Investigation Of The Exposure To Low-iron Multiple Micronutrient Powders (mnps) On Development Anaemia And Growth Of Infants And Young Children In Sidama Zone Southern Ethiopia

Micronutrient malnutrition is estimated to affect 2 billion people worldwide. The deficiency is morernprevalent in infants and young children during complementary feeding period. Inappropriaterncomplementary feeding contributes to growth faltering, anemia, and cognitive impairments. Among thernvarious strategies designed to prevent and treat the nutritional deficiency home fortification withrnmicronutrient powders (MNP) is a novel alternative for delivering micronutrients with foods. Limitedrnprogrammatic evidence exists on the effectiveness of low-iron micronutrient powders (MNPs) on anemia,rngrowth and development when provided every other day in the first year of life.rnThis study investigated associations between exposure of low-iron MNPs with anemia, growth, andrndevelopment of infants in Southern Ethiopia. Using a retrospective cohort design, the associations betweenrnMNP exposure (98 MNP exposed; 102 unexposed) and anemia, growth and motor development werernassessed among infants 9-11 months of age. This was followed by a prospective follow-up of the samerngroups six months after the intervention was interrupted. Children’s developmental milestone acquisitionrnlike language, social skills, and fine- and gross-motor skills were assessed. The retention of fat-solublernvitamins in the home-fortified foods was evaluated using HPLC-DAD.rnSocio-demographic characteristics and dietary patterns were similar between MNP exposed andrnunexposed groups. Provision of low-Fe (6 mg) MNP every other day, for three months, was associatedrnwith reduced risk of anaemia and stunting, and increased likelihood of standing alone (AOR=3.1; 95% CI:rn1.53, 6.46) or walking alone (4.9; 95% CI 2.12, 11.37). Dietary diversity and mothers’ education werernalso associated with motor development. The prospective follow-up (cohort) after the interruption of thernintervention revealed that difference-in-difference (DID) values between the two groups remainedrnsignificant and positive, meaning that earlier differences between the two groups widened with time evenrnin the absence of continued intervention. The risk of stunting and anemia in the MNP exposed infants werernstill reduced by 32.6 % (RR: 0.67; 95% CI: 0.48, 0.94) and 42.6% (RR: 0.57; 95% CI: 0.44, 0.75),rnrespectively. Similarly, children exposed to MNP intervention in their first year of life had a lower risk ofrndeficits in the ability to walk alone (RR: 0.47; 95% CI: 0.38, 0.57) or standing alone (RR: 0.60; 95% CI:rn0.46, 0.79) compared to those that were unexposed to MNP. Exposure to MNPs was positively associatedrnwith various indicators of cognitive development like gross motor (β=0.59; 95% CI: 0.27, 0.91), finernmotor (β=0.48; 95% CI: 0.17, 0.79), language (β=0.48; 95% CI: 0.10, 0.85) and social skills (β= 0.16;rn95% CI: 1.09, 2.24). Morbidity, head-circumference, and LAZ were all significantly associated withrndevelopment milestone acquisition (P

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