiveness study
title_full_unstemmed Combined infant and young child feeding with small-quantity lipid-based nutrient supplementation is associated with a reduction in anemia but no changes in anthropometric status of young children from Katanga Province of the Democratic Republic of Congo: a quasi-experimental effectiveness study
title_short Combined infant and young child feeding with small-quantity lipid-based nutrient supplementation is associated with a reduction in anemia but no changes in anthropometric status of young children from Katanga Province of the Democratic Republic of Congo: a quasi-experimental effectiveness study
title_sort combined infant and young child feeding with small-quantity lipid-based nutrient supplementation is associated with a reduction in anemia but no changes in anthropometric status of young children from katanga province of the democratic republic of congo: a quasi-experimental effectiveness study
topic Original Research Communications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458772/
https://www.ncbi.nlm.nih.gov/pubmed/32710737
http://dx.doi.org/10.1093/ajcn/nqaa170
work_keys_str_mv AT addooyaw combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy
AT lockslindseym combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy
AT jefferdsmariaelena combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy
AT nanamasimeon combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy
AT albertbope combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy
AT sandalinasfanny combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy
AT nanemaambroise combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy
AT whiteheadrdonnie combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy
AT meizuguo combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy
AT claytonheatherb combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy
AT gargaashima combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy
AT kupkaroland combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy
AT trippkatie combinedinfantandyoungchildfeedingwithsmallquantitylipidbasednutrientsupplementationisassociatedwithareductioninanemiabutnochangesinanthropometricstatusofyoungchildrenfromkatangaprovinceofthedemocraticrepublicofcongoaquasiexperimentaleffectivenessstudy