Strengths and Limitations
inflammation, anemia
INFLAMMATION, ANEMIA
The strength of this study is that it is a community-based clinical trial that was successfully completed. There was an uninterrupted supply of MNP to the study participants. The intervention consisted of locally produced nutritional supplements that met the required international standard for MNP. No issue in compliance was reported, resulting in no loss to follow-up over the study course. We also assessed inflammation status among the study participants to ensure that the assessed levels of the micronutrients reflect the actual nutritional status rather than an altered response to inflammation. Limitations of this study include the following: The gold standard in interventional research, random allocation, was not adopted. Nonetheless, distinct regions of the communities were used to prevent contamination between the intervention and control arms of the trial. Sharing of supplements and food is a common practice in local communities; however, MNP intake was closely monitored by Lady Health Workers (LHW), which ensured that the supplements were consumed by the study participant. Dietary assessment was conducted using a single 24 h dietary recall, which may not reflect the usual micronutrient intake of the children. However, the intent was to evaluate average group-level intake. According to the WHO recommendations for assessing the impact of MNP on micronutrient status, it is best to assess the Fe and anemia of the study population, but due to budget limitations, we only assessed anemia. Growth was only measured at two time points; ideally, it would be measured over a period of 3 months to enable consistent changes to be seen. However, due to a lack of resources and sample collection, we were unable to collect growth data over a period of three months.