Prenatal Iron and Malaria Study (PIMAL)
28. maj 2013 opdateret af: London School of Hygiene and Tropical Medicine
A Randomised Trial to Assess the Safety and Efficacy or Iron Supplementation in Kenyan Pregnant Women
The purpose of this study is to compare the presence of Plasmodium infection in parturient women who antenatally received a combination of iron-fortified foods with iron supplements versus iron-fortified foods only.
Studieoversigt
Detaljeret beskrivelse
As per recommendations by the World Health Organization (WHO), iron supplementation in children should be restricted in malaria-endemic areas because of concerns that it can lead to an increased burden of malaria.
Universal iron supplementation continues to be recommended, however, for women during pregnancy and 3 months postpartum.
Observational studies have shown that iron deficiency in parturient women is associated with a marked reduction in the prevalence and density of malarial parasites in the placenta.
Plasmodium infections in pregnant women have devastating effects on the foetus and neonate, causing low birth weight, intrauterine growth retardation, preterm delivery, spontaneous abortion, stillbirth and neonatal mortality.
Based on our previous work, the Kenyan government is currently drafting legislation for mandatory iron fortification of industrially milled flour.
Implementation of the new fortification policy means that pregnant women will receive iron through a combination of fortified foods and supplementation.
The investigators are concerned about the safety of the high iron intake resulting from such a policy.
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
470
Fase
- Fase 4
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
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Nairobi, Kenya
- University of Nairobi
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
15 år til 45 år (Barn, Voksen)
Tager imod sunde frivillige
Ja
Køn, der er berettiget til at studere
Kvinde
Beskrivelse
Inclusion Criteria:
- Women aged 15-45 years resident in the predefined study area
- Pregnant, with gestational age <23 weeks
Exclusion Criteria:
- Failure to provide a blood sample
- Initial haemoglobin concentration <90 g/L
- Reported medical history suggestive of sickle cell anaemia, epilepsy, diabetes
- Obstetric history suggestive of eclampsia or pre-eclampsia
- Obvious mental retardation or metabolic disorder;
- No written consent
- Carrying multiples
- Woman planning to leave the homestead or to be absent for prolonged periods in the course of the pregnancy or within a 1-month period thereafter
- Woman planning to deliver outside the research clinic.
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Forebyggelse
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Firedobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
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Placebo komparator: Placebo
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Daily supplementation with iron (60 mg) as ferrous sulphate
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Eksperimentel: Supplemental iron
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Daily supplementation with iron (60 mg) as ferrous sulphate
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Maternal Plasmodium infection
Tidsramme: Parturition
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Assessed by LDH- and HRP2-based dipstick test and PCR
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Parturition
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Serum non-transferrin bound iron concentration
Tidsramme: 3 h after ingestion of first supplement with either iron or placebo
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3 h after ingestion of first supplement with either iron or placebo
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Neonatal iron stores
Tidsramme: At 1 month of age
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Assessed by plasma ferritin concentration, restricted to infants without inflammation
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At 1 month of age
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Maternal iron status
Tidsramme: At 1 month after delivery
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To be assessed by haemoglobin concentrations, prevalence of iron deficiency anaemia (plasma ferritin concentration <12 µg/L) and iron stores (ratio of ferritin:transferrin receptor concentrations); indicators based on ferritin and/or transferrin receptor will be restricted to those without inflammation.
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At 1 month after delivery
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Maternal intestinal pathogens
Tidsramme: At 1 month after delivery
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At 1 month after delivery
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Efterforskere
- Ledende efterforsker: Hans Verhoef, PhD, London School of Hygiene and Tropical Medicine
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Mwangi MN, Roth JM, Smit MR, Trijsburg L, Mwangi AM, Demir AY, Wielders JP, Mens PF, Verweij JJ, Cox SE, Prentice AM, Brouwer ID, Savelkoul HF, Andang'o PE, Verhoef H. Effect of Daily Antenatal Iron Supplementation on Plasmodium Infection in Kenyan Women: A Randomized Clinical Trial. JAMA. 2015 Sep 8;314(10):1009-20. doi: 10.1001/jama.2015.9496.
- Mwangi MN, Maskey S, Andang o PE, Shinali NK, Roth JM, Trijsburg L, Mwangi AM, Zuilhof H, van Lagen B, Savelkoul HF, Demir AY, Verhoef H. Diagnostic utility of zinc protoporphyrin to detect iron deficiency in Kenyan pregnant women. BMC Med. 2014 Nov 26;12:229. doi: 10.1186/s12916-014-0229-8.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart
1. oktober 2011
Primær færdiggørelse (Faktiske)
1. april 2013
Studieafslutning (Faktiske)
1. maj 2013
Datoer for studieregistrering
Først indsendt
2. marts 2011
Først indsendt, der opfyldte QC-kriterier
2. marts 2011
Først opslået (Skøn)
3. marts 2011
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
29. maj 2013
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
28. maj 2013
Sidst verificeret
1. maj 2013
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- LSHTM-5664
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 .