Micronutrient Enhancement for Development and Health in Adolescents - The MEDHA Study (MEDHA)
Micronutrient Enhancement for Development and Health in Adolescents
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
Adolescents (10-19 year olds) are an understudied group despite increasing numbers in many regions, especially in low- and middle-income countries (LMICs). Numerous reviews on adolescent health and nutrition have identified major data gaps for this population, including lack of information on the nutritional challenges and the burden of existing deficiencies adolescents face and uncertainty about the level of nutritional support required during this period of rapid physical and cognitive development during and following puberty. The consequences of poor adolescent nutrition for reproductive health and survival as well as bone health in later life among females calls for special attention to vulnerable girls in LMICs.
The primary aim of this study is to determine the efficacy of daily supplementation with MMS (using the UNIMMAP formulation) and an enhanced regimen (MMS+) composed of UNIMMAP plus additional nutrients (calcium, choline, docosahexaenoic acid -DHA, and higher amount of vitamin D) vs. weekly iron-folic acid (IFA) alone on a range of neurodevelopment, biochemical, linear growth and functional outcomes among 10-18 year old girls in rural Bangladesh. The investigators hypothesize that daily MMS or MMS+ will result in an improvement for the co-primary outcomes of school achievement and physical growth (HAZ), and secondary functional outcomes including neurocognitive function, bone health, and biochemical nutrient status among adolescents following 6 and 12 months of supplementation compared with weekly IFA supplementation.
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Fase 3
Contacten en locaties
Studiecontact
Studiecontact
- Naam: Parul Christian, DrPH
- Telefoonnummer: 14109552061
- E-mail: pchrist1@jhu.edu
Studie Contact Back-up
- Naam: Daniel Erchick, PhD
- E-mail: derchick@jhu.edu
Studie Locaties
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Rangpur City, Bangladesh
- JiVitA Project Head Quarters
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Contact:
- Towfida Siddiqua, PhD
- Telefoonnummer: 880-1718-722147
- E-mail: towfida.jivita@gmail.com
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Contact:
- Hasmot Ali, MBBS, MPH
- E-mail: hasmot.jivita@gmail.com
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Kind
- Volwassen
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Unmarried 10-18 year old females
- living in their parental home in the study area
Exclusion Criteria:
- Married females under 18 years old;
- those with a history or diagnosis of chronic or congenital heart disease, chronic kidney or lung disease, cancer, and epilepsy
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Preventie
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
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Actieve vergelijker: Iron (60 mg)- folic acid (400 ug) [IFA]
Weekly IFA will be provided in the control arm as standard-of-care for a year as per government of Bangladesh policy and WHO guidelines for this age group.
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Weekly IFA will be provided in the control arm as standard-of-care for a year
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Experimenteel: Multiple micronutrient supplement [MMS]
A daily MMS supplement containing 15 micronutrients using the UNIMMAP (United Nations International Multiple Micronutrient Antenatal Preparation) formulation.
This will be provided in a daily tablet form for a year.
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Experimental: Multiple micronutrient supplement [MMS] A daily MMS supplement containing 15 micronutrients using the UNIMMAP (United Nations International Multiple Micronutrient Antenatal Preparation) formulation.
This will be provided in a daily tablet form for a year.
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Experimenteel: Multiple micronutrient supplement Plus [MMS+]
MMS+ will be a package of nutrient supplements comprising the UNIMMAP tablet and a lipid-based chickpea product with choline, calcium and additional vitamin D taken daily for a year, plus a local DHA/EPA softgel taken three times a week for a year.
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Experimental: Multiple micronutrient supplement Plus [MMS+] MMS+ will be a package of nutrient supplements comprising the UNIMMAP tablet, plus a lipid-based chickpea product with choline, calcium and additional vitamin D, plus a local DHA/EPA softgel taken daily for a year.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Height-for-age Z score
Tijdsspanne: Baseline (pre-supplementation) and at the midline (6 months) and endline (12 months) visits
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Height will be assessed and expressed as a Z-score using reference standards for children.
Stunting will be defined using HAZ < -2.
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Baseline (pre-supplementation) and at the midline (6 months) and endline (12 months) visits
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Wide Range Achievement Test (WRAT-5) Composite Score
Tijdsspanne: Baseline (pre-supplementation) and at midline (6 months) and endline (12 month) visits.
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The Wide Range Achievement Test assess reading, writing and arithmetic and is a school achievement test.
The total score on this test will be used.
The mean for the total composite score is 100 and SD is 15.
Most scores fall between 70 and 130, with higher scores indicating above-average achievement and lower scores indicating below-average achievement
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Baseline (pre-supplementation) and at midline (6 months) and endline (12 month) visits.
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Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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WRAT-5 math, reading and spelling scores
Tijdsspanne: Baseline, midline (6 months) and endline (12 months)
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Individual domain scores derived from the WRAT-5.
The mean for each is approximately 70 with SD of 20.
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Baseline, midline (6 months) and endline (12 months)
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General Intelligence as assessed by the Wechsler Abbreviated Scale of Intelligence (WASI-II)
Tijdsspanne: Baseline (presupplementation) and endline (12 months)
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This will be assessed using Wechsler Abbreviated Scale of Intelligence (WASI-II).
The full scale IQ has a mean (SD) of 75 (12).
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Baseline (presupplementation) and endline (12 months)
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Motor function standardized score as assessed by Movement Assessment Batter for Children - 3
Tijdsspanne: Baseline and endline (12months)
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Using Movement Assessment Battery for Children -3.
Standardized scores for Pegboard, Manual Dexterity, and Balance will be used.
Task scores have a mean (SD) of 10(3).
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Baseline and endline (12months)
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Bone mineral density
Tijdsspanne: Baseline and Endline (12 months)
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Radiography of radius and tibia
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Baseline and Endline (12 months)
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Body mass index Z-score
Tijdsspanne: At Baseline (pre-supplementation), midline (6 months) and 12 (months)
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BMIZ score will be derived using weight and height measurements using reference standards.
BMIZ < 2 is used to define underweight.
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At Baseline (pre-supplementation), midline (6 months) and 12 (months)
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Nutrient status
Tijdsspanne: Baseline (pre-supplementation) and Midline (6 months)
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Assessed using blood serum/plasma, or urine (vitamin A, D, E, B12, zinc, Hb, iodine, Thyroglobulin)
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Baseline (pre-supplementation) and Midline (6 months)
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Endocrine factors
Tijdsspanne: Baseline (pre-supplementation) and midline (6 months)
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Leptin, Estradiol, Osteocalcin
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Baseline (pre-supplementation) and midline (6 months)
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Health-related Quality of Life (HRQoL)
Tijdsspanne: At baseline and endline (12 months)
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The HRQoL; (EQ-5D-5L) will be used.
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At baseline and endline (12 months)
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Blood Pressure (mmHg)
Tijdsspanne: Baseline (pre-supplementation), midline (6 months) and endline (12 months)
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Blood pressure - systolic and diastolic BP (mm Hg) taken using a BP monitor.
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Baseline (pre-supplementation), midline (6 months) and endline (12 months)
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% Fat free mass
Tijdsspanne: Baseline (presupplementation), midline (6 months) and endline (12 months)
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Body composition will be assessed using anthropometry and skinfold measurements
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Baseline (presupplementation), midline (6 months) and endline (12 months)
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Waist-to-Height Ratio
Tijdsspanne: Baseline (presupplementation), midline (6months) and endline (12 months)
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Waist circumference and height will be assessed to derive this ratio
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Baseline (presupplementation), midline (6months) and endline (12 months)
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Hand grip strength
Tijdsspanne: Baseline (presupplementation), midline (6months), endline (12 months)
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Using kg pressure
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Baseline (presupplementation), midline (6months), endline (12 months)
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Executive function as assessed by Word Span
Tijdsspanne: Baseline and Endline (12months)
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Assessed using Word Span
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Baseline and Endline (12months)
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Executive function as assessed by Dimensional Card Change Sort
Tijdsspanne: Baseline and Endline (12months)
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Assessed using Dimensional Card Change Sort (DCCS)
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Baseline and Endline (12months)
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Conners Parent Rating Scale Scores
Tijdsspanne: Baseline and Endline (12 months)
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These standardized scales will be administered to assess behavioral disorders among children.
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Baseline and Endline (12 months)
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Medewerkers en onderzoekers
Sponsor
Sponsor
Medewerkers
Medewerkers
Onderzoekers
Onderzoekers
- Hoofdonderzoeker: Parul Christian, DrPH, Johns Hopkins University
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Pathologische processen
- Lichaamsgewicht
- Pathologische aandoeningen, tekenen en symptomen
- Tekenen en symptomen
- Groeistoornissen
- Dunheid
- Heterocyclische verbindingen
- Heterocyclische verbindingen, 2-ring
- Heterocyclische verbindingen, gefuseerd ring
- Anorganische chemicaliën
- Elementen
- Metalen
- Pterins
- Pteridines
- Metalen, zwaar
- Overgangselementen
- Foliumzuur
- Ijzer
Andere studie-ID-nummers
Andere studie-ID-nummers
- IRB00035686
- INV-071025 (Ander subsidie-/financieringsnummer: Gates foundation)
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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