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J Nutr. 2016 Mar 9. pii: jn225524. [Epub ahead of print]

Lipid-Based Nutrient Supplements Plus Malaria and Diarrhea Treatment Increase Infant Development Scores in a Cluster-Randomized Trial in Burkina Faso.

Author information

1
Departments of Nutrition and elprado@ucdavis.edu.
2
Departments of Nutrition and.
3
Departments of Individual, Family, and Community Education and Family and Community Medicine, University of New Mexico, Albuquerque, NM;
4
Departments of Nutrition and Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest (Health Sciences Research Institute/Western Regional Directorate), Bobo-Dioulasso, Burkina Faso; and.
5
Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest (Health Sciences Research Institute/Western Regional Directorate), Bobo-Dioulasso, Burkina Faso; and.
6
Agricultural and Resource Economics, University of California Davis, Davis, CA;
7
Departments of Nutrition and Bill & Melinda Gates Foundation, Seattle, WA.

Abstract

BACKGROUND:

Adequate nutrition is necessary for the rapid brain development that occurs during infancy.

OBJECTIVES:

We tested the hypothesis that the provision of small-quantity, lipid-based nutrient supplements (SQ-LNSs) plus malaria and diarrhea treatment positively affects infant development. We also tested the effect of various doses of zinc provided in SQ-LNSs or in a tablet.

METHODS:

In a partially masked, cluster-randomized controlled trial, communities in rural Burkina Faso were stratified by selected characteristics and then randomly assigned within strata to the intervention (IC; 25 communities, 2435 children) or the nonintervention (NIC; 9 communities, 785 children) cohorts. IC children were randomly assigned to 4 groups. As secondary outcomes, a subsample of 3 of these 4 groups (n = 747) and of the NIC (n = 376) were assessed for motor, language, and personal-social development at age 18 mo by using the Developmental Milestones Checklist II. The 3 IC groups received 20 g SQ-LNSs/d containing 0 or 10 mg added zinc with a placebo tablet or 20 g SQ-LNSs/d containing 0 mg added zinc with a tablet containing 5 mg Zn. All IC groups received treatment of malaria and diarrhea from age 9 to 18 mo. Data collectors and participants were aware of allocation to the IC or NIC but did not know the particular IC subgroup.

RESULTS:

Children in the IC scored 0.34 (95% CI: 0.21, 0.46), 0.30 (95% CI: 0.15, 0.44), and 0.32 (95% CI: 0.16, 0.48) SDs higher in motor, language, and personal-social development, respectively, than did children in the NIC (All P < 0.001). Children who received different amounts of zinc did not differ significantly in any of the scores. No effect on caregiver-child interaction was found.

CONCLUSION:

In rural Burkina Faso, the provision of SQ-LNSs to infants from age 9 to 18 mo, regardless of added zinc content, plus malaria and diarrhea treatment positively affected motor, language, and personal-social development at age 18 mo. This trial was registered at clinicaltrials.gov as NCT00944281.

KEYWORDS:

diarrhea; infant development; infant nutrition; language development; lipid-based nutrient supplements; malaria; motor development; personal-social development; zinc

PMID:
26962193
DOI:
10.3945/jn.115.225524

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