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Effect of multiple micronutrient-fortified food on mild morbidity and clinical symptoms in Zambian infants: results from a randomised controlled trial

European Journal of Clinical Nutrition volume 65, pages 1163–1166 (2011)Cite this article

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Abstract

Background/Objectives:

We aimed to assess the effects on mild morbidity of a richly micronutrient-fortified complementary/replacement food given to Zambian infants aged 6-18 months. Previous results (The Chilenje Infant Growth, Nutrition and Infection Study Team, 2010) showed an increase in the rate of hospital referral for pneumonia in the same cohort.

Subject/Methods:

A total of 743 six-month-old healthy Zambian infants were randomised to receive either a richly or a basal micronutrient-fortified porridge for 12 months. Mild morbidity was defined as an illness that did not cause death or require hospitalisation and was diagnosed on clinical examination at scheduled visits.

Results:

There was no evidence of an effect of trial arm on overall mild morbidity during the study (odds ratio (OR)=1.04, 95% confidence interval (CI)=0.90, 1.20, P=0.62). Infants in the richly fortified arm had significantly more visits in which they were diagnosed with lower respiratory tract infections/pneumonia (OR=1.65, 95% CI=1.06, 2.59, P=0.03) and fewer visits in which a diagnosis of urinary tract infection was made (OR=0.43, 95% CI=0.21, 0.87, P=0.02). Maternally reported symptoms were similar between trial arms.

Conclusion:

Compared with the basal diet, the richly micronutrient-fortified food was associated with more episodes of lower respiratory infections/pneumonia diagnosed at scheduled visits, which reinforces our previously reported findings of a higher incidence in hospital referral for pneumonia.

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Acknowledgements

We are grateful to the Bill and Melinda Gates Foundation for funding the study; to DSM, South Africa, for preparing and supplying free of charge the micronutrient premixes; to Mr Chongo of Quality Commodities, Lusaka, for preparing and storing the flours; to the Data Safety and Monitoring Board—Dr Paul Kelly, Dr Jim Todd and Dr Nigel Rollins—for their efforts to monitor and support the trial; to Max Katubulushi, UTH, for audit of the diet randomisation and distribution processes, and to Gabi Meineke, LSHTM, for help with financial management. We are particularly grateful to the mothers and children who participated in the study and to all the other members of the CIGNIS Study Team.

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Authors and Affiliations

  1. Department of Nutrition and Public Health Intervention Research, London School of Hygiene and Tropical Medicine (LSHTM), London, UK

    D Manno, N Larke, K Baisley & S Filteau

  2. Department of Obstetrics & Gynaecology, University Teaching Hospital, Lusaka, Zambia

    J Siame & L Kasonka

Authors
  1. D Manno
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  2. J Siame
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  3. N Larke
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  4. K Baisley
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  5. L Kasonka
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  6. S Filteau
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Correspondence to D Manno.

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The authors declare no conflict of interest.

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Manno, D., Siame, J., Larke, N. et al. Effect of multiple micronutrient-fortified food on mild morbidity and clinical symptoms in Zambian infants: results from a randomised controlled trial. Eur J Clin Nutr 65, 1163–1166 (2011). https://doi.org/10.1038/ejcn.2011.103

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