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Micronutrient Enhancement for Development and Health in Adolescents - The MEDHA Study (MEDHA)

3 september 2026 bijgewerkt door: Johns Hopkins Bloomberg School of Public Health

Micronutrient Enhancement for Development and Health in Adolescents

MEDHA is a randomized controlled trial among 10-18 year old girls to examine the use-case of the United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) multiple micronutrient supplement (MMS) formulation and to test an enhanced regimen (MMS+) with additional nutrients, vs. weekly iron-folic acid as standard of care on outcomes of neurodevelopment, linear growth, biochemical status, bone health, and other functional and health outcomes. This study is an individually randomized, open-label, three-arm trial of 3,000 participants supplemented for 12 months to assess the efficacy and safety of nutrient supplementation. Results of the study will inform the design of nutritional interventions and policy for this age group. In the context of the trial, the investigators will also do in-depth clinical and health assessments and collect biospecimens for a bio-archive for future deep-phenotyping of this population. This study will be conducted at the Johns Hopkins Bangladesh JiVitA field site in rural Gaibandha District of Bangladesh.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

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

Ingrijpend

Inschrijving (Geschat)

3000

Fase

  • Fase 3

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

  • Naam: Parul Christian, DrPH
  • Telefoonnummer: 14109552061
  • E-mail: pchrist1@jhu.edu

Studie Contact Back-up

Studie Locaties

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Kind
  • Volwassen

Accepteert gezonde vrijwilligers

Ja

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

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Preventie
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
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.
Weekly IFA will be provided in the control arm as standard-of-care for a year
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.
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.
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.
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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Height-for-age Z score
Tijdsspanne: Baseline (pre-supplementation) and at the midline (6 months) and endline (12 months) visits
Height will be assessed and expressed as a Z-score using reference standards for children. Stunting will be defined using HAZ < -2.
Baseline (pre-supplementation) and at the midline (6 months) and endline (12 months) visits
Wide Range Achievement Test (WRAT-5) Composite Score
Tijdsspanne: Baseline (pre-supplementation) and at midline (6 months) and endline (12 month) visits.
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
Baseline (pre-supplementation) and at midline (6 months) and endline (12 month) visits.

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
WRAT-5 math, reading and spelling scores
Tijdsspanne: Baseline, midline (6 months) and endline (12 months)
Individual domain scores derived from the WRAT-5. The mean for each is approximately 70 with SD of 20.
Baseline, midline (6 months) and endline (12 months)
General Intelligence as assessed by the Wechsler Abbreviated Scale of Intelligence (WASI-II)
Tijdsspanne: Baseline (presupplementation) and endline (12 months)
This will be assessed using Wechsler Abbreviated Scale of Intelligence (WASI-II). The full scale IQ has a mean (SD) of 75 (12).
Baseline (presupplementation) and endline (12 months)
Motor function standardized score as assessed by Movement Assessment Batter for Children - 3
Tijdsspanne: Baseline and endline (12months)
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).
Baseline and endline (12months)
Bone mineral density
Tijdsspanne: Baseline and Endline (12 months)
Radiography of radius and tibia
Baseline and Endline (12 months)
Body mass index Z-score
Tijdsspanne: At Baseline (pre-supplementation), midline (6 months) and 12 (months)
BMIZ score will be derived using weight and height measurements using reference standards. BMIZ < 2 is used to define underweight.
At Baseline (pre-supplementation), midline (6 months) and 12 (months)
Nutrient status
Tijdsspanne: Baseline (pre-supplementation) and Midline (6 months)
Assessed using blood serum/plasma, or urine (vitamin A, D, E, B12, zinc, Hb, iodine, Thyroglobulin)
Baseline (pre-supplementation) and Midline (6 months)
Endocrine factors
Tijdsspanne: Baseline (pre-supplementation) and midline (6 months)
Leptin, Estradiol, Osteocalcin
Baseline (pre-supplementation) and midline (6 months)
Health-related Quality of Life (HRQoL)
Tijdsspanne: At baseline and endline (12 months)
The HRQoL; (EQ-5D-5L) will be used.
At baseline and endline (12 months)
Blood Pressure (mmHg)
Tijdsspanne: Baseline (pre-supplementation), midline (6 months) and endline (12 months)
Blood pressure - systolic and diastolic BP (mm Hg) taken using a BP monitor.
Baseline (pre-supplementation), midline (6 months) and endline (12 months)
% Fat free mass
Tijdsspanne: Baseline (presupplementation), midline (6 months) and endline (12 months)
Body composition will be assessed using anthropometry and skinfold measurements
Baseline (presupplementation), midline (6 months) and endline (12 months)
Waist-to-Height Ratio
Tijdsspanne: Baseline (presupplementation), midline (6months) and endline (12 months)
Waist circumference and height will be assessed to derive this ratio
Baseline (presupplementation), midline (6months) and endline (12 months)
Hand grip strength
Tijdsspanne: Baseline (presupplementation), midline (6months), endline (12 months)
Using kg pressure
Baseline (presupplementation), midline (6months), endline (12 months)
Executive function as assessed by Word Span
Tijdsspanne: Baseline and Endline (12months)
Assessed using Word Span
Baseline and Endline (12months)
Executive function as assessed by Dimensional Card Change Sort
Tijdsspanne: Baseline and Endline (12months)
Assessed using Dimensional Card Change Sort (DCCS)
Baseline and Endline (12months)
Conners Parent Rating Scale Scores
Tijdsspanne: Baseline and Endline (12 months)
These standardized scales will be administered to assess behavioral disorders among children.
Baseline and Endline (12 months)

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Medewerkers

Onderzoekers

  • Hoofdonderzoeker: Parul Christian, DrPH, Johns Hopkins University

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 oktober 2026

Primaire voltooiing (Geschat)

31 december 2027

Studie voltooiing (Geschat)

30 juni 2028

Studieregistratiedata

Eerst ingediend

6 juli 2026

Eerst ingediend dat voldeed aan de QC-criteria

6 juli 2026

Eerst geplaatst (Werkelijk)

10 juli 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

4 september 2026

Laatste update ingediend die voldeed aan QC-criteria

3 september 2026

Laatst geverifieerd

1 september 2026

Meer informatie

Termen gerelateerd aan deze studie

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

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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