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Regular Growth Monitoring (RGM) of Young Children in Guinea-Bissau

2026年7月13日 更新者:Susan B. Roberts、Trustees of Dartmouth College

Pilot Study to Assess the Benefits and Sustainability of Regular Growth Monitoring (RGM) of Young Children in Villages in Guinea-Bissau

Wasting (severe thinness) is a common and serious problem among young children in rural Guinea-Bissau. Community Health Agents (CHAs) can help prevent malnutrition by regularly measuring children's growth and advising families on nutritious local foods. However, this practice is not consistently implemented.

This pilot study will test whether implementing Regular Growth Monitoring (RGM) by CHAs every month is feasible and effective in reducing malnutrition among children aged 6 months to 5 years in two rural villages. Investigators will also compare three methods for measuring mid-upper arm circumference (MUAC), which is used to detect malnutrition: the standard WHO tape measure, a photograph of the arm, and a simple bracelet. The goal is to identify which method is easiest for CHAs to use reliably.

Baseline and final measurements will be taken in both villages. One village will receive the monthly RGM intervention first, followed by the second village. Families will also be asked about their experiences with the program through brief questionnaires.

調査の概要

詳細な説明

Wasting is prevalent in rural Guinea-Bissau villages and adversely affects child health and cognitive development long-term. Prior work by this team of investigators suggests that regular feedback from Community Health Agents (CHAs) to caregivers, including recommendations of locally available nutritious recipes for at-risk children, may reduce the incidence of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). However, routine growth monitoring (RGM) has been largely unfeasible at the village level due to measurement complexity and limited training resources. Modern technology and artificial intelligence may help make this more scalable.

This is a proof-of-concept, sequential pilot study conducted in two villages in Guinea-Bissau with which the team has an established relationship. Baseline anthropometric measurements will be collected on all eligible children (aged 6 months to 5 years, without SAM at enrollment) in both villages. Children identified with SAM at baseline will be referred to the local malnutrition clinic and excluded from the study.

One village will begin the RGM intervention immediately after baseline data collection. The second village will begin the intervention after final data collection in the first village. Assignment order will be by PI decision rather than randomization, as required by the collaborating UCSF team members.

During the RGM period, CHAs will screen each child monthly using all three mid-upper arm circumference (MUAC) methods: (1) WHO tape measure (reference standard), (2) arm photograph, and (3) bracelet. Data will be entered into a secure REDCap database. Children meeting SAM criteria (by tape measure) will be referred to tertiary care; children with MAM will receive weekly CHA nutrition education on local recipes. Measurements collected at baseline and end-of-study include: weight, height, MUAC by all three methods, skinfold thicknesses (biceps and triceps), and family demographics.

After study completion, brief questionnaires will be administered to parents, CHAs, and Ministry of Health staff to assess perceived effects, acceptability, feasibility, and preferences among the monitoring methods. This study has been approved by both the Dartmouth College CPHS and the Ministry of Health in Guinea-Bissau.

研究の種類

介入

入学 (推定)

400

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

    • Bissau Region
      • Bissau、Bissau Region、ギニアビサウ、1000
        • Two villages in rural Guinea-Bissau

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 子

健康ボランティアの受け入れ

はい

説明

Inclusion Criteria:

  • Children aged 6 months to 5 years residing in one of the two selected villages in Guinea-Bissau
  • Caregiver willing to enroll the child in the study (verbal consent provided)
  • Caregiver can provide birth certificate or documentation of child's age
  • Child does not have severe acute malnutrition (SAM) at the baseline assessment

Exclusion Criteria:

  • Children diagnosed with severe acute malnutrition (SAM) at baseline (these children will be referred to the local malnutrition clinic)
  • Children whose caregivers do not wish to participate

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:防止
  • 割り当て:非ランダム化
  • 介入モデル:順次割り当て
  • マスキング:なし(オープンラベル)

武器と介入

参加者グループ / アーム
介入・治療
実験的:Village #1 (initial start)
Children aged 6 months to 5 years in the first village who do not have SAM at baseline. This village receives the monthly Regular Growth Monitoring (RGM) intervention immediately after baseline data collection. CHAs perform monthly MUAC screening using three methods; at-risk children are referred or receive caregiver nutrition education.
Monthly malnutrition screening by Community Health Agents (CHAs) using three MUAC methods: (1) WHO standard tape measure, (2) arm photograph for remote review, and (3) a solid bracelet device. The tape measure is the reference standard. Children identified with SAM are referred to a tertiary malnutrition clinic; children with MAM have their caregivers provided with weekly education on using local nutritious recipes to support recovery. Data are entered into REDCap and reviewed remotely by the US research team.
アクティブコンパレータ:Village #2 (delayed start)
Children aged 6 months to 5 years in the second village who do not have SAM at baseline. This village serves as a comparison group during the first village's RGM period, then receives the same RGM intervention subsequently.
Monthly malnutrition screening by Community Health Agents (CHAs) using three MUAC methods: (1) WHO standard tape measure, (2) arm photograph for remote review, and (3) a solid bracelet device. The tape measure is the reference standard. Children identified with SAM are referred to a tertiary malnutrition clinic; children with MAM have their caregivers provided with weekly education on using local nutritious recipes to support recovery. Data are entered into REDCap and reviewed remotely by the US research team.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Prevalence of severe acute malnutrition (SAM)
時間枠:Baseline to study completion (~4 months)
Proportion of enrolled children meeting SAM criteria (by WHO tape measure MUAC) at study completion, compared between early-start and delayed-start villages.
Baseline to study completion (~4 months)

二次結果の測定

結果測定
メジャーの説明
時間枠
Prevalence of moderate acute malnutrition (MAM)
時間枠:Baseline to study completion (~4 months)
Proportion of enrolled children meeting MAM criteria (by WHO tape measure MUAC) at study completion, compared between early-start and delayed-start villages.
Baseline to study completion (~4 months)
Weight-for-length z-score
時間枠:Baseline to study completion (~4 months)
Change in weight-for-length z-score between baseline and final assessment, compared between early-start and delayed-start villages
Baseline to study completion (~4 months)
Weight-for-age z-score
時間枠:Baseline to study completion (~4 months)
Change in weight-for-age z-score between baseline and final assessment, compared between early-start and delayed-start villages.
Baseline to study completion (~4 months)
Length-for-age z-score
時間枠:Baseline and study completion (~4 months)
Change in length-for-age z-score between baseline and final assessment, compared between early-start and delayed-start villages
Baseline and study completion (~4 months)

その他の成果指標

結果測定
メジャーの説明
時間枠
Agreement of new RGM methods vs. reference standard
時間枠:Assessed at each study visit (monthly from baseline to 4 months follow-up)
Accuracy of the arm photograph and bracelet for detecting MAM and SAM relative to the WHO tape measure MUAC.
Assessed at each study visit (monthly from baseline to 4 months follow-up)
Acceptability and feasibility of RGM methods
時間枠:N/A, data collected at study completion (4 month visit)
Perceived acceptability and feasibility of the three MUAC monitoring methods among parents, CHAs, and Ministry of Health staff, collected via brief structured questionnaires.
N/A, data collected at study completion (4 month visit)

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

捜査官

  • 主任研究者:Susan B. Roberts, Ph.D.、Dartmouth College

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2026年5月5日

一次修了 (推定)

2026年12月1日

研究の完了 (推定)

2026年12月1日

試験登録日

最初に提出

2026年4月30日

QC基準を満たした最初の提出物

2026年5月7日

最初の投稿 (実際)

2026年5月13日

学習記録の更新

投稿された最後の更新 (実際)

2026年7月15日

QC基準を満たした最後の更新が送信されました

2026年7月13日

最終確認日

2026年4月1日

詳しくは

本研究に関する用語

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD プランの説明

Deidentified participant data will be stored and made publicly available at an appropriate repository following publication of the primary manuscript. Participant names stored locally in Guinea-Bissau will be retained for 3 years after study completion and then destroyed. The US team will not have access to identifiable participant information.

IPD 共有時間枠

Following publication of the primary manuscript.

IPD 共有アクセス基準

Publicly available deidentified dataset; access details to be determined at time of publication.

IPD 共有サポート情報タイプ

  • STUDY_PROTOCOL
  • SAP

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米国FDA規制医薬品の研究

いいえ

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いいえ

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