Different Strategies for Preventing Severe Acute Malnutrition in Niger

Different Strategies for Preventing Severe Acute Malnutrition in Niger: a Pragmatic Trial

Options for large-scale preventive distributions include fortified blended flours, ready-to-use foods and direct cash transfer either alone or in combination with family protective rations. Finding the most appropriate strategy is essential to prevent child malnutrition in countries like Niger with annual hunger gaps. Here, the investigators compare different preventive strategies on the incidence of acute malnutrition among children 6 to 23 months.

Study Overview

• Status: Completed
• Conditions: Malnutrition

• Study Type: Observational
• Enrollment (Actual): 7836

Contacts and Locations

Study Locations

• Niger
  • Maradi
    • Madarounfa, Maradi, Niger
      • Villages

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 months to 2 years (Child)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Children 6 to 24 months

Description

Inclusion Criteria:

• resident in selected villages
• height between 60 and 80 cm.

Exclusion Criteria:

• refusal to participate

Study Plan

How is the study designed?

Number of groups / cohorts

7

Cohorts and Interventions

Group / Cohort
RUSF (500kcal/day) and cash transfer; Monthly distributions of Ready-to-use Supplementary Food (RUSF) 500kcal per day associated with cash transfer during hunger gap (5 months) then RUSF 500kcal/day for 10 months
Super Cereal Plus (SC+); Monthly distributions of SC+ 800kcal per day during hunger gaps (5 months twice) and SC+ 400kcal per day in-between (5 months)
RUSF; Monthly distributions of Ready-to-use Supplementary Food (RUSF) 500kcal per day during hunger gaps (5 months twice) and RUSF 250kcal per day in-between (5 months)
RUSF (250kcal/day) and cash transfer; Monthly distributions of Ready-to-use Supplementary Food (RUSF) 250kcal per day associated with cash transfer during hunger gap (5 months) then RUSF 250kcal/day for 10 months
SC+ and cash transfer; Monthly distributions of Super Cereal Plus (SC+) 800 kcal per day associated with cash transfer during hunger gap (5 months)
SC+ and household ration; Monthly distributions of Super Cereal Plus (SC+) 800 kcal per day associated with food ration for household support during hunger gap (5 months)
Cash transfer; Monthly distributions of cash transfer only during hunger gap (5 months)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of severe acute malnutrition	Severe acute malnutrition was defined as : Weight for Height Z-score (WHO Standards 2006)< -3 and/or mid-upper arm circumference (MUAC) < 115mm and/or bipedal oedema. MUAC was measured at the midpoint of a child's left arm with a plastic measuring tape with a precision of 1 mm. These indicators were evaluated monthly during the entire follow-up (15 months).	15 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mortality	Mortality events include all reports for which the cause for absence from surveillance visits was reported to be death by a family member.	duration of follow-up (15 months)

Collaborators and Investigators

• Sponsor: Epicentre
• Collaborators: United Nations World Food Programme (WFP)
• Investigators: Principal Investigator: Céline Langendorf, MPH, Epicentre

Publications and helpful links

General Publications

• Sayyad-Neerkorn J, Langendorf C, Roederer T, Doyon S, Mamaty AA, Woi-Messe L, Manzo ML, Harouna S, de Pee S, Grais RF. Preventive Effects of Long-Term Supplementation with 2 Nutritious Food Supplements in Young Children in Niger. J Nutr. 2015 Nov;145(11):2596-603. doi: 10.3945/jn.115.213157. Epub 2015 Sep 30.
• Langendorf C, Roederer T, de Pee S, Brown D, Doyon S, Mamaty AA, Toure LW, Manzo ML, Grais RF. Preventing acute malnutrition among young children in crises: a prospective intervention study in Niger. PLoS Med. 2014 Sep 2;11(9):e1001714. doi: 10.1371/journal.pmed.1001714. eCollection 2014 Sep.

Study record dates

Study Major Dates

• Study Start: July 1, 2011
• Primary Completion (Actual): October 1, 2012
• Study Completion (Actual): October 1, 2012

Study Registration Dates

• First Submitted: March 4, 2013
• First Submitted That Met QC Criteria: April 8, 2013
• First Posted (Estimate): April 11, 2013

Study Record Updates

• Last Update Posted (Actual): April 28, 2017
• Last Update Submitted That Met QC Criteria: April 27, 2017
• Last Verified: April 1, 2017

More Information

Terms related to this study

• Keywords: pediatrics; Niger; cash transfer; Ready-to-use Supplementary Food; corn soy blend; prevention of malnutrition
• Additional Relevant MeSH Terms: Nutrition Disorders; Malnutrition; Severe Acute Malnutrition
• Other Study ID Numbers: Epicentre