Poster Topical Area: Global Nutrition
Location: Hall D
Poster Board Number: 585
There is growing interest in assessing the impact on nutrition of integrated health, nutrition and agriculture interventions at community level in high-risk populations.
Objective: To evaluate the impact of an integrated intervention on iron status in rural women and young children.
Methods: 259 families with an index woman (pregnant or with a child ≤12 m of age), were recruited from rural municipalities of San Pablo Jocopilas (SPJ) and Santo Tomas La Unión (STU), Suchitepéquez, South West, low lands of Guatemala. This was a 30-month follow up non-blinded randomized controlled community trial. Basic intervention package for both communities included intensive health/nutrition education and home gardens extension services. Intervention community (SPJ) received support to raise animals (rabbits or chicken). Baseline (BL), follow up (FU) and final (F) assessments included anthropometrics, diet by 24hr recalls and hemoglobin (Hb) (HemoCue). INCAP´s IRB approved the study.
Results: At BL, children of both communities were comparable in age, anthropometrics (N= 191, short stature 19.5% vs 24%, ), mean Hb and anemia rates (AR). AR for children, 46.2% vs 41.1% (p>0.05); and women, 7.7 % vs 9.3% (p>0.05).
Follow up and F (mean FU, 28.6+4.8 months): Children: mean (CI 95%) Hb (g/dL) pairwise comparisons between BL vs 20 m follow up (SPJ, 1.4 g/dL, 1.07 – 1.73, p<0.001); for STU, 0.82, 0.53 – 1.10, p<0.001); and BL vs F (SPJ, 1.8, 1.46 – 2.18, p<0.001; for STU, 1.5, 1.17 – 1.84, p<0.001), showed significant increase in both communities. Correspondingly, mean Hb (CI 95%) difference of differences (MDoD) between communities at 20 months follow up was 0.59 g/dL (0.15 – 1.02, p<0.01) in favor of SPJ; however, at F (6 m later), it did not reach significance (0.3 g/dL, -0.18 – 0.80, p>0.05). AR fell to 2.6% (SPJ) vs 2.4% (STU). Women: BL vs F mean Hb increased in both communities, but it was significant only for STU (0.27 vs 0.63g/dL, p<0.01. MDoD in Hb was 0.36g/dL (p=0.07), and AR, 7.1% (SPJ) vs 0% (STU) (p<0.01).
Conclusion: A comprehensive health, nutrition and agriculture intervention was associated with a positive impact in hematological status of children and women in both treatment arms, with the greater impact observed at 20 months follow up. Differential response between treatment arms was time dependent.
Nestlé Foundation, Lausanne, Switzerland.
Maternal and Infant Nutrition Specialist
Instituto de Nutrición de Centro América y Panamá, INCAP
Guatemala City, Guatemala, Guatemala