Evaluation of Two Community Based Screening Strategies for Severe Acute Malnutrition in Children 6-59 Months in Mirria District, Niger (MàLÉ)

Evaluation of Two Community Based Screening Strategies for Severe Acute Malnutrition in Children Aged 6-59 Months in the Mirria District, Niger

The objective of this study is to determine the efficacity of a community strategy for screening children 06-59 months old for Severe Acute Malnutrition (SAM) conducted by their mothers' compared with a community screening strategy conducted by Community Health Workers.

Study Overview

• Status: Completed
• Conditions: Malnutrition
• Intervention / Treatment: Other: Active comparator: Screening by community health workers; Other: Screening by mothers

• Study Type: Interventional
• Enrollment (Anticipated): 4429
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Niger
  • Zinder
    • Mirria, Zinder, Niger
      • Mirriah health district

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 months to 4 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• children aged 06-59 months at the time of the study
• children who live in a village in the health district participating in the study

Exclusion Criteria:

• children whose legal guardian refuses to participate in the study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Screening by community health workers; One Community Health Worker (CHW) will be trained per village in the comparator arm. The training the CHWs receive will be identical to that delivered in the Community Management of Acute Malnutrition program run by ALIMA/BEFEN (Bien Être de la Femme et l'Enfant Niger) over the last 3 years. This involves 6 hours theoretical training and a practical session in the health centre. CHWs will screen children 06-59 months in their village once a month	Other: Active comparator: Screening by community health workers
Experimental: Screening by mothers; Mothers in the intervention health district will be trained in small womens' groups in their village. Training will have a theoretical component and a practical demonstration component on children in the village During the first baseline door to door mass screening campaign, mothers will also receive individual training on conducting a Mid Upper Arm Circumference (MUAC) classification and looking for pedal oedema. they will receive a brief recap during the three monthly door-to-door mass screening campaigns Mothers will be asked to check their child's MUAC and look for pedal oedema; whenever the child does not seem to be in 'good health' to the mother; whenever the mother feels that the child is 'unwell' or 'sick'; whenever it seems to the mother that her child has lost weight; whenever the mother thinks that it is necessary to do so	Other: Screening by mothers

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The coverage of the therapeutic nutritional program in the control and intervention health districts	Coverage of the the therapeutic nutritional treatment program is defined as the proportion of children 06-59 months with Severe Acute Malnutrition (Mid Upper Arm Circumference <115mm and/or oedema) receiving treatment in the program, amongst the total number of children diagnosed with Severe Acute Malnutrition	12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Malnutrition program data for children referred by community health workers & mothers	Nutritional status at admission (mid upper arm circumference +/- oedema) Type of admission to the programme (out-patient or immediate transfer for in-patient care) Source of reference to the programme (Community Health Worker, Mother, other) Date of discharge from the programme Weight at admission to the programme Discharge criteria (cured, died, failed to attend, non-response to treatment, transfer for in-patient nutrition care, transfer to other health care structures) Number of children screened by mothers confirmed to have SAM at the treatment centre Number of children screened by community health workers confirmed to have SAM at the treatment centre	12 months

Collaborators and Investigators

• Sponsor: Alliance for International Medical Action
• Collaborators: European Commission
• Investigators: Principal Investigator: Nikki BLACKWELL, FCICM, Alliance for International Medical Action; Study Director: Isabelle Defourney, MBBS, Alliance for International Medical Action

Publications and helpful links

General Publications

• Ale FG, Phelan KP, Issa H, Defourny I, Le Duc G, Harczi G, Issaley K, Sayadi S, Ousmane N, Yahaya I, Myatt M, Briend A, Allafort-Duverger T, Shepherd S, Blackwell N. Mothers screening for malnutrition by mid-upper arm circumference is non-inferior to community health workers: results from a large-scale pragmatic trial in rural Niger. Arch Public Health. 2016 Sep 6;74(1):38. doi: 10.1186/s13690-016-0149-5. eCollection 2016. Erratum In: Arch Public Health. 2020 Feb 26;78:17.

Study record dates

Study Major Dates

• Study Start: May 1, 2013
• Primary Completion (Actual): April 1, 2014
• Study Completion (Actual): April 1, 2014

Study Registration Dates

• First Submitted: May 7, 2013
• First Submitted That Met QC Criteria: May 28, 2013
• First Posted (Estimate): May 29, 2013

Study Record Updates

• Last Update Posted (Estimate): July 15, 2014
• Last Update Submitted That Met QC Criteria: July 14, 2014
• Last Verified: July 1, 2014

More Information

Terms related to this study

• Keywords: Screening; Malnutrition; Community Management of Acute Malnutrition
• Additional Relevant MeSH Terms: Nutrition Disorders; Malnutrition; Child Nutrition Disorders; Severe Acute Malnutrition
• Other Study ID Numbers: MUAC À L'ÉCHELLE