A global treatment for iron deficiency
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Source: PLoS MEDICINE (http://www.plosmedicine.org)
25 Jan 2005
Iron deficiency is the world's most common preventable nutri-
tional problem. It has largely been eradicated from developed
countries, but more than 750 million children in the developing
world have iron-deficiency anemia. According to an article by
researchers at The Hospital for Sick Children in Toronto, Can-
ada, published in this month's issue of the open access global
health journal PLoS Medicine, a simple sachet called "Sprinkles"
could be the key to eradicating this type of anemia.
In developing countries, the standard strategy to try and con-
trol iron-deficiency anemia is the use of an iron supplement
(ferrous sulphate) given to children as a syrup. But children
often find the treatment hard to take, since it has an unpleas-
ant metallic aftertaste, it leaves a dark stain on their teeth,
and it can give them abdominal discomfort. In contrast, Sprin-
kles--sachets containing microencapsulated iron and other micro-
nutrients as a powder that is sprinkled onto foods--avoids these
side effects. When it was tested in clinical trials in Bangla-
desh and Ghana, all of the mothers surveyed found the treatment
acceptable.
In the article, Stanley H. Zlotkin and colleagues summarize the
results of seven community-based trials of using Sprinkles in
four different countries. They found that Sprinkles were just as
good as ferrous sulphate at raising the level of hemoglobin in
children's blood (in other words, at treating anemia).
"Each stage in the evolution of the Sprinkles intervention has
been evaluated in a controlled manner," say the authors. "We de-
termined that the use of encapsulated iron did not appreciably
change the taste or color of the food to which it was added, we
showed that the haemoglobin response in anaemic infants was
equivalent to the current standard of practice, and we docu-
mented the acceptability of Sprinkles among caregivers who used
Sprinkles in their homes."
Importantly, the authors have developed a collaborative model to
scale up the intervention for countrywide use, including provid-
ing Sprinkles to the most vulnerable populations in the develop-
ing world. In Mongolia, for example, Sprinkles have been dis-
tributed to over 15,000 children in seven districts by a non-
governmental organization called World Vision. The cost was
about US$0.03 per sachet. In the project area, the prevalence of
anemia fell from 42% to 24%, and of rickets from 48% to 33%.
Stanley H. Zlotkin owns the intellectual property rights to
Sprinkles, and the H.J. Heinz Company is supporting the techni-
cal development of Sprinkles on a cost-recovery basis. Any
profit from royalty fees on the technology transfer of Sprinkles
is currently donated to The Hospital for Sick Children Founda-
tion.
"By developing Sprinkles as a cost-effective and simple strategy
to fortify foods in the home," said Professor Zlotkin, "we hope
to improve the nutritional health and well-being of disadvan-
taged infants, young children, and pregnant women worldwide, so
that they can meet their genetic potential for growth, health
and development."
Citation: Zlotkin S, Schauer C, Christofides A, Sharieff W, Ton-
deur M, et al. (2005) Micronutrient sprinkles to control child-
hood anaemia. PLoS Med 2 (1): e1.
CONTACT: Chelsea Gay
Communications Coordinator - Research Institute
The Hospital for Sick Children
555 University Avenue
Toronto, Ontario Canada M5G 1X8
Tel: +1-416-813-7654 ext. 1042
Fax: +1-416-813-5328
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