Regular Growth Monitoring (RGM) of Young Children in Guinea-Bissau
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
状態
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
入学 (推定)
段階
- 適用できない
連絡先と場所
研究場所
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-
Bissau Region
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Bissau、Bissau Region、ギニアビサウ、1000
- Two villages in rural Guinea-Bissau
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参加基準
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
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
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 |
|---|---|
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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.
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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.
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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.
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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.
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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 |
|---|---|---|
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Prevalence of severe acute malnutrition (SAM)
時間枠:Baseline to study completion (~4 months)
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Proportion of enrolled children meeting SAM criteria (by WHO tape measure MUAC) at study completion, compared between early-start and delayed-start villages.
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Baseline to study completion (~4 months)
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Prevalence of moderate acute malnutrition (MAM)
時間枠:Baseline to study completion (~4 months)
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Proportion of enrolled children meeting MAM criteria (by WHO tape measure MUAC) at study completion, compared between early-start and delayed-start villages.
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Baseline to study completion (~4 months)
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Weight-for-length z-score
時間枠:Baseline to study completion (~4 months)
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Change in weight-for-length z-score between baseline and final assessment, compared between early-start and delayed-start villages
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Baseline to study completion (~4 months)
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Weight-for-age z-score
時間枠:Baseline to study completion (~4 months)
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Change in weight-for-age z-score between baseline and final assessment, compared between early-start and delayed-start villages.
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Baseline to study completion (~4 months)
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Length-for-age z-score
時間枠:Baseline and study completion (~4 months)
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Change in length-for-age z-score between baseline and final assessment, compared between early-start and delayed-start villages
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Baseline and study completion (~4 months)
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Agreement of new RGM methods vs. reference standard
時間枠:Assessed at each study visit (monthly from baseline to 4 months follow-up)
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Accuracy of the arm photograph and bracelet for detecting MAM and SAM relative to the WHO tape measure MUAC.
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Assessed at each study visit (monthly from baseline to 4 months follow-up)
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Acceptability and feasibility of RGM methods
時間枠:N/A, data collected at study completion (4 month visit)
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Perceived acceptability and feasibility of the three MUAC monitoring methods among parents, CHAs, and Ministry of Health staff, collected via brief structured questionnaires.
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N/A, data collected at study completion (4 month visit)
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協力者と研究者
捜査官
- 主任研究者:Susan B. Roberts, Ph.D.、Dartmouth College
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- 33690
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?
IPD プランの説明
IPD 共有時間枠
IPD 共有アクセス基準
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
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