Ferric Pyrophosphate-fortified Rice for the Prevention of Iron Deficiency Anemia in Infants and Preschoolers: A Double-Blind Cluster-Randomized Controlled Trial

Background: Internationally, 47 percent of children under five years of age are projected to suffer from iron deficiency anaemia (IDA).
Objective: To investigate the effect of ferric pyrophosphate iron fortified rice, given once weekly, on haemoglobin (Hb) concentrations and anaemia prevalence rates in infants and preschoolers compared to controls (standard household rice).
Methods: This randomised, controlled trial was performed between August and December 2010 in the northeast of Brazil. Infants from two day-care centres (n=171) and preschoolers from two public schools (n=303) were part of the sample population. Fortified rice was allocated to 1 day-care centre and 1 public school, and the other centre and school received regular household rice. There were two major outcome variables analysed: improvement in the concentration of Hb and prevalence of anaemia before and after intervention. In order to describe anaemia, Hb concentration <11.0 g/dL was used as a cutoff point.
Results: There was a substantial increase in mean Hb concentration (p< .0001) and a decrease in anaemia prevalence (p= .012) in infant day care centres for the fortified rice community. The day-care centres were statistically similar to Hb at baseline; however, there was a substantial difference between groups at the endpoint, p= .027. There was no substantial improvement in the mean Hb concentration or anaemia prevalence in the before-and-after study for pre-school children. The number required (considering all groups) for treatment was 4.
Conclusions: In babies, iron-fortified rice increased Hb levels once weekly, decreased anaemia prevalence and prevented anaemia; in pre-school children, this same intervention was used to prevent IDA.

Author (s) Details

Francisco Plácido Nogueira Arcanjo
Federal University of Ceará, Brazil.

Cecília Costa Arcanjo
Federal University of Ceará, Brazil.

Caio Plácido Costa Arcanjo
University of Fortaleza, Brazil.

Paulo Roberto Santos
Federal University of Ceará, Brazil.

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