Fortified Snack Reduced Anemia in Rural School-Aged Children of Haiti: A Cluster-Randomized, Controlled Trial.
Fortified Snack Reduced Anemia in Rural School-Aged Children of Haiti: A Cluster-Randomized, Controlled Trial.
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DOI：
10.1371/journal.pone.0168121
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Wolff PB
中科院分区：
文献类型：
--
作者：
Iannotti L;Dulience SJ;Joseph S;Cooley C;Tufte T;Cox K;Eaton J;Delnatus JR;Wolff PB
学龄儿童的营养对大脑发育和全球公共政策投资至关重要。我们小组之前在海地的城市学校进行了一项试验，以检查强化花生酱零食Vita Mamba的效果，但对贫血的研究结果有限。我们的目标是验证这样的假设，即在两个研究臂中系统地驱虫的Vita Mamba将显著减少农村学龄儿童的贫血。2014-2015年，在海地东北省的两个农村社区进行了一项整群随机纵向研究。纳入321名3~16岁健康儿童，按学校分配进行干预(Vita Mamba和驱虫)和对照(驱虫)。Vita Mamba含有260千卡热量，符合推荐的临界微量营养素膳食营养量的75%。应用多元回归分析，包括校正潜在群体失衡的倾向分数匹配技术(基于核的匹配和倾向分数加权)，以检查差异中差异的干预效果。基线时，51%的儿童贫血，研究组之间没有显著差异。在调整了儿童年龄、维生素A补充剂、牛奶摄入量和身高z得分后，与对照组相比，维生素Mamba补充剂在提高Hb浓度和降低贫血几率方面在回归模型中显示出一致的、积极的效果。倾向计分加权模型的平均治疗效果为0.62±0.27g/100ml(g/dL)Hb浓度(F=4.64，P=0.001)，贫血发生几率降低88%(Waldχ²=9.77，P=0.02)。人体测量标记物的变化没有明显差异。将强化食品与驱虫相结合的学校供餐计划可以减轻贫血负担，对学习、健康和福祉具有重要影响。贫血症的城乡差异需要进一步研究。
Nutrition in the school-aged child matters for brain development and public policy investments globally. Our group previously conducted a trial in urban schools of Haiti to examine the effects of a fortified peanut butter snack, Vita Mamba, with limited findings for anemia. We aimed to test the hypothesis that Vita Mamba, with systematic deworming in both study arms, would significantly reduce anemia among rural, school-aged children. A cluster, randomized longitudinal study was conducted in two rural communities of the North-East Department of Haiti, 2014–2015. Healthy children ages 3–16 years were enrolled (n = 321) and assigned by school to intervention (Vita Mamba and deworming) and control (deworming). Vita Mamba contains 260 kcal and meets >75% of the Recommended Dietary Allowance for critical micronutrients. Multivariate regression analyses including propensity score matching techniques to correct for potential group imbalance (Kernel-based Matching and Propensity Score Weighting) were applied to examine difference-in-difference intervention effects. At baseline, 51% of the children were anemic with no significant differences between study groups. Vita Mamba supplementation showed a consistent, positive effect across regression models on increasing Hb concentration and reducing the odds of anemia compared to the control group after adjusting for child age, vitamin A supplementation, milk consumption, and height-for-age z score. The average treatment effect for the treated in the Propensity Score Weighting models was 0.62±0.27 grams per 100 milliliters (g/dL) for Hb concentration (F = 4.64, P = 0.001), and the odds of anemia were reduced by 88% (Wald χ² = 9.77, P = 0.02). No differences in change in anthropometric markers were evident. School feeding programs that integrate fortified foods with deworming could reduce anemia burden with important implications for learning, health, and well-being. The rural-urban differences in anemia require further study.
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影响因子：
2.2
作者：
El Menchawy I;El Hamdouchi A;El Kari K;Saeid N;Zahrou FE;Benajiba N;El Harchaoui I;El Mzibri M;El Haloui N;Aguenaou H
通讯作者：
Aguenaou H
影响因子：
3.3
作者：
Iannotti, Lora L.;Delnatus, Jacques R.;Wolff, Patricia B.
通讯作者：
Wolff, Patricia B.
影响因子：
5.8
作者：
Heckman, JJ;Ichimura, H;Todd, PE
通讯作者：
Todd, PE
影响因子：
1.9
作者：
Egbi, Godfred;Ayi, Irene;Steiner-Asiedu, Matilda
通讯作者：
Steiner-Asiedu, Matilda
影响因子：
5.9
作者：
Perignon M;Fiorentino M;Kuong K;Dijkhuizen MA;Burja K;Parker M;Chamnan C;Berger J;Wieringa FT
通讯作者：
Wieringa FT