Effect of routine prophylactic supplementation with iron and folic acid on preschool child mortality in southern Nepal: community-based, cluster-randomised, placebo-controlled trial

Study answer

What this study found

Daily iron plus folic acid, with or without zinc, did not reduce all-cause mortality versus placebo. All-cause mortality was similar across groups: HR 1.03 (95% CI 0.78 to 1.37) for iron plus folic acid and HR 1.00 (95% CI 0.74 to 1.34) for iron plus folic acid plus zinc. Neither regimen significantly reduced diarrhoea, dysentery, or acute lower respiratory infection, although effect estimates were generally in a protective direction. Iron status improved: haemoglobin increased by 0.71 g/L with iron plus folic acid and 0.59 g/L with iron plus folic acid plus zinc, and iron-deficiency anaemia…

Study & population

Community-based, cluster-randomized, placebo-controlled trial in the southern plains of Nepal.

Intervention

Children were assigned to daily oral dispersible tablets containing iron 12.5 mg and folic acid 50 g, given either without zinc or with added zinc, and supplementation continued until age 36 months.

Key limitation

Clinical event counts were modest for several outcomes, and morbidity analyses were based on subsamples rather than the full cohort.

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Original abstract