Determination of iron absorption from intrinsically labeled microencapsulated ferrous fumarate (sprinkles) in infants with different iron and hematologic status by using a dual-stable-isotope method

Tondeur, Mélody; Schauer, Claudia; Christofides, Anna; Asante, Kwaku Poku; Newton, Samuel S.; Serfass, R. C.; Zlotkin, Stanley

doi:10.1093/ajcn/80.5.1436

Cited by 76 publications

(47 citation statements)

References 34 publications

(49 reference statements)

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“…Such relatively high doses are mainly based on traditional practice, and recent recalculations suggest they are likely excessive (see below). Noteworthy, only a minor fraction (no more than 10-20%) of a high dose of oral iron is effectively absorbed [52][53][54].…”

Section: The Traditional Prescription Be Aware Of Elemental Iron Rementioning

confidence: 99%

Modern iron replacement therapy: clinical and pathophysiological insights

et al. 2017

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Iron deficiency, with or without anemia, is extremely frequent worldwide, representing a major public health problem. Iron replacement therapy dates back to the seventeenth century, and has progressed relatively slowly until recently. Both oral and intravenous traditional iron formulations are known to be far from ideal, mainly because of tolerability and safety issues, respectively. At the beginning of this century, the discovery of hepcidin/ferroportin axis has represented a turning point in the knowledge of the pathophysiology of iron metabolism disorders, ushering a new era. In the meantime, advances in the pharmaceutical technologies are producing newer iron formulations aimed at minimizing the problems inherent with traditional approaches. The pharmacokinetic of oral and parenteral iron is substantially different, and diversities have become even clearer in light of the hepcidin master role in regulating systemic iron homeostasis. Here we review how iron therapy is changing because of such important advances in both pathophysiology and pharmacology.

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Section: The Traditional Prescription Be Aware Of Elemental Iron Rementioning

confidence: 99%

Modern iron replacement therapy: clinical and pathophysiological insights

et al. 2017

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“…The efficacy, bioavailability and safety of Sprinkles have been demonstrated in many diverse settings (Zlotkin et al, 2001(Zlotkin et al, , 2003Tondeur et al, 2004;Giovannini et al, 2006;Sharieff et al, 2006). For example, a recent field trial in India showed that a daily iron dose of 12.5 mg given as Sprinkles over a two-month period significantly increased haemoglobin concentrations and successfully treated anaemia (Hirve et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Improved adherence and anaemia cure rates with flexible administration of micronutrient Sprinkles: a new public health approach to anaemia control

Hyder

Haseen

et al. 2007

Eur J Clin Nutr

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Background/Objectives: Despite repeated public commitments and availability of various forms of iron supplements, rates of anaemia in developing countries remain high. A major reason for this lack of success has been poor adherence. The objective of this study was to compare the effectiveness of daily and flexible administration of micronutrient Sprinkles on adherence, acceptability and haematological status among young children in rural Bangladesh. Subjects/Methods: A sample of 362 children (haemoglobin (Hb)X70 g l À1 ) aged 6-24 months were cluster-randomized to receive 60 sachets of Sprinkles either (i) daily over 2 months; (ii) flexibly over 3 months; or (iii) flexibly over 4 months. With a flexible regimen, mothers/caregivers decided how frequently to use Sprinkles without exceeding one sachet per day. Adherence was assessed monthly by counting the number of sachets used and acceptability was evaluated through focus group discussions. Haemoglobin was measured at baseline, at the end of each intervention period and 6 months post-intervention. Results: Mean percent adherence was significantly higher in the flexible-4-month group (98%) compared to the flexible-3-month (93%) and daily-2-month (88%) groups (Po0.01). Most mothers found flexible administration to be more acceptable than daily due to perceived benefits of use. Hb at the end of intervention was significantly higher in the flexible-4-month group compared to the daily group (P ¼ 0.03). Anaemia prevalence decreased by 65% in the flexible-4-month group compared to 54% in the flexible-3-month and 51% in the daily-2-month groups. Percent of cured children who maintained a non-anaemic status 6 months post-intervention was significantly higher in the flexible-4-month (82%) and flexible-3-month (80%) groups than the daily-2-month (53%) group (Po0.05). Conclusions: The adherence, acceptability and haematological response to flexible administration over 4 months were found preferable to daily.

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“…Studies in Malawi (4,5) and Ghana (6,7) showed a promising impact on linear growth, iron status and motor development when the LNS was added to the diet in small amounts (about 20-75 g/d). Bioavailability studies on MNP have shown that iron is well absorbed in infants (8,9) and multiple randomized studies have demonstrated the efficacy of MNP in treating anaemia in young children (10) . The acceptability of various LNS and MNP products was previously tested and generally found to be high in Pakistan (11) , Ghana (12) , Burkina Faso (13,14) and Malawi (15) .…”

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confidence: 99%

Rapid acceptability and adherence testing of a lipid-based nutrient supplement and a micronutrient powder among refugee children and pregnant and lactating women in Algeria

Tondeur

Salse²,

Wilkinson

et al. 2016

Public Health Nutr.

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Objective: To assess the acceptability and adherence to daily doses of lipid-based nutrient supplement (LNS) among children and micronutrient powder (MNP) among children and pregnant and lactating women. Design: Household interviews and sachet counting were conducted to measure acceptability and adherence, 15 and 30 d after product distribution. Qualitative information on product acceptability was collected using focus group discussions. Setting: Saharawi refugee camps, Algeria, August-October 2009. Subjects: LNS was distributed to 123 children aged 6-35 months (LNS-C), and MNP to 112 children aged 36-59 months (MNP-C) and 119 pregnant or lactating women (MNP-W). Results: At the end of the test 98·4 % of LNS-C, 90·4 % of MNP-C and 75·5 % of MNP-W participants reported that they liked the product (P < 0·05). Other measures of acceptability did not differ. Median consumption of sachets was highest in the LNS-C group (P < 0·001). 'Good' adherence to the daily regimen (consumption of 75-125 % of recommended dose) was 89·1 % in the LNS-C, compared with 57·0 % in the MNP-C and 65·8 % in the MNP-W groups (P < 0·001). Qualitative findings supported the quantitative measures and guided selection of local product names, packaging designs, distribution mechanisms, and the design of the information campaign in the subsequent programme scale-up. Conclusions: Acceptability, consumption and adherence were higher in participants receiving LNS compared with MNP. However, both products were found to be suitable when compared with predefined acceptability criteria. Acceptability studies are feasible and important in emergency nutrition programmes when the use of novel special nutritional products is considered.

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Determination of iron absorption from intrinsically labeled microencapsulated ferrous fumarate (sprinkles) in infants with different iron and hematologic status by using a dual-stable-isotope method

Abstract: During infancy, iron absorption from sprinkles in a maize-based porridge meets and surpasses requirements for absorbed iron and is up-regulated in infants with IDA.

Cited by 76 publications

References 34 publications

Modern iron replacement therapy: clinical and pathophysiological insights

Modern iron replacement therapy: clinical and pathophysiological insights

Improved adherence and anaemia cure rates with flexible administration of micronutrient Sprinkles: a new public health approach to anaemia control

Rapid acceptability and adherence testing of a lipid-based nutrient supplement and a micronutrient powder among refugee children and pregnant and lactating women in Algeria

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