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Small-quantity lipid-based nutrient supplements, regardless of their zinc content, increase growth and reduce the prevalence of stunting and wasting in young Burkinabe children : a cluster-randomized trial

(2015) PLOS ONE. 10(3).
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Abstract
Small-quantity lipid-based nutrient supplements (SQ-LNS) are promising home fortification products, but the optimal zinc level needed to improve growth and reduce morbidity is uncertain. We aimed to assess the impact of providing SQ-LNS with varied amounts of zinc, along with illness treatment, on zinc-related outcomes compared with standard care. In a placebo-controlled, cluster-randomized trial, 34 communities were stratified to intervention (IC) or nonintervention cohorts (NIC). 2435 eligible IC children were randomly assigned to one of four groups: 1) SQ-LNS without zinc, placebo tablet; 2) SQ-LNS containing 5mg zinc, placebo tablet; 3) SQ-LNS containing 10mg zinc, placebo tablet; or 4) SQ-LNS without zinc and 5mg zinc tablet from 9-18 months of age. During weekly morbidity surveillance, oral rehydration salts were provided for reported diarrhea and antimalarial therapy for confirmed malaria. Children in NIC (n = 785) did not receive SQ-LNS, tablets, illness surveillance or treatment. At 9 and 18 months, length, weight and hemoglobin were measured in all children. Reported adherence was 97 +/- 6% for SQ-LNS and tablets. Mean baseline hemoglobin was 89 +/- 15g/L. At 18 months, change in hemoglobin was greater in IC than NIC (+8 vs -1g/L, p<0.0001), but 79.1% of IC were still anemic (vs. 91.1% in NIC). Final plasma zinc concentration did not differ by group. During the 9-month observation period, the incidence of diarrhea was 1.10 +/- 1.03 and of malaria 0.54 +/- 0.50 episodes per 100 child-days, and did not differ by group. Length at 18 months was significantly greater in IC compared to NIC (77.7 +/- 3.0 vs. 76.9 +/- 3.4cm; p<0.001) and stunting prevalence was significantly lower in IC (29.3%) than NIC (39.3%; p<0.0001), but did not differ by intervention group within IC. Wasting prevalence was also significantly lower in IC (8.7%) than in NIC (13.5%; p = 0.0003). Providing SQ-LNS daily with or without zinc, along with malaria and diarrhea treatment, significantly increased growth and reduced stunting, wasting and anemia prevalence in young children.
Keywords
DEVELOPING-COUNTRIES, HOME-FORTIFICATION, MICRONUTRIENT SUPPLEMENTS, PREPUBERTAL CHILDREN, COMPLEMENTARY FOODS, NUTRITIONAL-STATUS, MALARIA, DIARRHEA, METAANALYSIS, SPRINKLES

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MLA
Hess, Sonja Y, Souheila Abbeddou, Elizabeth Yakes Jimenez, et al. “Small-quantity Lipid-based Nutrient Supplements, Regardless of Their Zinc Content, Increase Growth and Reduce the Prevalence of Stunting and Wasting in Young Burkinabe Children : a Cluster-randomized Trial.” PLOS ONE 10.3 (2015): n. pag. Print.
APA
Hess, S. Y., Abbeddou, S., Jimenez, E. Y., Somé, J. W., Vosti, S. A., Ouédraogo, Z. P., Guissou, R. M., et al. (2015). Small-quantity lipid-based nutrient supplements, regardless of their zinc content, increase growth and reduce the prevalence of stunting and wasting in young Burkinabe children : a cluster-randomized trial. PLOS ONE, 10(3).
Chicago author-date
Hess, Sonja Y, Souheila Abbeddou, Elizabeth Yakes Jimenez, Jérôme W Somé, Stephen A Vosti, Zinéwendé P Ouédraogo, Rosemonde M Guissou, Jean-Bosco Ouédraogo, and Kenneth H Brown. 2015. “Small-quantity Lipid-based Nutrient Supplements, Regardless of Their Zinc Content, Increase Growth and Reduce the Prevalence of Stunting and Wasting in Young Burkinabe Children : a Cluster-randomized Trial.” Plos One 10 (3).
Chicago author-date (all authors)
Hess, Sonja Y, Souheila Abbeddou, Elizabeth Yakes Jimenez, Jérôme W Somé, Stephen A Vosti, Zinéwendé P Ouédraogo, Rosemonde M Guissou, Jean-Bosco Ouédraogo, and Kenneth H Brown. 2015. “Small-quantity Lipid-based Nutrient Supplements, Regardless of Their Zinc Content, Increase Growth and Reduce the Prevalence of Stunting and Wasting in Young Burkinabe Children : a Cluster-randomized Trial.” Plos One 10 (3).
Vancouver
1.
Hess SY, Abbeddou S, Jimenez EY, Somé JW, Vosti SA, Ouédraogo ZP, et al. Small-quantity lipid-based nutrient supplements, regardless of their zinc content, increase growth and reduce the prevalence of stunting and wasting in young Burkinabe children : a cluster-randomized trial. PLOS ONE. 2015;10(3).
IEEE
[1]
S. Y. Hess et al., “Small-quantity lipid-based nutrient supplements, regardless of their zinc content, increase growth and reduce the prevalence of stunting and wasting in young Burkinabe children : a cluster-randomized trial,” PLOS ONE, vol. 10, no. 3, 2015.
@article{8547320,
  abstract     = {Small-quantity lipid-based nutrient supplements (SQ-LNS) are promising home fortification products, but the optimal zinc level needed to improve growth and reduce morbidity is uncertain. We aimed to assess the impact of providing SQ-LNS with varied amounts of zinc, along with illness treatment, on zinc-related outcomes compared with standard care. In a placebo-controlled, cluster-randomized trial, 34 communities were stratified to intervention (IC) or nonintervention cohorts (NIC). 2435 eligible IC children were randomly assigned to one of four groups: 1) SQ-LNS without zinc, placebo tablet; 2) SQ-LNS containing 5mg zinc, placebo tablet; 3) SQ-LNS containing 10mg zinc, placebo tablet; or 4) SQ-LNS without zinc and 5mg zinc tablet from 9-18 months of age. During weekly morbidity surveillance, oral rehydration salts were provided for reported diarrhea and antimalarial therapy for confirmed malaria. Children in NIC (n = 785) did not receive SQ-LNS, tablets, illness surveillance or treatment. At 9 and 18 months, length, weight and hemoglobin were measured in all children. Reported adherence was 97 +/- 6% for SQ-LNS and tablets. Mean baseline hemoglobin was 89 +/- 15g/L. At 18 months, change in hemoglobin was greater in IC than NIC (+8 vs -1g/L, p<0.0001), but 79.1% of IC were still anemic (vs. 91.1% in NIC). Final plasma zinc concentration did not differ by group. During the 9-month observation period, the incidence of diarrhea was 1.10 +/- 1.03 and of malaria 0.54 +/- 0.50 episodes per 100 child-days, and did not differ by group. Length at 18 months was significantly greater in IC compared to NIC (77.7 +/- 3.0 vs. 76.9 +/- 3.4cm; p<0.001) and stunting prevalence was significantly lower in IC (29.3%) than NIC (39.3%; p<0.0001), but did not differ by intervention group within IC. Wasting prevalence was also significantly lower in IC (8.7%) than in NIC (13.5%; p = 0.0003). Providing SQ-LNS daily with or without zinc, along with malaria and diarrhea treatment, significantly increased growth and reduced stunting, wasting and anemia prevalence in young children.},
  articleno    = {e0122242},
  author       = {Hess, Sonja Y and Abbeddou, Souheila and Jimenez, Elizabeth Yakes and Somé, Jérôme W and Vosti, Stephen A and Ouédraogo, Zinéwendé P and Guissou, Rosemonde M and Ouédraogo, Jean-Bosco and Brown, Kenneth H},
  issn         = {1932-6203},
  journal      = {PLOS ONE},
  keywords     = {DEVELOPING-COUNTRIES,HOME-FORTIFICATION,MICRONUTRIENT SUPPLEMENTS,PREPUBERTAL CHILDREN,COMPLEMENTARY FOODS,NUTRITIONAL-STATUS,MALARIA,DIARRHEA,METAANALYSIS,SPRINKLES},
  language     = {eng},
  number       = {3},
  pages        = {19},
  title        = {Small-quantity lipid-based nutrient supplements, regardless of their zinc content, increase growth and reduce the prevalence of stunting and wasting in young Burkinabe children : a cluster-randomized trial},
  url          = {http://dx.doi.org/10.1371/journal.pone.0122242},
  volume       = {10},
  year         = {2015},
}

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