Growth and Nutritional Impact of Small Fish Powder Supplementation in Infants

Assessing the Efficacy of Small Fish Powder Supplementation on the Growth of Infants Aged 6-7 Months in Northern Cameroon

This randomized controlled trial evaluated the effectiveness of supplementing the diets of infants aged 6-7 months with small fish powder on growth outcomes in the Garoua 1st Health District, Northern Cameroon. A total of 240 infants were enrolled and randomly assigned to receive either small fish powder or a millet flour control for six months. The primary endpoint was growth effectiveness, defined as achieving a height-for-age Z-score ≥ -1.5 after six months. Secondary outcomes included prevention of acute malnutrition, weight gain, mid-upper arm circumference (MUAC) gain, morbidity frequency, and intervention failure rate. Study procedures comprised weekly ration distribution, anthropometric measurements, hemoglobin and malaria testing, and parental nutritional education. Data were analyzed using SPSS and XLSTAT, with statistical significance set at p < 0.05.

Study Overview

• Status: Completed
• Conditions: Child Malnutrition
• Intervention / Treatment: Dietary supplement: Small Fish Powder; Dietary supplement: Millet Flour

• Study Type: Interventional
• Enrollment (Actual): 240
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Cameroon
  • Garoua, Cameroon
    • Garoua 1 Health District

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Infants aged 6-7 months.
• Families residing in the study area with no plans to relocate during the study period.
• Absence of severe illness at enrollment.

Exclusion Criteria:

• Severe anemia.
• Severe acute malnutrition.
• Clinically defined illness such as dehydration, severe diarrhea, or respiratory disease.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Small Fish Powder	Dietary supplement: Small Fish Powder; Infants aged 6-7 months will receive a daily ration of small fish powder equivalent to ~25 kcal/day, providing approximately 65% of the recommended daily protein intake for children aged 6-24 months. Parents will be instructed on how to incorporate the powder into the child's usual diet. Weekly distribution will occur at the health center, accompanied by monthly nutrition education and biweekly clinical monitoring.; Dietary supplement: Millet Flour; Infants aged 6-7 months will receive a daily ration of millet flour equivalent to ~25 kcal/day, providing approximately 10% of the recommended daily protein intake for children aged 6-24 months. To standardize taste, 3% fish powder will be added. Parents will be instructed on how to incorporate the flour into the child's usual diet. Weekly distribution will occur at the health center, accompanied by monthly nutrition education and biweekly clinical monitoring.
Active Comparator: Millet Flour	Dietary supplement: Small Fish Powder; Infants aged 6-7 months will receive a daily ration of small fish powder equivalent to ~25 kcal/day, providing approximately 65% of the recommended daily protein intake for children aged 6-24 months. Parents will be instructed on how to incorporate the powder into the child's usual diet. Weekly distribution will occur at the health center, accompanied by monthly nutrition education and biweekly clinical monitoring.; Dietary supplement: Millet Flour; Infants aged 6-7 months will receive a daily ration of millet flour equivalent to ~25 kcal/day, providing approximately 10% of the recommended daily protein intake for children aged 6-24 months. To standardize taste, 3% fish powder will be added. Parents will be instructed on how to incorporate the flour into the child's usual diet. Weekly distribution will occur at the health center, accompanied by monthly nutrition education and biweekly clinical monitoring.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Height-for-Age Z-score	Growth effectiveness, defined as the proportion of children achieving a height-for-age Z-score ≥ -1.5 SD after six months of supplementation.	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Weight-for-Height Z-score	Prevention of acute malnutrition, defined as weight-for-height Z-score ≥ -1.5 SD.	6 months
Weight Gain	Mean change in body weight (kg) from baseline to six months.	6 months
Mid-Upper Arm Circumference (MUAC) Gain	Mean change in MUAC (cm) from baseline to six months.	6 months
Morbidity Frequency	Number of morbidity episodes (e.g., diarrhea, respiratory infections, malaria) recorded per child during the six-month intervention period.	6 months
Intervention Failure Rate	Proportion of children failing to achieve growth effectiveness (height-for-age Z-score < -1.5 SD) after six months.	6 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hemoglobin Concentration	Mean change in hemoglobin levels (g/dL) from baseline to six months.	6 months
Malaria Prevalence	Proportion of children testing positive for malaria by rapid diagnostic test (RDT) during follow-up.	6 months

Collaborators and Investigators

• Sponsor: Centre for Food and Nutrition Research, Yaounde
• Collaborators: UNICEF; Ministry of Public Health, Cameroon

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2024
• Primary Completion (Actual): February 1, 2025
• Study Completion (Actual): February 1, 2025

Study Registration Dates

• First Submitted: August 26, 2026
• First Submitted That Met QC Criteria: August 26, 2026
• First Posted (Actual): August 31, 2026

Study Record Updates

• Last Update Posted (Actual): August 31, 2026
• Last Update Submitted That Met QC Criteria: August 26, 2026
• Last Verified: August 1, 2026

More Information

Terms related to this study

• Keywords: Complementary feeding; Small fish powder; Infant malnutrition; Nutritional effectiveness; Northern Cameroon
• Additional Relevant MeSH Terms: Nutrition Disorders; Nutritional and Metabolic Diseases; Child Nutrition Disorders; Infant Nutrition Disorders
• Other Study ID Numbers: CRASAN-UNICEF2024

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

Baseline Characteristics: Infant age, sex, household sociodemographic data, maternal education, household food security and dietary diversity scores.

Anthropometric Data: Weight, height/length, mid upper arm circumference (MUAC), Derived indices (height for age, weight for age, weight for height Z scores).

Clinical and Laboratory Data: Hemoglobin concentration, Malaria test results, Morbidity episodes (diarrhea, respiratory infections, fever, malaria).

Dietary Intake Data: 24 hour dietary recall, Weekly food frequency data, Product consumption records (amount of small fish powder or millet flour consumed, adherence, unused product returned).

Follow up Data: Longitudinal measurements at enrollment, 2 months, 4 months, and 6 months, Survival analysis endpoints (growth recovery vs. non recovery).

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No