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Background & Objective: Malnutrition is one of the main nutritional problems among children under 5 years especially in developing countries. The effects of malnutrition in this range of age group includes ; disorder of mental and physical growth and development, increase in the morbidity and mortality, decrease of the learning capacity. A detailed epidemiological picture of the prevalent malnutrition status among children under 5 years in different regions of Iran enables health policy makers to identify priorities, establish political commitment and design appropriate interventional programs to prevent and control malnutrition and improve nutritional status of children. To determine the prevalence rate of malnutrition among children under 5 years. Methods: Demographic data, weight and height of 34200 Iranian children between 0-72 months old in 28 provinces of the country in 2005 year based on a cluster sampling were gathered. The subjects' weight and height were measured by trained staff. Prevalence of underweight, stunting, and wasting indicators was determined by measuring the weight and height of subjects in urban and rural areas. EPI6 statistical software, version b6/04, was used for all statistical analyses. Results: 4.7% of the children aged less than five years suffered from stunting (95% CI: 4.5- 4.9%) The prevalence of this type of malnutrition among urban children is significantly less than rural children (95% CI: 3.1- 3.5% and 6.5-7.1% respectively). Meanwhile the prevalence of underweight was 5.2% in the country (95% CI: 5.1-5.4% while the prevalence of this type of malnutrition was significantly less among urban children than those in rural ones. Moreover, the prevalence of wasting was 3.7% (95%CI: 3.5-3.9%) and there was a significant difference in this regard between the urban and rural children. Thus this indicator was significantly higher among urban children than those in rural areas (95%CI: 3.8-4.3% and 3.0-3.5% respectively). Conclusion: The results of the study show that the prevalence of protein-energy malnutrition was low among Iranian children under five years old. In comparison with previous studies, it is felt that there has been a prudent decrease in all malnutrition in all levels. However, there were significant differences in the prevalence of malnutrition in different provinces, which has resulted in the differences in their developmental stages as well. It appears that subjective strategies are required to improve the nutritional and health status among children under five in all provinces.

Background/objectives: Multiple micronutrient supplementation with Sprinkles powder and crushable Foodlets tablets may be effective means of controlling micronutrient deficiencies in infants. Their efficacy has not been tested in countries like Iran where wheat as the staple food may affect nutrient bioavailability. This study aimed to compare the efficacy of Sprinkles, Foodlets and the current supplement (Drops) for improving micronutrient status and growth among Iranian infants., Subjects/methods: Infants of 6-18 months of age, living in an urban district of Iran were randomised to receive daily Sprinkles (n=120), Foodlets (n=121) or Drops (n=121) for 4 months. Haemoglobin (Hb), serum ferritin, serum retinol, serum zinc, 25(OH) D concentration and anthropometry were assessed at baseline and at 4 months., Results: Iron status improved with all treatments. Drops showed significantly greater changes in Hb and serum ferritin, though changes in anaemia prevalence were not different across groups. Infants having Foodlets and Sprinkles had significantly greater reductions in proportion of children with zinc deficiency compared with Drops. No significant differences in treatment effects were observed for mean serum 25(OH) D and retinol, or for growth of infants across groups., Conclusion: The study was the first efficacy trial with Sprinkles and Foodlets in the Middle East where wheat or rice is the principal complementary foods. Differences across treatment groups were largely consistent with supplement micronutrient composition for iron and zinc, with no benefit in this population for serum retinol, 25(OH) D, growth or anthropometric status. The trial identified trade-offs in combining multiple micronutrients in a single delivery mechanism.

Objectives: Iron-deficiency anaemia is a major nutritional problem in Iran. A programme of flour fortification with iron was launched in 2001. A mid-term evaluation was conducted in 2004 to determine the effectiveness and coverage of this programme., Methods: To determine the effectiveness of the program, a field trial was conducted in which blood hemoglobin and ferritin levels were measured in a sample population from Bushehr (intervention) and Fars (control) provinces. The target population was women aged 15-49 years. The coverage of the programme was determined using a cross-sectional study that measured iron content in samples of flour and bread from Bushehr province., Results: Five hundred and sixty-seven and 296 women were studied in the intervention and control provinces, respectively. Women in the intervention province had a lower prevalence of low ferritin levels compared with women in the control province (P=0.04). Women from the two provinces did not differ in terms of haemoglobin levels and iron-deficiency anaemia. The coverage of fortified flour and bread was 100% and 99.7%, respectively., Conclusions: This mid-term evaluation found that the iron fortification programme in Iran has only had a beneficial effect on the prevalence of low ferritin levels. The final evaluation is likely to provide more useful information regarding the effect of this programme on a number of anaemia indicators.

Objective: To determine the reliability and acceptability of the Uniscale., Methods: Two studies were conducted from December 2000 to February 2001 in Iran. In the first study, weights of subjects were obtained using the Uniscale and compared with weights obtained from the currently used scale. The sample comprised pregnant women and children under 5 years old. The main measure was reliability, which was assessed by two indicators: intra-instrument error for each of the two scales, and inter-instrument error. The second study was a descriptive study designed to test providers' perceptions of acceptability of Uniscale measurements., Results: In the first study, a total of 458 subjects participated in the study. Overall, mean values of repeated measurements using each of the scales (intra-instrument error) were not significantly different. There was no significant difference between the weight measurements of the two scales (inter-instrument error) when weighing children, but a significant difference was detected when weighing pregnant women (p < 0.001). In the second study, 54 providers were included. The proportions of providers who recommended use of the Uniscale for children under 2 years, children 2-5 years and pregnant women were 57%, 75% and 80%, respectively., Conclusions: The Uniscale had the same accuracy as the current scale when weighing children. However, for use with adults, we suggest additional studies be conducted with increased training of providers because we found that measurements were influenced by individual variation in use. It is recommended that new versions of mother-child scales be developed that are more user friendly.