Bioequivalence of Micronutrient Powders to Corn-Soy Blend on Serum Zinc Concentration of Children (6–36 Months) With Moderate Acute Malnutrition in Thika Urban Slums, Kenya: A Cluster-Randomized Controlled Trial

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dc.contributor.authorKiio, Juliana
dc.contributor.authorOchola, Sophie
dc.contributor.authorNduati, Ruth
dc.contributor.authorKuria, Elizabeth
dc.contributor.authorMathenge, Scholastica
dc.contributor.authorOkoth, Judith
dc.date.accessioned2023-08-02T13:21:32Z
dc.date.available2023-08-02T13:21:32Z
dc.date.issued2022
dc.descriptionArticleen_US
dc.description.abstractZinc deficiency is common among children with Moderate Acute Malnutrition (MAM) and contributes to growth failure, increased morbidity and mortality. Diarrhoea and poor dietary practices are the main causes of zinc deficiency. Corn-soy Blend (CSB), the standard product in management of children with MAM has a limitation of poor micronutrient bioavailability. Micronutrient powders (MNPs) which are added at the point of consumption have a potential in improving micronutrient status however, scientific evidence on efficacy on improving the zinc status is scarce. A cluster-randomized clinical trial was designed to establish bioequivalence of MNPs to CSB on serum zinc status among children (6–36 months) with MAM in Thika informal settlements, Kenya. Sample size was calculated to show bioequivalence within ±20% limit. Twelve villages were randomized to four study groups. Three experimental groups received different formulations of MNPs added to unfortified CSB porridge as; multiple micronutrients containing zinc (CSB-MNP-A n = 84), multiple micronutrients without zinc (CSB-MNP-B n = 88) and zinc only (CSB-MNP-C n = 94). Control group (n = 80) received standard CSB fortified with multiple micronutrients. Standard amount of CSB was consumed in feeding centres for six months. Serum zinc concentration was assessed pre- and post-intervention. Data was analyzed based on treatment assignment regardless of adherence and drop-out status. Mixed effects linear regression was used to model pre-post change in serum zinc concentration, adjusting for clustering effect and baseline differences. Bioequivalence was assessed using two one-sided t-tests. At baseline, 84.4% were zinc deficient (serum zinc <65μg/dL) and zinc intake was sub-optimal (<3 mg/day) for 95.7% of children. Mean change in serum zinc concentration was significantly higher (p = 0.024) in CSB-MNP-A (18.7 ± 2.1) μg/dL compared to control group (11.8 ± 2.6 μg/dL). MNPs are not bioequivalent to CSB within the ±20% bioequivalence limiten_US
dc.identifier.citationKiio, J., Ochola, S., Nduati, R., Kuria, E., Mathenge, S., & Okoth, J. (2022). Bioequivalence of micronutrient powders to Corn-soy Blend on serum zinc concentration of children (6–36 months) with Moderate Acute Malnutrition in Thika urban slums, Kenya: A cluster-randomized controlled trial. Plos one, 17(9), e0274870.en_US
dc.identifier.otherhttps://doi.org/10.1371/journal.pone.0274870
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/26505
dc.language.isoenen_US
dc.publisherPublic Library of Science San Francisco, CA USAen_US
dc.titleBioequivalence of Micronutrient Powders to Corn-Soy Blend on Serum Zinc Concentration of Children (6–36 Months) With Moderate Acute Malnutrition in Thika Urban Slums, Kenya: A Cluster-Randomized Controlled Trialen_US
dc.typeArticleen_US
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