AnemiaNCT01001871
Treatment of Iron Deficiency Anemia in Malaria Endemic Ghana
A study testing Sprinkles® and vitamin/mineral fortificant without iron in people with Anemia, run by The Hospital for Sick Children at 1 site in Ghana.
Trial summary
Iron deficiency and iron deficiency anemia (IDA) are the most prevalent micronutrient deficiencies on a worldwide basis, especially in developing countries. The impact of severe IDA can have mortal consequences, since without adequate hemoglobin, the brain and body become deprived of oxygen and, if allowed to… Read more about this study
- Who is it for?
- Ages 6 to 24 monthsHealthy volunteers can take part
- Conditions the study is for
- Anemia
- What is being tested?
- Sprinkles® and vitamin/mineral fortificant without iron
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 3,880 participants
- Where
- 1 siteGhana
- Study dates
- Nov 2009to May 2011
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 6 to 24 months
- All sexes
- Healthy volunteers accepted
- Child
Who may be able to join
- Age 6-24 months
- Ingesting weaning food in addition to breastmilk
- Free from malaria or other major illnesses
- Afebrile
- Living in Brong Ahafo Region of Ghana for duration of intervention and follow-up
Who cannot join
- Severe anemia (hemoglobin <70g/L)
- Weight-for-height <-3 z-score(severe wasting)
- Kwashiorkor (defined as evidence of edema)
- Congenital abnormality
- Treatment with iron supplements within the past 6 months
- Presence of any chronic illness
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Seasonal Impact of Iron Fortification on Malaria Incidence in Ghanaian Children
Iron deficiency and iron deficiency anemia (IDA) are the most prevalent micronutrient deficiencies on a worldwide basis, especially in developing countries. The impact of severe IDA can have mortal consequences, since without adequate hemoglobin, the brain and body become deprived of oxygen and, if allowed to continue, death may ensue. It has been shown that iron supplementation in infants and young children can enhance child development, however, it may also result in increased rates of malaria in high burden areas.
The primary objective of this study is to determine the impact of providing encapsulated iron (as a powder added to complementary foods) on the susceptibility to clinical malaria among anemic and non-anemic infants and young children (6-24 months of age) living in a high malaria burden area.
The value of performing this research in Ghana is primarily that malaria and anemia remain the most important causes of death and morbidity.
Read the detailed description
Study Design:
The proposed study is a community-based blinded randomized controlled trial with 2 study arms that will be conducted in two phases:
- Phase I will take place during the dry season (December to April), when malaria transmission rates are lower. Eligible subjects (one per household) will be individually randomized to receive a daily dose of either a powdered vitamin/mineral fortificant containing 12.5 mg of iron (plus ascorbic acid, vitamin A and zinc), or a placebo (containing all micronutrients excluding iron), added to complementary foods, for 5 months.
- Phase II will take place during the wet season (June to October), when malaria transmission rates are higher. Eligible subjects, who did not participate in Phase I, will be individually randomized to one of the two study arms as described above and followed for 5 months.
A dual phase design, with two unique cohorts, was chosen so that preliminary results (at the end of phase 1) could be assessed by an independent Data Safety and Monitoring Committee. It is possible that during the dry season no impact of iron will be detected, while during the wet season, an impact will be observed. With this possible outcome, it is potentially feasible to translate this knowledge into a Ministry of Health Program to only provide iron supplementation (fortification) during the dry months of the year (December to April).
- Conditions
- Anemia
- Being tested
- Sprinkles®, vitamin/mineral fortificant without iron
- Keywords
- Iron deficiency anemia, Sprinkles®, micronutrients, malaria incidence, iron supplement
- Medical subject headings
- Anemia, Anemia, Iron-Deficiency
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Sprinkles®Dietary supplement
powdered vitamin/mineral fortificant WITH iron sprinkled onto food once a day for 5 months
vitamin/mineral fortificant without ironDietary supplement
powdered vitamin/mineral fortificant WITHOUT iron sprinkled onto food once a day for 5 months
| Study group | Role | What they receive |
|---|---|---|
| Vitamin/mineral fortificant with iron | Experimental | Not described Receives: Dietary Supplement: Sprinkles® |
| Vitamin/mineral fortificant without iron | Placebo comparator | Not described Receives: Dietary Supplement: vitamin/mineral fortificant without iron |
What is being measured
The primary outcome is the main question the study is designed to answer.
incidence of clinical malaria (if fever recorded a blood sample will be taken to determine parasite species and count)
Measured: 5 months
Secondary outcomes (8)
changes in anemia status (blood levels of: haemoglobin(Hb) , ferritin (SF))
Measured: 5 months
severity of clinical malaria (blood parasite count)
Measured: 5 months
cerebral malaria (defined by a parasite count >5000/μL blood and a concurrent score of <2 on the Blantyre coma scale, with or without convulsions)
Measured: 5 months
hospitalization (documentation of hospitalization for any reason)
Measured: 5 months
death
Measured: 5 months
pneumonia (defined by the presence of a cough or breathing difficulties, tachypnea, lower chest wall indrawing, and the appearance of consolidation or pleural effusion on a chest X-ray)
Measured: 5 months
diarrhea (defined by >3 loose or watery stools in the previous 24 hours)
Measured: 5 months
dehydration (defined by lethargy, sunken eyes, and decreased skin turgor [>2 seconds for skin to return following a skin pinch])
Measured: 5 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Oct 2009 (estimated)
- Study startNov 2009
- Primary completionOct 2010
- Study completionMay 2011
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for AnemiaStudies of the same condition, open and under way.
- More trials run by The Hospital for Sick ChildrenThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 3,880 participants (actual)
Sponsor and investigators
- Lead sponsor
- The Hospital for Sick Children
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Stanley Zlotkin, The Hospital for Sick Children
- Investigators
- Stanley H Zlotkin, PhD, Principal investigator, The Hospital for Sick Children, Toronto, Canada
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01001871
- Sponsor's protocol ID
- 1000013476
- Status last verified
- Apr 2021
- First submitted
- 21 Oct 2009
- Last updated
- 19 Apr 2021
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Tchum EKY, Koto JE, Kanyoke F, Opoku O, Ussher F, Dassah SD, Amoani B, Tchum SK, Nyarko E. Effect of Iron-Containing Micronutrient Powders on Growth and Malaria-Induced Anaemia Among Preschool Children in Ghana: A Cluster-Randomized, Double-Blind, Placebo-Controlled Trial. medRxiv [Preprint]. 2026 Apr 27:2026.04.24.26351649. doi: 10.64898/2026.04.24.26351649.
PubMed 42094124Tetteh Danquah A, Courtin D, Asamoah Sakyi S, Nakotey GK, Tchum SK, Afriyie Duah N, Lagrave A, Sewor C, Amoani B. HLA-G 14 bp polymorphism: Implications and its associated risk to malaria severity among iron-fortified Ghanaian infants and young children. PLoS One. 2025 Sep 15;20(9):e0322524. doi: 10.1371/journal.pone.0322524. eCollection 2025.
PubMed 40953010Tchum SK, Sakyi SA, Arthur F, Adu B, Abubakar LA, Oppong FB, Dzabeng F, Amoani B, Gyan T, Asante KP. Effect of iron fortification on anaemia and risk of malaria among Ghanaian pre-school children with haemoglobinopathies and different ABO blood groups. BMC Nutr. 2023 Mar 23;9(1):56. doi: 10.1186/s40795-023-00709-w.
PubMed 36959634Tchum SK, Sakyi SA, Adu B, Arthur F, Oppong FB, Dzabeng F, Amoani B, Gyan T, Poku-Asante K. Impact of IgG response to malaria-specific antigens and immunity against malaria in pre-school children in Ghana. A cluster randomized, placebo-controlled trial. PLoS One. 2021 Jul 20;16(7):e0253544. doi: 10.1371/journal.pone.0253544. eCollection 2021.
PubMed 34283841Aimone AM, Brown P, Owusu-Agyei S, Zlotkin SH, Cole DC. Impact of iron fortification on the geospatial patterns of malaria and non-malaria infection risk among young children: a secondary spatial analysis of clinical trial data from Ghana. BMJ Open. 2017 Jun 6;7(5):e013192. doi: 10.1136/bmjopen-2016-013192.
PubMed 28592572Aimone AM, Brown PE, Zlotkin SH, Cole DC, Owusu-Agyei S. Geo-spatial factors associated with infection risk among young children in rural Ghana: a secondary spatial analysis. Malar J. 2016 Jul 8;15:349. doi: 10.1186/s12936-016-1388-1.
PubMed 27391972Zlotkin S, Newton S, Aimone AM, Azindow I, Amenga-Etego S, Tchum K, Mahama E, Thorpe KE, Owusu-Agyei S. Effect of iron fortification on malaria incidence in infants and young children in Ghana: a randomized trial. JAMA. 2013 Sep 4;310(9):938-47. doi: 10.1001/jama.2013.277129.
PubMed 24002280
Study at a glance
From the registry record, last updated by the sponsor on 19 Apr 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Seasonal Impact of Iron Fortification on Malaria Incidence in Ghanaian Children
- ClinicalTrials.gov ID
- NCT01001871
- Acronym / sponsor ID
- 1000013476
- Conditions
- Anemia
- Keywords
- Iron deficiency anemia, Sprinkles®, micronutrients, malaria incidence, iron supplement
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 3,880 participants (actual)
- Lead sponsor
- The Hospital for Sick ChildrenUniversity, hospital or other
- Study start
- Nov 2009 (actual)
- Primary completion
- Oct 2010 (actual)
- Study completion
- May 2011 (actual)
- First posted
- 27 Oct 2009 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Iron deficiency and iron deficiency anemia (IDA) are the most prevalent micronutrient deficiencies on a worldwide basis, especially in developing countries. The impact of severe IDA can have mortal consequences, since without adequate hemoglobin, the brain and body become deprived of oxygen and, if allowed to continue, death may ensue. It has been shown that iron supplementation in infants and young children can enhance child development, however, it may also result in increased rates of malaria in high burden areas.
The primary objective of this study is to determine the impact of providing encapsulated iron (as a powder added to complementary foods) on the susceptibility to clinical malaria among anemic and non-anemic infants and young children (6-24 months of age) living in a high malaria burden area.
The value of performing this research in Ghana is primarily that malaria and anemia remain the most important causes of death and morbidity.
Detailed description
Study Design:
The proposed study is a community-based blinded randomized controlled trial with 2 study arms that will be conducted in two phases:
- Phase I will take place during the dry season (December to April), when malaria transmission rates are lower. Eligible subjects (one per household) will be individually randomized to receive a daily dose of either a powdered vitamin/mineral fortificant containing 12.5 mg of iron (plus ascorbic acid, vitamin A and zinc), or a placebo (containing all micronutrients excluding iron), added to complementary foods, for 5 months.
- Phase II will take place during the wet season (June to October), when malaria transmission rates are higher. Eligible subjects, who did not participate in Phase I, will be individually randomized to one of the two study arms as described above and followed for 5 months.
A dual phase design, with two unique cohorts, was chosen so that preliminary results (at the end of phase 1) could be assessed by an independent Data Safety and Monitoring Committee. It is possible that during the dry season no impact of iron will be detected, while during the wet season, an impact will be observed. With this possible outcome, it is potentially feasible to translate this knowledge into a Ministry of Health Program to only provide iron supplementation (fortification) during the dry months of the year (December to April).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Vitamin/mineral fortificant with iron | Experimental | Dietary Supplement: Sprinkles® |
| Vitamin/mineral fortificant without iron | Placebo comparator | Dietary Supplement: vitamin/mineral fortificant without iron |
Who may qualify
- Ages
- 6 to 24 months
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child
Key inclusion criteria (5 listed)
- Age 6-24 months
- Ingesting weaning food in addition to breastmilk
- Free from malaria or other major illnesses
- Afebrile
- Living in Brong Ahafo Region of Ghana for duration of intervention and follow-up
Key exclusion criteria (6 listed)
- Severe anemia (hemoglobin <70g/L)
- Weight-for-height <-3 z-score(severe wasting)
- Kwashiorkor (defined as evidence of edema)
- Congenital abnormality
- Treatment with iron supplements within the past 6 months
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Sprinkles®powdered vitamin/mineral fortificant WITH iron sprinkled onto food once a day for 5 months | Dietary supplement | Vitamin/mineral fortificant with iron |
| vitamin/mineral fortificant without ironpowdered vitamin/mineral fortificant WITHOUT iron sprinkled onto food once a day for 5 months | Dietary supplement | Vitamin/mineral fortificant without iron |
Primary outcome
incidence of clinical malaria (if fever recorded a blood sample will be taken to determine parasite species and count)
Time frame: 5 months
8 secondary outcomes
changes in anemia status (blood levels of: haemoglobin(Hb) , ferritin (SF))
Time frame: 5 months
severity of clinical malaria (blood parasite count)
Time frame: 5 months
cerebral malaria (defined by a parasite count >5000/μL blood and a concurrent score of <2 on the Blantyre coma scale, with or without convulsions)
Time frame: 5 months
hospitalization (documentation of hospitalization for any reason)
Time frame: 5 months
death
Time frame: 5 months
pneumonia (defined by the presence of a cough or breathing difficulties, tachypnea, lower chest wall indrawing, and the appearance of consolidation or pleural effusion on a chest X-ray)
Time frame: 5 months
diarrhea (defined by >3 loose or watery stools in the previous 24 hours)
Time frame: 5 months
dehydration (defined by lethargy, sunken eyes, and decreased skin turgor [>2 seconds for skin to return following a skin pinch])
Time frame: 5 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Apr 2021.
- Derived from this study: PubMed 42094124Tchum EKY, Koto JE, Kanyoke F, Opoku O, Ussher F, Dassah SD, Amoani B, Tchum SK, Nyarko E. Effect of Iron-Containing Micronutrient Powders on Growth and Malaria-Induced Anaemia Among Preschool Children in Ghana: A Cluster-Randomized, Double-Blind, Placebo-Controlled Trial. medRxiv [Preprint]. 2026 Apr 27:2026.04.24.26351649. doi: 10.64898/2026.04.24.26351649.
- Derived from this study: PubMed 40953010Tetteh Danquah A, Courtin D, Asamoah Sakyi S, Nakotey GK, Tchum SK, Afriyie Duah N, Lagrave A, Sewor C, Amoani B. HLA-G 14 bp polymorphism: Implications and its associated risk to malaria severity among iron-fortified Ghanaian infants and young children. PLoS One. 2025 Sep 15;20(9):e0322524. doi: 10.1371/journal.pone.0322524. eCollection 2025.
- Derived from this study: PubMed 36959634Tchum SK, Sakyi SA, Arthur F, Adu B, Abubakar LA, Oppong FB, Dzabeng F, Amoani B, Gyan T, Asante KP. Effect of iron fortification on anaemia and risk of malaria among Ghanaian pre-school children with haemoglobinopathies and different ABO blood groups. BMC Nutr. 2023 Mar 23;9(1):56. doi: 10.1186/s40795-023-00709-w.
- Derived from this study: PubMed 34283841Tchum SK, Sakyi SA, Adu B, Arthur F, Oppong FB, Dzabeng F, Amoani B, Gyan T, Poku-Asante K. Impact of IgG response to malaria-specific antigens and immunity against malaria in pre-school children in Ghana. A cluster randomized, placebo-controlled trial. PLoS One. 2021 Jul 20;16(7):e0253544. doi: 10.1371/journal.pone.0253544. eCollection 2021.
- Derived from this study: PubMed 28592572Aimone AM, Brown P, Owusu-Agyei S, Zlotkin SH, Cole DC. Impact of iron fortification on the geospatial patterns of malaria and non-malaria infection risk among young children: a secondary spatial analysis of clinical trial data from Ghana. BMJ Open. 2017 Jun 6;7(5):e013192. doi: 10.1136/bmjopen-2016-013192.
- Derived from this study: PubMed 27391972Aimone AM, Brown PE, Zlotkin SH, Cole DC, Owusu-Agyei S. Geo-spatial factors associated with infection risk among young children in rural Ghana: a secondary spatial analysis. Malar J. 2016 Jul 8;15:349. doi: 10.1186/s12936-016-1388-1.
- Derived from this study: PubMed 24002280Zlotkin S, Newton S, Aimone AM, Azindow I, Amenga-Etego S, Tchum K, Mahama E, Thorpe KE, Owusu-Agyei S. Effect of iron fortification on malaria incidence in infants and young children in Ghana: a randomized trial. JAMA. 2013 Sep 4;310(9):938-47. doi: 10.1001/jama.2013.277129.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Stanley H Zlotkin, PhD principal investigator
The Hospital for Sick Children, Toronto, Canada
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Sprinkles® and vitamin/mineral fortificant without iron in people with Anemia, run by The Hospital for Sick Children at 1 site in Ghana.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 19 Apr 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Ghana. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
incidence of clinical malaria (if fever recorded a blood sample will be taken to determine parasite species and count) (time frame: 5 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01001871, which also lists 7 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Apr 2021.