Pediatric research · 2025
Impact of interventions delivered from preconception till early childhood on anemia in children.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Karantha Sowmya C, Manapurath Rukman, Chowdhury Ranadip, Bhatia Kiran, Taneja Sunita, Dang Navin, Dang Arjun, Chatterjee Leena, Sharma Sitanshi, Chellani Harish K, Bhandari Nita
Аннотация
BACKGROUND: More than half of under-fives in South Asia are anemic. Rate of decline in prevalence of childhood anemia is very slow. An integrated package of interventions may be needed to address this.
METHODS: The main study was factorial randomized controlled trial where integrated interventions: nutrition, health, WASH (water, sanitation and hygiene) and psychosocial care were started from preconception. Hemoglobin and micronutrient analysis at 24 months of age was done in subsample. Effects of the interventions were compared across: preconception vs no preconception, pregnancy and early childhood vs no pregnancy and early childhood and both preconception, pregnancy and early childhood interventions vs routine care.
RESULTS: The proportion of mild anemia was 74% (IRR: 0.26, 98.3% CI: 0.26, 0.17-0.40; ARR: -16.66, 98.3% CI: -21.24 to -12.08)), moderate anemia 80% (IRR: 0.20, 98.3% CI: 0.13 to 0.31; ARR: -16.54, 98.3% CI: -20.47 to -12.61) and severe anemia 94% (IRR: 0.06, 98.3% CI: 0.01 to 0.24; ARR: -4.31, 98.3% CI: -6.18 to -2.44) lower in the pregnancy and early childhood intervention groups than in the groups that did not receive these interventions.
CONCLUSION: Integrated package of interventions delivered from early pregnancy till childhood are highly effective in reducing early childhood anemia.
CLINICAL TRIAL REGISTRY: India CTRI/2017/06/00890.
IMPACT: The effects of delivery of integrated interventions: nutrition, health, WASH (water sanitation and hygiene), and psychosocial care through a life cycle approach, from early pregnancy till childhood substantially reduces the risk of anemia in children at 24 months. Integrated interventions can be delivered through already existing government programmers especially in southeast Asian countries to reduce burden of anemia in children.
METHODS: The main study was factorial randomized controlled trial where integrated interventions: nutrition, health, WASH (water, sanitation and hygiene) and psychosocial care were started from preconception. Hemoglobin and micronutrient analysis at 24 months of age was done in subsample. Effects of the interventions were compared across: preconception vs no preconception, pregnancy and early childhood vs no pregnancy and early childhood and both preconception, pregnancy and early childhood interventions vs routine care.
RESULTS: The proportion of mild anemia was 74% (IRR: 0.26, 98.3% CI: 0.26, 0.17-0.40; ARR: -16.66, 98.3% CI: -21.24 to -12.08)), moderate anemia 80% (IRR: 0.20, 98.3% CI: 0.13 to 0.31; ARR: -16.54, 98.3% CI: -20.47 to -12.61) and severe anemia 94% (IRR: 0.06, 98.3% CI: 0.01 to 0.24; ARR: -4.31, 98.3% CI: -6.18 to -2.44) lower in the pregnancy and early childhood intervention groups than in the groups that did not receive these interventions.
CONCLUSION: Integrated package of interventions delivered from early pregnancy till childhood are highly effective in reducing early childhood anemia.
CLINICAL TRIAL REGISTRY: India CTRI/2017/06/00890.
IMPACT: The effects of delivery of integrated interventions: nutrition, health, WASH (water sanitation and hygiene), and psychosocial care through a life cycle approach, from early pregnancy till childhood substantially reduces the risk of anemia in children at 24 months. Integrated interventions can be delivered through already existing government programmers especially in southeast Asian countries to reduce burden of anemia in children.