{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:16:12Z","timestamp":1790378172111,"version":"4.1.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nutr"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Iron deficiency anemia (IDA) remains high in Kenya despite interventions. Twenty-seven percent of children aged 6\u2009months-14\u2009years are anemic, with low iron intake (7%) among children aged 6\u201323\u2009months. Standard food interventions involve a corn soy blend (CSB), which is limited in micronutrients, and fortifiers are not accessible locally. Moreover, the use of spirulina as a strategy for mitigating IDA has not been adequately documented. This study compared the impact of a spirulina corn soy blend (SCSB) on IDA among children aged 6\u201323\u2009months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 240 children with IDA were randomly assigned to study groups at a ratio of 1:1:1 through lotteries, and caregivers and research assistants were blinded to group assignment. Dry-take-home SCSB, CSB and placebo flour (1.7\u2009kg) was given to caregivers to prepare porridges using a flour water ratio of 1:4, producing 600\u2009ml\u2013700\u2009ml of porridge to feed children 200\u2009ml of porridge three times a day for 6 months. Impact was assessed as plasma hematocrit at baseline and after the study. Blood drawing, preparation and analysis were performed in accordance with approved procedures by the EthicsResearchCommittee. Monthly follow-up and data collection on dietary intake, anthropometry, morbidity and infant feeding practices were performed using questionnaires. Relative risk, magnitude of change and log-rank tests were used to compare the impact of the intervention, and significant differences were determined at <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The survival probabilities for children consuming SCSB were significantly higher than those consuming CSB (log-rank-X<jats:sup>2<\/jats:sup>\u2009=\u20090.978; CI: 0.954\u20131.033, <jats:italic>P<\/jats:italic>\u2009=\u20090.001) and the placebo (log-rankX2\u2009=\u20090.971; CI: 0.943\u20130.984, <jats:italic>P<\/jats:italic>\u2009=\u20090.0001). Children consuming SCSB had a mean recovery time of 8\u2009days (CI: 7\u201312\u2009days) compared to those consuming CSB (19\u2009days; CI: 20\u201323\u2009days) and placebo (33\u2009days; CI: 3 1\u201335\u2009days). The recovery rate was 15.4 per 100 persons per day for children who consumed SCSB as opposed to 4.6 and 1.8 per 100 persons per day for those who consumed CSB and the placebo, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Management of IDA with SCSB compared to CSB and the placebo led to faster reversal and large numbers of recoveries from IDA. The recovery rates were above the World Health Organizations (WHO) minimums standards for food interventions. Efforts to realize high and faster recoveries from IDA should be heightened by fortifying CSB with spirulina powder.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40795-021-00472-w","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:02:27Z","timestamp":1636416147000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Impact of Spirulina corn soy blend on Iron deficient children aged 6\u201323\u2009months in Ndhiwa Sub-County Kenya: a randomized controlled trial"],"prefix":"10.1186","volume":"7","author":[{"given":"Dorothy Apondi","family":"Othoo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Ochola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Kuria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Kimiywe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"472_CR1","volume-title":"Knowledge attitude and practice on immunization in Kenya","author":"Ministry of Health","year":"2014","unstructured":"Ministry of Health. Knowledge attitude and practice on immunization in Kenya. Nairobi: Government Press; 2014."},{"key":"472_CR2","volume-title":"Indicators for monitoring maternal dietary intakes in low and medium economies","author":"World Health Organization","year":"2012","unstructured":"World Health Organization (2012). Indicators for monitoring maternal dietary intakes in low and medium economies."},{"key":"472_CR3","unstructured":"National Bureau of Statistics-Kenya and ICF International. 2014KDHS Key Findings. Rockville: KNBS and ICF International; 2015."},{"key":"472_CR4","volume-title":"Immunization coverage and knowledge attitude and practice on vitamin a, iron, folic acid supplement and zinc and ORS in Kenya","author":"Ministry of Health and Micronutrient Initiative","year":"2014","unstructured":"Ministry of Health and Micronutrient Initiative. Immunization coverage and knowledge attitude and practice on vitamin a, iron, folic acid supplement and zinc and ORS in Kenya. Nairobi: Government Press; 2014."},{"key":"472_CR5","volume-title":"Guidelines on nutritional management of moderate acute malnutrition","author":"Ministry of Health","year":"2013","unstructured":"Ministry of Health. Guidelines on nutritional management of moderate acute malnutrition. Nairobi: Government Press; 2013."},{"key":"472_CR6","volume-title":"Recommended composition of cereal blends for complementary feeding","author":"World Food Program","year":"2011","unstructured":"World Food Program. Recommended composition of cereal blends for complementary feeding. England: Workshop Paper for Health Workers; 2011."},{"key":"472_CR7","volume-title":"Integrated Management of Acute Malnutrition","author":"Ministry of Health","year":"2013","unstructured":"Ministry of Health. Integrated Management of Acute Malnutrition. Nairobi: Government Press; 2013."},{"key":"472_CR8","volume-title":"Food and agriculture organization\/government of Kenya (2018). Kenya Food Composition","author":"Ministry of Health","year":"2013","unstructured":"Ministry of Health. Food and agriculture organization\/government of Kenya (2018). Kenya Food Composition. Nairobi: Government Press; 2013."},{"key":"472_CR9","volume-title":"WHO guidelines for assessing dietary intakes of infants on complementary feeding","author":"World Health Organization","year":"2012","unstructured":"World Health Organization. WHO guidelines for assessing dietary intakes of infants on complementary feeding. Geneva: WHO Press, World Health Organization; 2012."},{"key":"472_CR10","volume-title":"Kenya food composition","author":"Food and Agriculture Organization\/Government of Kenya","year":"2018","unstructured":"Food and Agriculture Organization\/Government of Kenya. Kenya food composition. Nairobi: Government Press; 2018."},{"key":"472_CR11","volume-title":"Energy requirements across life cycle","author":"Food and Agriculture Organization","year":"2014","unstructured":"Food and Agriculture Organization. Energy requirements across life cycle. Rome: FAO multimedia Press; 2014."},{"key":"472_CR12","first-page":"110","volume":"54","author":"KG Dewey","year":"2003","unstructured":"Dewey KG, Brown KH. Effects of exclusive breast feeding for four months versus six months on maternal nutrition status and infant motor development. Am J Nutr. 2003;54:110\u201328.","journal-title":"Am J Nutr"},{"key":"472_CR13","volume-title":"Kenya food composition","author":"Food and Agriculture Organization","year":"2018","unstructured":"Food and Agriculture Organization. Kenya food composition. Nairobi: Government Press; 2018."},{"key":"472_CR14","volume-title":"Guidelines on food fortification with micronutrients","author":"World Health Organization & Food and Agriculture Organization of the United Nations","year":"2006","unstructured":"World Health Organization & Food and Agriculture Organization of the United Nations. Guidelines on food fortification with micronutrients. Geneva: WHO Press, World Health Organization; 2006."},{"key":"472_CR15","volume-title":"Infant and Young Child Feeding Indicators","author":"World Health Organization & United Nations Childrens Fund","year":"2008","unstructured":"World Health Organization & United Nations Childrens Fund. Infant and Young Child Feeding Indicators. Geneva: WHO Press, World Health Organization; 2008."},{"key":"472_CR16","volume-title":"WHO guidelines on drawing blood: best practices in phlebotomy","author":"World Health Organization","year":"2010","unstructured":"World Health Organization. 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J Appl Phycol. 1993;5(2):235\u201341.","journal-title":"J Appl Phycol"},{"issue":"6","key":"472_CR35","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1159\/000088889","volume":"49","author":"J Simpore","year":"2005","unstructured":"Simpore J, Zongo F, Kabore F, Dansou D, Bere A, Nikiema JB, et al. Nutrition rehabilitation of HIV-infected and HIV- negative undernourished children utilizing spirulina. Ann Nutr Metab. 2005;49(6):373\u201380. https:\/\/doi.org\/10.1159\/000088889.","journal-title":"Ann Nutr Metab"},{"issue":"6","key":"472_CR36","first-page":"CD009584.pub2","volume":"21","author":"M Lazzereni","year":"2013","unstructured":"Lazzereni M, Rubert L, Pani P. Specially formulated foods for treating children with moderate acute malnutrition in low-and middle income countries. Cochrane Database Syst Rev. 2013;21(6):CD009584.pub2.","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"472_CR37","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1093\/jn\/138.3.593","volume":"138","author":"CA Lin","year":"2008","unstructured":"Lin CA, Manary MJ, Maleta K, Briend A, Ashron P. An energy dense complementary food is associated with modest increase in weight gain when compared with fortified porridge in Malawian children aged 6-18 months. J Nutr. 2008;138(3):539\u20138. https:\/\/doi.org\/10.1093\/jn\/138.3.593.","journal-title":"J Nutr"}],"container-title":["BMC Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40795-021-00472-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40795-021-00472-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40795-021-00472-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:05:07Z","timestamp":1636416307000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcnutr.biomedcentral.com\/articles\/10.1186\/s40795-021-00472-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,9]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["472"],"URL":"https:\/\/doi.org\/10.1186\/s40795-021-00472-w","relation":{},"ISSN":["2055-0928"],"issn-type":[{"value":"2055-0928","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,9]]},"assertion":[{"value":"25 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 September 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval was obtained from Kenyatta National Hospital and University of Nairobi Ethical Committee (Permit number: KNH-ERC\/A\/240; permit extension number: KNH\/ERC\/R\/113) and administrative approval research permit obtained from National Commission for Science, Technology and Innovation (Permit: Number NCST\/RCD\/12A\/012A\/55) Kenya respectively. Research protocol including blood draw, preparation and analysis were done in accordance with approved guidelines and regulations by the Ethics-Research-Committee. Caregivers who were the respondents for primary study participants gave a written informed consent before commencement of data collection.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"70"}}