Table 7.
Studies of micronutrient supplementation at the community level
| Intervention | Type of outcome | Population size of study area | Specific outcome | Effect compared to control | Statistical significance | Reference number* |
|---|---|---|---|---|---|---|
|
Randomized controlled interventions: | ||||||
| Vitamin A supplementation: | ||||||
| Supplemental vitamin A 8333 IU weekly and E at the household level |
Mortality |
7764 children, 0 to <5 y |
Risk of death in girls; risk of death in boys |
Decreased by 59%; Decreased by 48% |
0.01; 0.04 |
[S161], [S161] |
| Maternal vitamin A 3330 IU daily and folate supplementation |
Mortality |
3389 pregnant women and children |
Perinatal, and neonatal mortality |
Decreased by 20% |
0.01 |
[S162] |
| Vitamin A (200 000 IU for 12–59 mo–old children, 100 000 IU for 6–11 mo–old children, and 50 000 IU –5m) in a single dose |
Mortality |
3786 children, 0 to <5 years |
1–59 mo mortality |
Decreased by 26% |
0.05 |
[S14] |
| Vitamin A every 4 mo (60 000 IU) |
Mortality |
28 630 children, 6–72 mo |
1–59 mo mortality; case fatality rate for measles |
Decreased by 30%; decreased by 76% |
0.05; 0.001 |
[S163], [S163] |
| Vitamin A 200 000 IU every 6 mo for 18 mo |
Morbidity |
12 109 children, 9–72 mo |
Incidence of night blindness |
Decreased by 50% |
0.001 |
[S164] |
| Vitamin A 200 000 IU for 12–59 mo–old children and 100 000 IU for 1–11m–old children every 4 mo |
Mortality |
9200 children, 0 to <5 y |
1–59 mo mortality |
Decreased by 19% |
0.05 |
[S165] |
| Vitamin A 60 000 IU every 4 mo |
Mortality |
28 630 children, 6–72 mo |
1–59 mo mortality in females |
Decreased by 90% |
0.0001 |
[S166] |
| Vitamin A 200 000 IU for 1–3 mo–old children at 1–3 mo of age and again 6–8 mo later |
Mortality |
25 000 children, 0 to <5 y |
1–59 mo mortality |
Decreased by 34% |
0.01 |
[S167] |
| Infants received 24 000 IU of vitamin A on days 1 and 2 after delivery |
Mortality |
5786 newborns |
Mortality during the 1st 6m of life |
Decreased by 22% |
0.02 |
[S168] |
| Vitamin A given at birth (50 000 IU) |
Mortality |
7953 newborns |
All–cause infant mortality |
Decreased by 15% |
0.045 |
[S169] |
| Vitamin A 200 000 IU for 12–59 mo–old children and 100 000 IU for 1–11 mo–old infants |
Morbidity |
1405 children, 6–47 mo |
Incidence of acute respiratory infection in normal children. |
Increased by 8% |
0.05 |
[S170] |
| Vitamin A 200 000 IU for 12–59 mo–old children and 100 000 IU for 1–11 mo– old infants twice a year and accompanied by nutrition education |
Change in nutritional status |
720 children 0–36 mo |
Prevalence of stunting |
Decreased by 11% |
0.01 |
[S171] |
| Zinc supplementation: | ||||||
| Vitamin A 200 000 IU as one dose plus 10 mg zinc 6 days a week |
Morbidity |
148 children, 6–72 mo |
Prevalence of malaria |
Decreased by 32% |
<0.001 |
[S172] |
| Zinc (70 mg) weekly for one year |
Morbidity |
809 children, 6–18 mo |
Incidence of pneumonia |
Decreased by 44% |
0.01 |
[S83] |
| Daily supplementation
with 10 mg of zinc |
Mortality |
21 274 children, 12–48 mo for 485 days |
Relative risk of all–cause mortality in children 12–48 mo |
Decreased by 18% |
0.045 |
[S173] |
| Daily supplementation with 10 mg of zinc |
Morbidity |
854 children 6–48 mo |
Incidence of diarrhea in children 0 to < 2 y |
Decreased by 25% |
0.001 |
[S174] |
| Zinc 20mg zinc daily for 15 d (for children with diarrhea) |
Morbidity |
139 children 6–35 mo |
Duration of persistent diarrhea |
Decreased by 28% |
0.01 |
[S175] |
| Iron supplementation: | ||||||
| Iron, folate and zinc supplementation: iron (12.5 mg), folic acid (5 µg) zinc (10mg) daily |
Morbidity |
Children, 1 to <6 mo |
Risk of severe morbidity (from severe malaria) and death in groups that received iron |
Increased by 12% |
0.02 |
[S176] |
| Sale to households of “Sprinkles” (a powder to sprinkle on top of food) containing iron and B vitamins |
Morbidity |
561 children, 0 to <5 y |
Prevalence of anemia |
Decreased by 19% |
0.001 |
[S177] |
| Daily home fortification with micronutrient powder containing iron for 2 mo |
Change in nutritional status |
1103 children, 0 to <5 y |
Mean hemoglobin concentration |
Increased by 7% |
0.001 |
[S178] |
| Multivitamin and mineral powder (MMP) supplement: 2 sachets 2 times a week (compared to 2 sachets MMP daily and controls) |
Morbidity |
115 children, 0 to <5 y in each of the 3 groups |
Prevalence of anemia, compliance with MMP supplement |
Decreased by 32% in daily MMP; 200% greater in 2 times a week group compared to daily |
0.001; 0.001 |
[S179] |
|
Non–randomized controlled interventions: | ||||||
| Vitamin A supplementation: | ||||||
| Fortification of monosodium gluconate sold in markets with vitamin A |
Morbidity |
5755 children 0 to <5 y |
Prevalence of Bitot’s spots; mortality |
Decreased by 600%; mortality rate among pre–school children in the control villages was 1.8 times greater than that for children in intervention villages |
0.0001; 0.001 |
[S180], [S180] |
| Education on weaning practices, Vitamin A provision to children, Provision of iron to mothers, immunizations, door–to–door visits from CHWs | Mortality | 6663 children, 0–35 mo and 14 551 women | All–cause mortality among children 6–35 mo; pneumonia–specific mortality among children 6–35 mo | Decreased by 32%; decreased by 53% | 0.001; 0.001 | [S181], [S181] |