Treatment of anemia with microencapsulated ferrous fumarate plus ascorbic acid supplied as sprinkles to complementary (weaning) foods

Background: Standard therapy for anemia in infants is ferrous sulfate drops administered 3 times/d. Adherence to treatment, however, is often poor. On e likely reason for poor adherence is the unpleasant side effects associate d with drops. Objective: The objective was to evaluate the use of a new form of iron and a delivery system to treat anemia in infants that is likely to produce bett er adherence to treatment. Design: Using a prospective, randomized, controlled design, we studied 557 anemic children aged 6-18 mo (hemoglobin: 70-99 g/L) in rural Ghana. One gr oup received a daily sachet of microencapsulated ferrous fumarate (80 mg el emental Fe) in powder form plus ascorbic acid to be sprinkled onto any comp lementary food eaten (sprinkles group); a control group received ferrous su lfate drops 3 times/d for 2 mo (total dose: 40 mg elemental Fe). Hemoglobin and serum ferritin concentrations were measured at baseline and at the end of treatment. Results: Successful treatment of anemia (hemoglobin > 100 g/L) occurred in 58% of the sprinkles croup and in 56% of the drops group, with minimal side effects in both groups. Geometric mean ferritin concentrations increased s ignificantly in each group from baseline to the end of treatment (P < 0.001 ). Conclusion: Use of ferrous sulfate drops or a single daily dose of microenc apsulated ferrous fumarate sprinkles plus ascorbic acid resulted in a simil ar rate of successful treatment of anemia without side effects. To our know ledge, this is the first demonstration of the use of microencapsulated iron sprinkles to treat anemia. Improved ease of use may favor the use of sprin kles to deliver iron.