Author: Supplefer

For the past 150 years or more, oral ferrous sulphate drops or syrup has been the primary source of iron for the treatment (and prevention) of iron deficiency anemia. When a soluble form or iron (such as ferrous sulphate) is ingested in the proper dose, this intervention is effective. However, adherence to long-term ingestion of oral drops is often poor because of the unpleasant metallic taste of drops; drops can stain a baby’s teeth unless wiped off immediately after use; and if the dose is high, the infant may complain of abdominal discomfort.

Supplefer Sprinkles was specifically developed to improve adherence (ie. acceptance and use). Compared to drops or syrup,
Sprinkles are easier to use. The table below exemplifies this point. Sprinkles may provide a possible
solution to the problem of adherence and a valuable supplementation method (Taken from Zlotkin, 2002-Editorial).

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Mathematical Modeling

Once efficacy is demonstrated by conducting numerous studies in different geographical areas, program planning and implementation must be examined. Owing to the high prevalence of anemia in most developing countries, such a program must be targeted to all children less than three years of age. For large scale community based intervention, individualized screening procedure for IDA is not possible because: (a) there is no single marker for IDA; and (b) multiple marker studies will be very expensive. Therefore all children will receive iron intervention and a single safe dose is desired that is effective for all ‘at risk’ children under the age of 3 years. Such an ideal dose is challenging to compute, particularly because of the unique and complex metabolism of iron, and the changing needs of iron in rapidly growing children.

While dosing and frequency issues remain unresolved, the conventional approach to these challenges has been …

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Articles:

1) Zlotkin S, Arthur P, Antwi KY, Yeung G. Treatment of anemia with microencapsulated ferrous fumarate plus ascorbic acid supplied as sprinkles to complementary (weaning) foods. Am J Clin Nutr. 2001 Dec;74(6):791-5.

2) Zlotkin S, Arthur P, Antwi KY, Yeung G. Randomized, controlled trial of single versus 3-times-daily ferrous sulfate drops for treatment of anemia. Pediatrics. 2001 Sep;108(3):
613-6.

3) Zlotkin S, Arthur P, Schauer C, Antwi K, Yeung G, Piekarz A. Home-Fortification with Iron and Zinc Sprinkles Alone Successfully treats anemia in infants and young children. Journal of Nutrition. January 2003, 133: 1075-1080.

4) Zlotkin S. (editorial) Current issues for the prevention and treatment of iron deficiency anemia. Indian Pediatrics. February 2002; 39:125-129.
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5) Zlotkin S. Clinical Nutrition: 8. The role of nutrition in the prevention of iron deficiency anemia in infants, children and adolescents. Canadian Medical Association Journal. January 2003; 168(1):59-63.
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6) Zlotkin …

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Benin and Vietnam (Contact: Claudia Schauer; Planning Stage)

In developing countries of Asia and Africa prevalence of anemia ranges from 45 to 76% and weaning infants, adolescent girls and women of reproductive age (WRA) are at particular risk. The etiology of anemia in both Benin and Vietnam is multifactorial thereby, necessitating interventions to address multiple causes of anemia to achieve the desired results.

We are evaluating a combination of interventions to reduce iron deficiency and anemia in Benin and Vietnam. In each country we will test iron cooking pots as well as one dietary intervention, (Sprinkles) and one public health intervention (anti-helminth).

Phase I: Field-based qualitative research will be carried out to determine which interventions are most acceptable and affordable. In addition, a lab-based study will be conducted to determine the increase in iron content and to estimate bioavailability of iron from typical weaning foods and traditional family foods cooked …

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Study 1: Emergency Relief in Haiti: A distribution study within the ACF canteen program

Food aid is the provision of food commodities as a form of international assistance. It is a form of aid,
which can directly address poverty and hunger issues in developing countries. Commonly speaking, objectives of food aid
are to reduce starvation and acute malnutrition problems in communities affected by emergencies and to contribute to the
food security of a population or country. According to the 1996 World Food Summit held in Rome, the concept of food security encompasses a wide range of issues
affecting both quantity and quality of diet meeting an individual’s demands for protein, calorie and all sorts of necessary
micronutrients. A comprehensive and effective food aid plan should consider all these nutritional details.

The population groups mostly affected by any emergency situation namely war and natural disasters include women and children.
While general …

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China Study (Contact: Waseem Sharrief; Completed)

China is the most rapidly developing and populous nation in the world. However, the nutritional benefits from economic growth have not been shared equally among its people. Studies in China have shown great geographical variation in the prevalence of anemia, most likely the result of large economic disparity between rural and urban areas. In addition, there is a great diversity of environmental, dietary, and genetic factors in the Chinese population. In Northern China, the prevalence of iron-deficiency anemia has been reported to be as high as 41%. It has been suggested from a meta-analysis that intermittent iron supplementation could be as effective as daily supplementation in a supervised (e.g. school) setting and appears to be a promising strategy to control anemia.

A government preschool in Baotou city, Northern China was selected to participate in a prospective study whose objectives are (1) To determine the …

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Home fortification with micronutrient Sprinkles-a new approach for the prevention and
treatment of nutritional anemias. Journal of Paediatrics and Child Health. Journal of Paediatrics and Child Health. Feb 2003;8(2):87-90.

C Schauer, SH Zlotkin

Despite global goals set by UN agencies over the past decade for significant reductions in iron deficiency anemia (IDA), it remains a largely unaddressed public health problem affecting more than 2 billion people, one third of the world’s population. The negative impact of IDA on health and human potential are greatest in the developing world where it is estimated that 51% of children less than 4 years of age, are anemic mainly due to a diet inadequate in bioavailable iron. Studies in both developed and developing countries have consistently shown mental and motor impairments that may not be reversible in children less than 2 years of age with IDA. From a public health standpoint there are …

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