Differing growth responses to nutritional supplements in neighboring health districts of Burkina Faso are likely due to benefits of small-quantity lipid-based nutrient supplements (LNS).
<h4>Background</h4>Of two community-based trials among young children in neighboring health districts of Burkina Faso, one found that small-quantity lipid-based nutrient supplements (LNS) increased child growth compared with a non-intervention control group, but zinc supplementation did...
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Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0181770&type=printable |
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| author | Sonja Y Hess Janet M Peerson Elodie Becquey Souheila Abbeddou Césaire T Ouédraogo Jérôme W Somé Elizabeth Yakes Jimenez Jean-Bosco Ouédraogo Stephen A Vosti Noël Rouamba Kenneth H Brown |
| author_facet | Sonja Y Hess Janet M Peerson Elodie Becquey Souheila Abbeddou Césaire T Ouédraogo Jérôme W Somé Elizabeth Yakes Jimenez Jean-Bosco Ouédraogo Stephen A Vosti Noël Rouamba Kenneth H Brown |
| author_sort | Sonja Y Hess |
| collection | DOAJ |
| description | <h4>Background</h4>Of two community-based trials among young children in neighboring health districts of Burkina Faso, one found that small-quantity lipid-based nutrient supplements (LNS) increased child growth compared with a non-intervention control group, but zinc supplementation did not in the second study.<h4>Objectives</h4>We explored whether the disparate growth outcomes were associated with differences in intervention components, household demographic variables, and/or children's morbidity.<h4>Methods</h4>Children in the LNS study received 20g LNS daily containing different amounts of zinc (LNS). Children in the zinc supplementation study received different zinc supplementation regimens (Z-Suppl). Children in both studies were visited weekly for morbidity surveillance. Free malaria and diarrhea treatment was provided by the field worker in the LNS study, and by a village-based community-health worker in the zinc study. Anthropometric assessments were repeated every 13-16 weeks. For the present analyses, study intervals of the two studies were matched by child age and month of enrollment. The changes in length-for-age z-score (LAZ) per interval were compared between LNS and Z-Suppl groups using mixed model ANOVA or ANCOVA. Covariates were added to the model in blocks, and adjusted differences between group means were estimated.<h4>Results</h4>Mean ages at enrollment of LNS (n = 1716) and Z-Suppl (n = 1720) were 9.4±0.4 and 10.1±2.7 months, respectively. The age-adjusted change in mean LAZ per interval declined less with LNS (-0.07±0.44) versus Z-Suppl (-0.21±0.43; p<0.0001). There was a significant group by interval interaction with the greatest difference found in 9-12 month old children (p<0.0001). Adjusting for demographic characteristics and morbidity did not reduce the observed differences by type of intervention, even though the morbidity burden was greater in the LNS group.<h4>Conclusions</h4>Greater average physical growth in children who received LNS could not be explained by known cross-trial differences in baseline characteristics or morbidity burden, implying that the observed difference in growth response was partly due to LNS. |
| format | Article |
| id | doaj-art-edbea9c01860453b8e2a4f96dec43ff1 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
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| spelling | doaj-art-edbea9c01860453b8e2a4f96dec43ff12025-08-20T02:45:24ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01128e018177010.1371/journal.pone.0181770Differing growth responses to nutritional supplements in neighboring health districts of Burkina Faso are likely due to benefits of small-quantity lipid-based nutrient supplements (LNS).Sonja Y HessJanet M PeersonElodie BecqueySouheila AbbeddouCésaire T OuédraogoJérôme W SoméElizabeth Yakes JimenezJean-Bosco OuédraogoStephen A VostiNoël RouambaKenneth H Brown<h4>Background</h4>Of two community-based trials among young children in neighboring health districts of Burkina Faso, one found that small-quantity lipid-based nutrient supplements (LNS) increased child growth compared with a non-intervention control group, but zinc supplementation did not in the second study.<h4>Objectives</h4>We explored whether the disparate growth outcomes were associated with differences in intervention components, household demographic variables, and/or children's morbidity.<h4>Methods</h4>Children in the LNS study received 20g LNS daily containing different amounts of zinc (LNS). Children in the zinc supplementation study received different zinc supplementation regimens (Z-Suppl). Children in both studies were visited weekly for morbidity surveillance. Free malaria and diarrhea treatment was provided by the field worker in the LNS study, and by a village-based community-health worker in the zinc study. Anthropometric assessments were repeated every 13-16 weeks. For the present analyses, study intervals of the two studies were matched by child age and month of enrollment. The changes in length-for-age z-score (LAZ) per interval were compared between LNS and Z-Suppl groups using mixed model ANOVA or ANCOVA. Covariates were added to the model in blocks, and adjusted differences between group means were estimated.<h4>Results</h4>Mean ages at enrollment of LNS (n = 1716) and Z-Suppl (n = 1720) were 9.4±0.4 and 10.1±2.7 months, respectively. The age-adjusted change in mean LAZ per interval declined less with LNS (-0.07±0.44) versus Z-Suppl (-0.21±0.43; p<0.0001). There was a significant group by interval interaction with the greatest difference found in 9-12 month old children (p<0.0001). Adjusting for demographic characteristics and morbidity did not reduce the observed differences by type of intervention, even though the morbidity burden was greater in the LNS group.<h4>Conclusions</h4>Greater average physical growth in children who received LNS could not be explained by known cross-trial differences in baseline characteristics or morbidity burden, implying that the observed difference in growth response was partly due to LNS.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0181770&type=printable |
| spellingShingle | Sonja Y Hess Janet M Peerson Elodie Becquey Souheila Abbeddou Césaire T Ouédraogo Jérôme W Somé Elizabeth Yakes Jimenez Jean-Bosco Ouédraogo Stephen A Vosti Noël Rouamba Kenneth H Brown Differing growth responses to nutritional supplements in neighboring health districts of Burkina Faso are likely due to benefits of small-quantity lipid-based nutrient supplements (LNS). PLoS ONE |
| title | Differing growth responses to nutritional supplements in neighboring health districts of Burkina Faso are likely due to benefits of small-quantity lipid-based nutrient supplements (LNS). |
| title_full | Differing growth responses to nutritional supplements in neighboring health districts of Burkina Faso are likely due to benefits of small-quantity lipid-based nutrient supplements (LNS). |
| title_fullStr | Differing growth responses to nutritional supplements in neighboring health districts of Burkina Faso are likely due to benefits of small-quantity lipid-based nutrient supplements (LNS). |
| title_full_unstemmed | Differing growth responses to nutritional supplements in neighboring health districts of Burkina Faso are likely due to benefits of small-quantity lipid-based nutrient supplements (LNS). |
| title_short | Differing growth responses to nutritional supplements in neighboring health districts of Burkina Faso are likely due to benefits of small-quantity lipid-based nutrient supplements (LNS). |
| title_sort | differing growth responses to nutritional supplements in neighboring health districts of burkina faso are likely due to benefits of small quantity lipid based nutrient supplements lns |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0181770&type=printable |
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