(OR02-01-26) UNIMMAP-MMS and IFA With 30 mg Fe Did Not Differ Significantly From Each Other in Improving Hb and Ferritin Among WRA, SOMALI REGION, Ethiopia: Double-Blind, Controlled Trial

Objectives: This trial aimed to assess the effectiveness of UNIMMAP-Multiple Micronutrient Supplement (UNIMMAP-MMS) and iron-folic acid (IFA) in enhancing hemoglobin (Hb) concentration and ferritin among WRA.

Methods: This double-blind, placebo-controlled trial included 171 non-pregnant women (18-49 years old) previously identified as being mildly and moderately anemic. These women of reproductive age (WRA) were individually randomized to Control (inactive anhydrous lactose), UNIMMAP-MMS, or IFA trial arms. Both UNIMMAP-MMS and IFA contained 30 mg of iron. The research team delivered and recorded consumption of each supplement or placebo twice per week. Venous blood samples were collected to assess Hb and ferritin at the end of the 17-week intervention. Hb was adjusted for altitude, and ferritin was adjusted for inflammation using the BRINDA equation. Hb analysis included 56 in the control arm, 54 in the MMS arm, and 61 in the IFA arm. Ferritin analyses included 47 in the control arm, 40 in the UNIMMAP-MMS arm, and 52 in the IFA arm. Stata v. 16.1 was used for statistical analysis with the ANCOVA model.

Results: Adjusted mean Hb concentration after 17 weeks of supplementation twice a week with a placebo was 10.33 g/dL in the control arm. In the IFA arm, mean Hb was 11.02 g/dL (mean difference 0.69 g/dL, p=0.009) while in the UNIMMAP-MMS arm, mean Hb was 10.83 g/dL (mean difference 0.50 g/dL, p = 0.068). Mean Hb concentrations in the IFA and MMS arms were not different from each other (p = 0.467). Adjusted mean ferritin for the control arm was 18.0 µg/L. In the IFA arm, ferritin was 24.2 µg/L (mean difference 6.2 µg/L, p = 0.097), and in the UNIMMAP-MMS arm, ferritin was 22.3 µg/L (mean difference 4.3 µg/L, p = 0.283). Ferritin concentrations in the IFA and MMS arms also were not different from each other (p = 0.622).

Conclusions: WRA who received 30 mg of iron as IFA showed a significant increase in Hb concentration compared with the control group, while the Hb change shown with UNIMMAP-MMS did not reach significance. Neither IFA nor MMS significantly increased ferritin concentrations compared to control. UNIMMAP-MMS and IFA, both with 30 mg iron and consumed twice per week, did not show significant differences when compared with each other.

Funding Sources: This project was supported by the European Union through the Ethiopian Public Health Institute.