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Effectiveness of Selling Micronutrient Sprinkles in Rural Kenya (NICHE)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01088958
Recruitment Status : Completed
First Posted : March 18, 2010
Last Update Posted : July 30, 2015
Safe Water and AIDS Project
Kenya Medical Research Institute
Global Alliance for Improved Nutrition
Information provided by (Responsible Party):
Centers for Disease Control and Prevention

Brief Summary:
The purpose of the study is to evaluate the effectiveness of household-based distribution of evidence-based health products and to measure the health impact of these combined interventions on a population basis.

Condition or disease Intervention/treatment Phase
Anemia, Iron-deficiency Dietary Supplement: Micronutrient powders (Sprinkles) Phase 4

Detailed Description:

Nyanza Province has the highest mortality rates for infants and children under 5 years of age and the highest HIV prevalence rates in Kenya. Burden of disease in western Kenya is further characterized by endemic malaria transmission, diarrheal diseases due to poor access to safe water, and iron deficiency anemia (IDA) in over 60% of children. Access to health interventions in rural Nyanza Province is poor due to limited transportation and communication infrastructure. Delivery of household-based interventions through local institutions offers the potential for increased utilization and improved health outcomes in rural areas. The Centers for Disease Control and Prevention (CDC) in partnership with the Rotary-supported Safe Water and AIDS Project (SWAP), initiated a program in 2007 that combines household, clinic, school, and local commercial distribution approaches to increase access to various evidence-based health products (WaterGuard(TM) and PuR(TM) water disinfectant products, water storage containers, soap, insecticide treated bednets, micronutrient Sprinkles(TM), and albendazole) and measures the health impact of these combined interventions on a population basis.

Evaluation of the intervention will take place over 36 months and will include: 1) baseline and follow-up cross sectional surveys among households in communities visited by SWAP for purchase of products; 2) active household surveillance of diarrhea, febrile illness and Sprinkles(TM) usage; 3) testing of hemoglobin and iron status and anthropometry measurement among children aged 6-35 months; 4) focus groups and targeted interviews to assess the acceptability of health products; and 5) other program evaluation methods.

During the baseline and follow-up surveys, demographic information, water, sanitation, hygiene, and health information, dietary intake history, and other data will be collected by questionnaire. A blood specimen collected by fingerstick will be used to test for hemoglobin concentration, malaria parasitemia, and iron status. Follow-up surveys 12 and 24 months after baseline data collection will include collection of similar data to assess the effectiveness of product distribution. Anthropometry will be measured at baseline, 12, and 24 months. Qualitative information on user preferences will be obtained using ongoing focus groups, observations and targeted interviews. The results of these evaluations will be published in reports distributed to SWAP, the Kenyan government, and local NGO's and in peer-reviewed journals.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 7200 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Diarrhea, Malaria, Anemia, and Helminthiasis Prevention Through Household-based Interventions in Rural Western Kenya: the Nyando Integrated Child Health and Education (NICHE) Project
Study Start Date : January 2007
Actual Primary Completion Date : January 2012
Actual Study Completion Date : September 2014

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Anemia Iron

Arm Intervention/treatment
Experimental: Micronutrient Sprinkles
Sales of Sprinkles in these groups of villages by community vendors
Dietary Supplement: Micronutrient powders (Sprinkles)

Sprinkles were developed in 1996 by Stanley Zlotkin's research group at the Hospital for Sick Children, University of Toronto as a novel approach for delivering iron and other micronutrients. They come in 1g sachets of dry powder that is then added to any home-prepared semi-solid food, intended for daily consumption by children aged 6-59 months. Formulation includes:

Iron (Ferrous fumarate) 12.5 mg, Folic acid 150 µg, Vitamin A 375 µg, Vitamin C 35 mg, Zinc 5 mg, Vitamin B1 0.5 mg, Vitamin B2 0.5 mg, Vitamin B6 0.5 mg, Vitamin B12 0.9 µg, Vitamin D3 5 µg, Vitamin E 6.0 mg, Niacin 6.0 mg, Copper 0.6 mg, Iodine 50 µg

Primary Outcome Measures :
  1. Product sales and use (coverage) [ Time Frame: Every 2 weeks ]
    Biweekly household visits of selected cohort take place to assess purchases and use of health products and self reported morbidity outcomes. Household visits started at enrollment and continued throughout 2-year study period.

Secondary Outcome Measures :
  1. Prevalence of anemia [ Time Frame: Baseline and 12 and 24-month follow-up surveys ]
  2. Prevalence of iron deficiency [ Time Frame: Baseline and 12 and 24-month follow-up surveys ]

Information from the National Library of Medicine

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Ages Eligible for Study:   6 Months to 3 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Age 6-36 months at the time of enrollment
  • Live within the study area for the duration of the intervention and follow-up period

Exclusion Criteria:

  • Unavailable for enrollment on 3 separate household visits
  • Parental refusal to give informed consent

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01088958

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CDC/Kenya Medical Research Institute
Kisumu, Kenya
Sponsors and Collaborators
Centers for Disease Control and Prevention
Safe Water and AIDS Project
Kenya Medical Research Institute
Global Alliance for Improved Nutrition
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Principal Investigator: Parminder S Suchdev, MD MPH Centers for Disease Control and Prevention
Additional Information:
Publications of Results:
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Centers for Disease Control and Prevention Identifier: NCT01088958    
Other Study ID Numbers: CDC-NCEZID-5039
First Posted: March 18, 2010    Key Record Dates
Last Update Posted: July 30, 2015
Last Verified: July 2015
Keywords provided by Centers for Disease Control and Prevention:
Child Nutrition Disorders
Social marketing
Additional relevant MeSH terms:
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Anemia, Iron-Deficiency
Hematologic Diseases
Anemia, Hypochromic
Iron Metabolism Disorders
Metabolic Diseases
Trace Elements
Growth Substances
Physiological Effects of Drugs