Impact of the WHO Recommended Vitamin A Supplementation at Immunisation Contacts
Evaluation of the Impact on Mortality and Morbidity of the WHO Recommended Vitamin A Supplementation at First Immunisation Contact After 6 Months of Age
High-dose vitamin A to children above 6 months of age reduces all-cause mortality by 23-30%. The WHO recommends vitamin A supplementation (VAS) with the first vaccine after 6 months of age. However, the effect of providing VAS with vaccines has never been investigated. We have hypothesised that the effect of VAS depends on the immune stimulus at the time of supplementation. Hence, the effect might vary depending on which type of vaccine it is given with. In particular, we hypothesised that VAS might be beneficial when given with measles vaccine but not when given with DTP vaccine. Normally the first vaccine after 6 months of age would be a measles vaccine, but many children come late for their DTP vaccinations and receive DTP alone or together with measles vaccine. Hence, it is important to study whether the effect of VAS is the same irrespective of the vaccine(s) administered at the same time.
Guinea-Bissau has not yet implemented the WHO vitamin A policy of providing VAS with vaccines, but plans to do so within the next years. Together with the Ministry of Health in Guinea-Bissau, the Bandim Health Project (BHP) in Guinea-Bissau will investigate the effect on mortality and morbidity of implementing the WHO vitamin A policy in Guinea-Bissau. This will be done in a large randomised trial.
BHP has a demographic surveillance system (DSS) which has followed a population of now more than 150,000 individuals for almost 30 years. Children will be randomised to receive VAS or placebo with their first vaccine after 6 months of age, and will be followed through the DSS to assess mortality and morbidity. Based on previous observations, the effects of VAS might differ according to sex and season. The interaction between VAS, sex, and season will also be studied in the present trial. By identifying situations where VAS may be beneficial, ineffective, or even harmful the study may contribute importantly to optimising the VAS policy for low-income countries.
Studieoversigt
Undersøgelsestype
Tilmelding (Forventet)
Fase
- Fase 4
Kontakter og lokationer
Studiesteder
-
-
-
Bissau, Guinea-Bissau
- Bandim Health Project, Apartado 861
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Urban area: 6-17-month-old children, presenting for vaccination at a health centre in the study area.
- Rural area: 6-23-month-old children who are missing one or more routine vaccinations when visited by our mobile team.
Exclusion Criteria:
- Normally applied contraindications for receiving vaccinations, including high fever.
- VAS within last month.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Forebyggelse
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Firedobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Placebo komparator: 2
Placebo
|
The effect of vitamin A given with different vaccines will be studied
|
|
Aktiv komparator: 1
Vitamin A supplementation
|
The effect of vitamin A given with different vaccines will be studied
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Mortality, morbidity
Tidsramme: 1 year
|
1 year
|
Sekundære resultatmål
Resultatmål |
|---|
|
Growth, Vitamin A status, Immunology
|
Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Ledende efterforsker: Christine S Benn, MD, PhD, Bandim Health Project, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark
- Studieleder: Peter Aaby, Dr.Med., Bandim Health Project, Apartado 861, 1004 Bissau Codex, Guinea-Bissau
Publikationer og nyttige links
Generelle publikationer
- Fisker AB, Bale C, Rodrigues A, Balde I, Fernandes M, Jorgensen MJ, Danneskiold-Samsoe N, Hornshoj L, Rasmussen J, Christensen ED, Bibby BM, Aaby P, Benn CS. High-dose vitamin A with vaccination after 6 months of age: a randomized trial. Pediatrics. 2014 Sep;134(3):e739-48. doi: 10.1542/peds.2014-0550.
- Fisker AB, Bale C, Jorgensen MJ, Balde I, Hornshoj L, Bibby BM, Aaby P, Benn CS. High-dose vitamin A supplementation administered with vaccinations after 6 months of age: sex-differential adverse reactions and morbidity. Vaccine. 2013 Jun 28;31(31):3191-8. doi: 10.1016/j.vaccine.2013.04.072. Epub 2013 May 14.
- Danneskiold-Samsoe N, Fisker AB, Jorgensen MJ, Ravn H, Andersen A, Balde ID, Leo-Hansen C, Rodrigues A, Aaby P, Benn CS. Determinants of vitamin a deficiency in children between 6 months and 2 years of age in Guinea-Bissau. BMC Public Health. 2013 Feb 25;13:172. doi: 10.1186/1471-2458-13-172.
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Forventet)
Studieafslutning (Forventet)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- CVK-2006-7041-99
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
produkt fremstillet i og eksporteret fra U.S.A.
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med Vitamin A
-
Ohio State University Comprehensive Cancer CenterAktiv, ikke rekrutterendeAllogen hæmatopoietisk stamcelletransplantationsmodtagerForenede Stater
-
Institut de Recherche pour le DeveloppementUniversity of Copenhagen; Thrasher Research Fund; National Institute of Nutrition...AfsluttetSunde kvinder, der føder singleton spædbørnVietnam
-
Sheba Medical CenterIkke rekrutterer endnuForholdet mellem oral administration af vitamin A og forekomsten af BPD hos præmature spædbørn født før uge 29 af graviditeten
-
Tehran University of Medical SciencesUkendtÅreforkalkningIran, Islamisk Republik
-
Instituto Materno Infantil Prof. Fernando FigueiraAfsluttetA-vitamin mangel | HypovitaminoseBrasilien
-
Shiraz University of Medical SciencesIkke rekrutterer endnu
-
Harvard School of Public Health (HSPH)Muhimbili University of Health and Allied SciencesAfsluttetMødre og børns sundhedsresultaterForenede Stater
-
Medical Research Council, South AfricaUniversity of Wisconsin, Madison; International Atomic Energy AgencyAfsluttetHypervitaminose ASydafrika
-
University of Wisconsin, MadisonNational Institute of Health Research and Development, Ministry of Health...AfsluttetA-vitamin mangelForenede Stater, Indonesien
-
Centre for Food and Nutrition Research, YaoundeInternational Atomic Energy AgencyAfsluttet