世界卫生组织推荐在 2 岁以下儿童的食物中添加多种微量营养素粉进行家庭强化，以及其在贫血和体重方面的有效性：一项实用的群组随机对照试验。
The WHO recommendation of home fortification of foods with multiple-micronutrient powders in children under 2 years of age and its effectiveness on anaemia and weight: a pragmatic cluster-randomized controlled trial.
机构信息
1School of Public Health,Université Libre de Bruxelles,CP 594,Route de Lennik 808,Brussels 1070,Belgium.
2Malian Red Cross,Bamako,Mali.
出版信息
Public Health Nutr. 2018 May;21(7):1350-1358. doi: 10.1017/S1368980017003858. Epub 2018 Jan 21.
OBJECTIVE
To assess under real community settings the effectiveness of the WHO strategy of home fortification of foods (HFF) with multiple-micronutrient powders on Hb change, anaemia and weight in children.
DESIGN
A pragmatic cluster-randomized controlled trial.
SETTING
Forty villages in the Nioro Circle in Mali and 722 children aged 6-23 months were randomized to the intervention or control group. The intervention consisted of a daily dose of multiple-micronutrient powder for 3 months; in the control group, no supplement was given. In both groups, mothers received group education on child complementary feeding. Changes in weight, Hb concentration and anaemia were assessed as primary outcomes at baseline and 3 months. The HFF effect was determined using regression analyses and quantile regression with standard errors taking account of the cluster design.
SUBJECTS
Children aged 6-23 months.
RESULTS
Overall prevalence of anaemia in the sample was high: 90 %. HFF provided a modest but statistically significant Hb change v. no intervention (0·50 v. 0·09 g/dl, P=0·023). Prevalence of anaemia changed little: 91·3-85·8 % (P=0·04) in the intervention group v. 88·1-87·5 % % (P=0·86) in the control group. Proportion of severe anaemia was reduced by 84 % (from 9·8 to 1·6 %) in the intervention group, but increased in the control group (from 8·5 to 10·8 %). No effect was observed on weight.
CONCLUSIONS
The WHO HFF strategy to fight anaemia showed a modest change on Hb concentration and significantly reduced the rate of severe anaemia.
目的
在真实社区环境下评估世界卫生组织（WHO）用多种微量营养素粉进行家庭强化食物（HFF）策略对儿童血红蛋白变化、贫血和体重的影响。
设计
一项实用的整群随机对照试验。
地点
马里尼奥罗环的 40 个村庄和 722 名 6-23 个月大的儿童被随机分为干预组或对照组。干预组每天服用多种微量营养素粉 3 个月；对照组不给予补充。在两组中，母亲都接受了关于儿童补充喂养的小组教育。在基线和 3 个月时评估体重、血红蛋白浓度和贫血的变化作为主要结局。使用回归分析和分位数回归来确定 HFF 的效果，采用标准误差考虑到群组设计。
研究对象
6-23 个月大的儿童。
结果
样本中贫血的总体患病率很高：90%。HFF 与无干预相比，提供了适度但具有统计学意义的血红蛋白变化（0.50 与 0.09 g/dl，P=0.023）。贫血的患病率变化不大：干预组从 91.3%降至 85.8%（P=0.04），对照组从 88.1%降至 87.5%（P=0.86）。干预组严重贫血的比例降低了 84%（从 9.8%降至 1.6%），但对照组的比例增加了（从 8.5%升至 10.8%）。体重没有变化。
结论
WHO 用于对抗贫血的 HFF 策略显示血红蛋白浓度有适度变化，并显著降低了严重贫血的发生率。
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