Low dose ‘Sprinkles ’- An innovative Approach to Treat Iron Deficiency Anemia in Infants and Young Children

Iron supplementation programs using pediatric tablets or drops have not been successful in the control of anemia amongst infants and children in India. ‘Sprinkles ’ is an innovative multi-micronutrient home fortification strategy to control iron deficiency and anemia. Objective: We aimed to determine the hematologic response to different doses and forms of iron in Sprinkles and iron drops. Setting: Twenty two villages of Vadu Rural Health Program, KEM Hospital, Pune. Design: Double blind clustered randomized community-based trial. Subjects: Children (n = 432) aged 6-18 mo age with Hb between 70-100 g/L were enrolled. Methods: Selected villages were randomized into 5 groups: Sprinkles 12.5, 20 or 30 mg ferrous fumarate (FF), Sprinkles 20 mg micronized ferric pyrophosphate (MFP) or drops 20 mg ferrous glycine sulphate (DROPS) for 8 weeks. Household socio-demographic information was collected at baseline. Side effects and compliance were monitored through weekly visits. Hemoglobin was estimated at baseline, 3 and 8 wk. Ferritin was assessed at baseline and 8 wk. Results: Baseline characteristics were similar across all groups. Hemoglobin increased significantly (P <0.0001) in all groups at 8 weeks with no difference between groups. Ferritin increased (P <0.0001) significantly in all groups with no difference across the groups. Compliance (overall range: 42-62%) was lowest for DROPS. Side effects were significantly higher among DROPS compared to Sprinkles (p>0.05). Conclusions: Sprinkles 12.5 mg FF dose is as efficaciou