The effect of providing lipid-based nutrient supplements on morbidity in rural Malawian infants and young children: a randomized controlled trial. Issue 10 (9th March 2016)

• Record Type: Journal Article
• Authors: Bendabenda, Jaden; Alho, Lotta; Ashorn, Ulla; Cheung, Yin Bun; Dewey, Kathryn G; Vosti, Stephen A; Phuka, John; Maleta, Kenneth; Ashorn, Per
• Is Part Of: Public health nutrition. Volume 19:Issue 10(2016)
• Page Start: 1893
• Page End: 1903
• Publication Date: 2016-03-09
• Subjects: Lipid-based nutrient supplements, -- Infectious disease morbidity, -- Iron, -- Children, -- Low-income countries; Nutrition -- Periodicals; Nutrition policy -- Periodicals; Public health -- Periodicals; 613.2
• DOI: 10.1017/S1368980016000331
• Languages: English
• ISSNs: 1368-9800

Abstract

Abstract: Objective: Safety of home fortificants in children is uncertain in areas where infections are common. We tested the hypothesis that provision of lipid-based nutrient supplements (LNS) containing Fe does not increase infectious morbidity in children. Design: Randomized controlled trial. Infants were randomised to receive 10, 20 or 40 g LNS/d; or no supplement until age 18 months. All LNS contained 6 mg Fe/d. Morbidity outcomes (serious adverse events, non-scheduled visits and guardian-reported morbidity episodes) were compared between control and intervention groups using a non-inferiority margin of 20 %. Setting: Namwera and Mangochi catchment areas in rural Malawi. Subjects: Infants aged 6 months ( n 1932). Results: The enrolled 1932 infants contributed 1306 child-years of follow-up. Baseline characteristics were similar across groups. Compared with the control group, the relative risk (95 % CI) of serious adverse events was 0·71 (0·48, 1·07), 0·67 (0·48, 0·95) and 0·91 (0·66, 1·25) in 10, 20 and 40 g LNS/d groups, respectively. The incidence rate ratio (95 % CI) of non-scheduled visits due to malaria was 1·10 (0·88, 1·37), 1·08 (0·89, 1·31) and 1·21 (1·00, 1·46), and of guardian-reported morbidity episodes was 1·04 (0·96, 1·11), 1·03 (0·97, 1·10) and 1·04 (0·97, 1·10), in the respective LNS groups. Conclusions: Provision of 10 and 20 g LNS/d containing 6 mg Fe/d did not increase morbidity in the children. Provision of 40 g LNS/d did not affect guardian-reported illness episodes but may have increased malaria-related non-scheduled visits.