(OR11-03-24) Predictors of Anemia Among Young Children Receiving Daily MNPs for 24 Weeks in Bangladesh

Sunday, June 30, 2024

10:12 AM – 10:24 AM CT

Location: W183

Presenting Author(s)

Lauren Thompson, MSc.

PhD Candiate
University of California, Davis
Sacramento, California, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

CA

Charles D. Arnold, MS

Statistician
University of California, Davis
Davis, California, United States
JP

Janet M. Peerson, Ph.D

University of California, Davis
Davis, California, United States
Julie M. Long, MS, MPH, RDN

Research Services Senior Clinical Science Professional
University of Colorado School of Medicine
Aurora, Colorado, United States
JW

Jamie L. Wescott

University of Colorado Anschutz Medical Campus, United States
MI

Md. Munirul Islam

Nutrition Research Division, icddr,b, Bangladesh
Robert Black, MPH, MD

Johns Hopkinds University
Baltimore, Maryland, United States
Nancy F. Krebs, MD, MS (she/her/hers)

Professor of Pediatrics, Head, Section of Nutrition
University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States
CM

Christine M. McDonald

University of California, San Francisco, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; International Zinc Nutrition Consultative Group

Objectives: Anemia affected nearly 40% of children 6-59 months in 2019. Micronutrient powders (MNPs) are designed to increase micronutrient (MN) intake in young children; however, in some settings the anemia prevalence may remain elevated despite high coverage of MNPs. Using data from the Zinc in Powders trial (ZiPT), we identified socioeconomic, maternal, and child factors that were associated with anemia among Bangladeshi infants who received standard MNPs daily for 24 weeks.

Methods: ZiPT was a randomized, partially double-blind, controlled, community-based efficacy trial conducted in Dhaka, Bangladesh from 2017-2020. Infants 9-11 months of age were randomized to one of six intervention groups that provided different doses, forms, and frequencies of zinc supplementation with or without other MN. Analyses were restricted to 481 infants who received standard 15-component MNPs daily for 24 weeks. At enrollment, data on background, socioeconomic status, maternal and household characteristics were collected. MNPs were provided, adherence was evaluated, and signs and symptoms of morbidity were assessed during semi-weekly home visits. Hemoglobin (Hb) concentrations (measured via the Hemocue 301) and child anthropometry were assessed at enrollment, 12, and 24 weeks. Preliminary logistic regression analysis, adjusting for child age and sex, was used to identify predictors of anemia (Hb < 11 g/dL) at 24 weeks. Results of multivariate analyses are forthcoming.

Results: 442 children (91.9%) in the standard MNP group completed the intervention and had Hb measurements at 24 weeks. Mean ± SD MNP adherence was 81.7% ± 14.4%. The prevalence of anemia at enrollment and 24 weeks was 68.8% and 42.2%, respectively. In bivariate analyses, the following variables were significantly associated with an increased risk of anemia at 24 weeks: low maternal education, poor hygiene, household food insecurity, anemia at enrollment, MNP adherence, and cumulative morbidity (poor appetite, acute upper respiratory infections, cough, and shortness of breath) above the median.

Conclusions: Standard MNPs alone may be inadequate to reduce anemia to the greatest extent possible. Complementary interventions that address the underlying causes of anemia and undernutrition are necessary.

Funding Sources: Bill & Melinda Gates Foundation