Small-quantity lipid-based nutrient supplements containing different amounts of zinc along with diarrhea and malaria treatment increase iron and vitamin A status and reduce anemia prevalence, but do not affect zinc status in young Burkinabe children: a cluster-randomized trial

Abbeddou, Souheila; Yakes Jimenez, Elizabeth; Somé, Jérome W.; Ouédraogo, Jean Bosco; Brown., Kenneth H.; Hess, Sonja Y.

doi:10.1186/s12887-016-0765-9

Table 3 Effect of SQ-LNS containing different amounts and sources of zinc provided along with malaria and diarrhea treatment on hemoglobin concentration and iron status indicators among children 9–18 months of age, by study group

From: Small-quantity lipid-based nutrient supplements containing different amounts of zinc along with diarrhea and malaria treatment increase iron and vitamin A status and reduce anemia prevalence, but do not affect zinc status in young Burkinabe children: a cluster-randomized trial

	LNS-Zn0	LNS-Zn5	LNS-Zn10	LNS-TabZn5	P-value among 4 intervention groups^b	IC	NIC	P-value between cohorts^b	ICC^c	DE^d
Hemoglobin (g/L)^{a, e}
N (9 and 18 months)	80	73	76	68		297	87
Hb at 9 months	89 ± 15	87 ± 14	88 ± 16	89 ± 15	0.925	88 ± 15	88 ± 16	0.805	0.02	1.3
Hb at 18 months	97 ± 17	96 ± 15	98 ± 16	98 ± 15	0.731	97 ± 16	90 ± 15	0.003	0.04	1.5
Plasma ferritin (μg/L)^f
N (9 and 18 months)	84	75	79	73		311	93
Unadjusted pF at 9 months	35.9 (29.6, 43.4)	29.7 (24.9, 35.4)	34.1 (28.5, 40.9)	33.0 (26.5, 41.1)	0.127	33.2 (30.2, 36.5)	27.4 (23.3, 32.3)	0.096	0.00	1.0
Adjusted pF at 9 months	23.1 (19.4, 27.4)	18.5 (15.7, 21.8)	21.6 (18.2, 25.5)	19.7 (16.3, 23.8)	0.166	20.7 (19.0, 22.6)	17.0 (14.6, 19.8)	0.038	0.00	1.0
Unadjusted pF at 18 months	44.6 (36.3, 54.7)	47.7 (38.9, 58.5)	34.0 (28.7, 40.2)	42.0 (34.0, 52.1)	0.023	41.7 (37.8, 46.0)	27.0 (22.3, 32.8)	<0.0001	0.04	1.5
Adjusted pF at 18 months	29.5 (24.9, 35.0)^ab	30.5 (25.2, 36.8)^a	22.1 (18.5, 26.4)^b	28.6 (23.3, 35.0)^ab	0.016	27.4 (25.0, 30.0)	16.9 (14.3, 19.9)	<0.0001	0.06	1.8
Soluble transferrin receptor (mg/L)^g
N (9 and 18 months)	84	75	79	73		311	93
Unadjusted sTfR at 9 months	17.8 (15.8, 20.0)	19.7 (17.7, 22.0)	18.4 (16.5, 20.4)	18.4 (14.7, 18.6)	0.286	18.1 (17.1, 19.1)	16.6 (14.8, 18.7)	0.385	0.03	1.4
Adjusted sTfR at 9 months	15.7 (14.0, 17.6)	17.4 (15.7, 19.4)	16.2 (14.6, 18.0)	14.4 (12.9, 16.1)	0.162	15.9 (15.1, 16.8)	14.6 (13.0, 16.3)	0.270	0.03	1.4
Unadjusted sTfR at 18 months	8.8 (8.1, 9.6)	9.1 (8.3, 9.9)	9.0 (8.3, 9.8)	9.2 (8.4, 10.0)	0.860	9.0 (8.6, 9.4)	11.9 (10.9, 13.0)	<0.0001	0.01	1.1
Adjusted sTfR at 18 months	7.8 (7.2, 8.5)	8.0 (7.3, 8.7)	8.0 (7.3, 8.6)	8.2 (7.5, 8.9)	0.828	8.0 (7.7, 8.3)	10.6 (9.7, 11.5)	<0.0001	0.00	1.0
Body iron stores (mg/kg)
N (9 and 18 months)	84	75	79	73		311	93
Unadjusted BIS at 9 months	1.06 (0.23, 1.88)	0.00 (–0.75, 0.75)	0.76 (0.06, 1.47)	1.02 (0.18, 1.86)	0.069	0.72 (0.33, 1.10)	0.34 (–0.37, 1.05)	0.521	0.01	1.1
Adjusted BIS at 9 months	–0.08 (–0.88, 0.72)	–1.25 (–1.98,–0.52)	–0.44 (–1.13, 0.25)	–0.35 (–1.14, 0.44)	0.120	–0.52 (–0.89,–0.14)	–0.91 (–1.60,–0.22)	0.401	0.01	1.1
Unadjusted BIS at 18 months	4.37 (3.64, 5.10)	4.51 (3.69, 5.34)	3.30 (2.57, 4.03)	4.02 (3.19, 4.84)	0.025	4.05 (3.67, 4.43)	1.48 (0.76, 2.19)	<0.0001	0.05	1.7
Adjusted BIS at 18 months	3.31 (2.66, 3.97)^ab	3.35 (2.56, 4.14)^a	2.21 (1.44, 2.98)^b	3.04 (2.25, 3.83)^ab	0.019	2.98 (2.61, 3.35)	0.22 (–0.44, 0.88)	<0.0001	0.06	1.8
Zinc protoporphyrin (μmol/mol heme)^h
N (9 and 18 months)	81	73	79	73		306	92
Unadjusted ZPP at 9 months	212 (184, 244)	235 (206, 269)	208 (186, 233)	202 (177, 230)	0.703	214 (200, 228)	198 (169, 233)	0.646	0.10	2.2
Adjusted ZPP at 9 months	193 (167, 223)	212 (185, 242)	188 (169, 210)	180 (158, 204)	0.574	193 (181, 206)	180 (154, 210)	0.625	0.09	2.1
Unadjusted ZPP at 18 months	144 (129, 161)	151 (137, 168)	151 (132, 159)	145 (132, 156)	0.920	146 (139, 153)	203 (184, 225)	<0.0001	0.05	1.7
Adjusted ZPP at 18 months	132 (118, 148)	137 (124, 151)	132 (122, 144)	133 (121, 145)	0.946	133 (127, 140)	182 (164, 203)	<0.0001	0.05	1.7

Hb hemoglobin concentration, pF plasma ferritin, sTfR soluble transferrin receptor, ZPP zinc protoporphyrin
^aAdjusted means ± standard deviation, and geometric mean (95% confidence interval); all such values
^bValues in a row with superscripts with different letters differ P < 0.05 using Proc MIXED. Values are adjusted for the random effect of the village
^cInter-cluster coefficient calculated based on the cluster (village) variance and the residual variance from proc MIXED
^dDesign effect calculated based on the standard error of the intervention with or without the random effect of the cluster
^eHb values adjusted for AGP, CRP, and at 18 months, adjusted additionally for baseline value and study season
^fpF values adjusted for AGP, CRP, and at 18 months, adjusted additionally for baseline value, baseline iron supplementation, RDT, maternal BMI and study season
^gsTfR values adjusted for AGP, CRP, age and sex; and at 18 months, adjusted additionally for baseline value, baseline iron supplementation, study season, and minimum meal frequency
^hZPP values adjusted for AGP, CRP and sex; and at 18 months, adjusted additionally for baseline value, baseline iron supplementation, maternal BMI, study season, and animal food source

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