Enhancing Hemoglobin Levels in Moderately Acute Malnourished Children Aged 6-59 Months: A Randomized Controlled Trial of a Novel Ready-to-Use Food (RUF).

Iron deficiency anemia among children with moderate acute malnutrition (MAM) presents a significant challenge that can negatively impact treatment outcomes. This burden and its contributing factors among children with MAM in Tanzania prompted the current study, which aimed to assess the efficacy of ready-to-use food (RUF) supplements in increasing hemoglobin levels specifically among children with MAM aged 6-59 months. A total of 271 children (RUF: 91; CSB+: 90; standard of care: 90) recruited for the study, and the randomized controlled trial employed a three-parallel-arm design; the first arm received corn soy blend plus (CSB+) with infant and young child feeding (IYCF) counseling, the second arm received RUF and IYCF counseling, and the third arm served as a control group. The intervention was administered over 3 months, following the WHO guidelines for intervention studies. Results indicated a mean increase of 2.70 g/dL in mean hemoglobin (Hb) concentration (at p ≤ 0.01) among the RUF intervention arm. Similarly, the CSB arm showed an increase in mean Hb concentration from 9.88 g/dL to 11.88 g/dL (p ≤ 0.01). In contrast, the standard of care arm experienced a decrease in mean Hb levels by 0.25 g/dL (p  >  0.05) at the end line. Additionally, the prevalence of anemia was significantly reduced from 65.90% to 27.20% at baseline and at the end of the study, respectively, with a notably lower prevalence of 14.3% in the RUF arm as compared to the standard of care arm of 44%. The study provides strong evidence that RUF is efficacious in improving Hb concentration, a key biomarker for nutritional anemia among children with MAM, and successfully reduces the prevalence of anemia.