Peer-reviewed article
Micronutrient Powders Combined With Malaria Chemoprevention to Improve Anaemia and Cognitive Function in Early Childhood in Mali: A Cluster-Randomised Trial.
Niélé H Diarra, Yahia Dicko, Natalie Roschnik, Modibo Bamadio, Michael Boivin et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001A large cluster-randomised trial in Mali tested whether giving children micronutrient powders combined with malaria prevention drugs would reduce anaemia and improve cognitive development. Over 2,000 children aged 3-5 years were followed for up to 3 years across 60 communities. Despite good implementation and high rates of anaemia at the start, the intervention showed no benefit for any of the measured outcomes including anaemia, malaria infection, stunting, or thinking skills.
Key points
- Anaemia prevalence remained around 57-60% in 3-year-olds and 51-53% in 5-year-olds in both intervention and control arms after 3 years
- No difference was found between intervention and control groups for Plasmodium infection, stunting, or cognitive function
- The intervention had good fidelity with high compliance rates to both micronutrient powder and seasonal malaria chemoprevention delivery
- Study included 60 communities with cross-sectional surveys at 1 and 3 years measuring 1,052 and 1,081 children respectively
Limitations
The document does not explain why the intervention was ineffective despite good implementation; it does not discuss whether the dose, duration, or combination approach may have been suboptimal, or whether other factors in the setting may have limited impact.
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.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Daily micronutrient powders (4 months after peak malaria season) combined with two rounds of seasonal malaria chemoprevention per year
- Population
- Children aged 6-59 months in intervention communities and children aged 3-59 months receiving malaria chemoprevention in both arms, in southern Mali
Key finding
Anaemia prevalence in 3-year-olds: 57.6% intervention vs 60.1% control after 3 years (p = 0.352)