Micronutrient Powders Combined With Malaria Chemoprevention to Improve Anaemia and Cognitive Function in Early Childhood in Mali: A Cluster-Randomised Trial.

Abstract

A cluster-randomised controlled trial was conducted in 60 communities in southern Mali to evaluate the impact of micronutrient powders (MNP) combined with seasonal malaria chemoprevention (SMC) on anaemia (primary endpoint), Plasmodium infection, stunting and cognitive function in children < 5 years. The 60 communities were randomly allocated to the intervention or control arm, and cross-sectional biomedical and cognitive surveys were conducted after 1 and 3 years in a random sample of 3 and 5 years olds (1052 and 1081 children, respectively). All children aged 3-59 m in intervention and control communities received two rounds of SMC each year during the peak malaria season, and in intervention communities, all children aged 6-59 m additionally received 4 months of daily MNP after the peak malaria season. Despite a high baseline prevalence of anaemia and good fidelity to intervention, this trial found no evidence of impact on study outcomes. The prevalence of anaemia was similar in both arms for both age groups after 1 and 3 years of intervention-after 3 years, the prevalence of anaemia amongst 3-year olds was 57.6% in the intervention arm versus 60.1% in the control group (p = 0.352). For 5-year olds, it was 51.3% and 53.0%, respectively (p = 0.607). No effect was observed on stunting or cognitive function either.