Efficacy of processed amaranth-containing bread compared to maize bread on hemoglobin, anemia and iron deficiency anemia prevalence among two-to-five year-old anemic children in Southern Ethiopia: A cluster randomized controlled trial

Abstract

Background Few studies have evaluated iron-rich plant-based foods, such as amaranth grain, to reduce anemia and iron deficiency anemia. Amaranth is rich in nutrients, but with high level of phytate. The objective of this trial was to evaluate the efficacy of home processed amaranth grain containing bread in the treatment of anemia, hemoglobin concentration and iron deficiency anemia among two-to-five year-old children in Southern Ethiopia. Method Children with anemia (hemoglobin concentration <110.0g/L) (N = 100) were identified by random sampling and enrolled in a 1:1 cluster randomized controlled trial for six months in 2017. The amaranth group (N = 50), received 150g bread containing 70% amaranth and 30% chickpea, the amaranth grain was processed at home (soaking, germinating, and fermenting) to decrease the phytate level. The maize group (N = 50), received 150g bread, containing processed maize (roasted and fermented) to give a similar color and structure with amaranth bread. Hemoglobin, ferritin, and CRP were measured at baseline and at the end of intervention. Hemoglobin and ferritin values were adjusted for altitude and infection, respectively. Generalized estimating equation and generalized linear model were used to analyze the data. Result In the last follow-up measure anemia prevalence was significantly lower in the amaranth group (32%) as compared with the maize group (56%) [adjusted risk ratios, aRR: 0.39 (95%

Prevalence of Anemia, Iron-Deficiency Anemia, and Associated Factors among Children Aged 1–5 Years in the Rural, Malaria-Endemic Setting of Popokabaka, Democratic Republic of Congo: A Cross-Sectional Study

“…The biological pathway involves an increase in iron absorption capacity in some of these conditions even though the storage capacity is normal. Taking into account the low consumption of animal-source foods in Popokabaka, a possible explanation is a frequent consumption of iron-rich vegetables (e.g., cassava and amaranth) [ 24 ] and the widespread self-prescription of iron tablets [ 12 ].…”

Co-morbid anaemia and stunting among children 2–5 years old in southern Ethiopia: a community-based cross-sectional study

“…However, the study area was selected purposively since this study was a part of a larger study that aimed to evaluate the efficacy of home-processed amaranth grain containing bread in the treatment of anaemia among 2-to-5-year-old children in southern Ethiopia. 24 Also, our sample size calculation based on the EDHS 2011 report since our proposal development and approval was before the release of the 2016 EDHS report. Furthermore, children aged 3–5 years were used for sample size calculation as EDHS was not reporting on the age group 2–5 years.…”

“…23 Sample size and sampling procedure The sample size was calculated using anaemia prevalence because this study was a part of a larger study that aimed to evaluate the efficacy of home-processed amaranth grain containing bread in the treatment of anaemia among 2-to-5-year-old children in southern Ethiopia. 24 Thus, the sample size of 340 was calculated assuming a 33% national average anaemia prevalence among children aged 3-5 years, 17 95% confidence level and ±5% margin of error. A post hoc sample size calculation done for this study was 281 assuming a 24% CAS prevalence, 95% confidence level and ±5% margin of error.…”

Iron deficiency anemia among children aged 2–5 years in southern Ethiopia: a community-based cross-sectional study

“…This cross sectional study is a part of a larger study that aimed to evaluate the efficacy of home processed amaranth grain containing bread in the treatment of anemia among 2–5 year-old children in southern Ethiopia ( Orsango et al, 2020 ). Thus, the Cheffe Cote Jebessa Kebele was purposively selected because amaranth grain grows as a wild crop in the village.…”

“…Thus, the Cheffe Cote Jebessa Kebele was purposively selected because amaranth grain grows as a wild crop in the village. The plant amaranth was used to prepare an alternative plant-based iron-rich food that is easily accessible and acceptable for children ( Orsango et al, 2020 ; Zebdewos et al, 2015 ). The study area is located in a semi-urban part of Hawassa city in southern Nations Nationalities Peoples Regional state, 273 km south of Addis Ababa, the capital city of Ethiopia.…”