Effectiveness of multiple micronutrient supplements for supporting adequate hemoglobin, ferritin, and zinc levels among children aged 6–11 months in rural Vietnam: A randomized control trial

Micronutrient deficiencies remain a major public health concern among infants in rural Vietnam. Nutrition during the 6–11-month period, which is characterized by the introduction of complementary feeding, plays a critical role in child development. This study aimed to evaluate effectiveness of a multiple micronutrient supplement, Bibomix, for improving hemoglobin, ferritin, and zinc levels in children aged 6–11 months.

A double-blind, randomized controlled trial was conducted across 10 communes in Quang Xuong District, Thanh Hoa Province, Vietnam. A total of 360 infants were randomly assigned to either an intervention or control group stratified by age and sex. The intervention group received a daily sachet of Bibomix, while the control group received a placebo for 12 months.

After 12 months, the intervention group showed significantly greater improvements than the control group in hemoglobin levels (Mean ± SD: 7.9 ± 7.2 g/L vs. 3.9 ± 1.3 g/L; Difference-in-Differences (DID) = 4.41; p < 0.001), ferritin concentrations (Median [IQR]: 8.5 [1.0–16.6] vs. 5.52 [-7.4–13.4]; DID = 2.97; p = 0.001), and serum zinc levels (Mean ± SD: 1.67 ± 1.33 vs. 1.26 ± 1.47 µmol/L; DID = 0.41; p = 0.008). The intervention also reduced anemia prevalence by 18.4 % (RR = 25.0; 95 % CI: 1.8–333.3) and zinc deficiency by 31.0 % (RR = 7.1; 95 % CI: 3.3–14.3).

The multiple micronutrient supplementation program demonstrated significant efficacy in improving key micronutrient statuses among infants in rural areas. Scaling up this nutritional intervention is recommended for regions with high rates of anemia and micronutrient deficiencies.