التفاصيل البيبلوغرافية
| العنوان: |
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 |
| المؤلفون: |
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 |
| المصدر: |
American Journal of Clinical Nutrition; Sep2020, Vol. 112 Issue 3, p683-694, 12p, 1 Diagram, 4 Charts |
| مصطلحات موضوعية: |
ANEMIA, ANTHROPOMETRY, DIETARY supplements, FOOD habits, RESEARCH methodology, MEDICAL care, SURVEYS, MICRONUTRIENTS, CROSS-sectional method, DESCRIPTIVE statistics |
| مصطلحات جغرافية: |
CONGO (Brazzaville) |
| مستخلص: |
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. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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