Relationship of the Availability of Micronutrient Powder with Iron Status and Hemoglobin among Women and Children in the Kakuma Refugee Camp, Kenya

• Published in: Food and nutrition bulletin 2011-09, Vol.32 (3), p.286-291
• Main Authors: Ndemwa, Philip, Klotz, Christine L., Mwaniki, David, Sun, Kai, Muniu, Erastus, Andango, Pauline, Owigar, Joyce, Rah, Jee Hyun, Kraemer, Klaus, Spiegel, Paul B., Bloem, Martin W., de Pee, Saskia, Semba, Richard D.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anemia, Iron-Deficiency - drug therapy; Anemia, Iron-Deficiency - epidemiology; Biological Availability; Child, Preschool; Female; Food, Fortified; Hemoglobins - analysis; Hemoglobins - deficiency; Humans; Infant; Iron, Dietary - administration & dosage; Iron, Dietary - pharmacokinetics; Kenya - epidemiology; Logistic Models; Male; Micronutrients - deficiency; Micronutrients - pharmacokinetics; Middle Aged; Nutritional Requirements; Nutritional Status; Receptors, Transferrin - analysis; Receptors, Transferrin - blood; Refugees; Young Adult
• ISSN: 1564-8265; 0379-5721; 1564-8265
• DOI: 10.1177/156482651103200314

Background Micronutrient powder is a potential strategy to improve iron status and reduce anemia in refugee populations. Objective To evaluate the effect of the availability of home fortification with a micronutrient powder containing 2.5 mg of sodium iron ethylenediaminetetraacetate (NaFeEDTA) on iron status and hemoglobin in women and children in the Kakuma Refugee Camp in northwest Kenya. Methods Hemoglobin and soluble transferrin receptor were measured in 410 children 6 to 59 months of age and 458 women of childbearing age at baseline (just before micronutrient powder was distributed, along with the regular food ration) and at midline (6 months) and endline (13 months) follow-up visits. Results At the baseline, midline, and endline visits, respectively, the mean (± SE) hemoglobin concentration in women was 121.4 ± 0.8, 120.8 ± 0.9, and 120.6 ± 1.0 g/L (p = .42); the prevalence of anemia (hemoglobin < 120 g/L) was 42.6%, 41.3%, and 41.7% (p = .92); and the mean soluble transferrin receptor concentration was 24.1 ± 0.5, 20.7 ± 0.7, and 20.8 ± 0.7 nmol/L (p = .0006). In children, the mean hemoglobin concentration was 105.7 ± 0.6, 109.0 ± 1.5, and 105.5 ± 0.3 g/L (p = .95), respectively; the prevalence of anemia (hemoglobin < 110 g/L) was 55.5%, 52.3%, and 59.8% (p = .26); and the mean soluble transferrin receptor concentration was 36.1 ± 0.7, 29.5 ± 1.9, and 28.4 ± 3.2 nmol/L (p = .02), in models that were adjusted for age using least squares means regression. Conclusions In children and in women of childbearing age, the availability of micronutrient powder was associated with a small improvement in iron status but no significant change in hemoglobin in this refugee camp setting.