- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT00131209
Trial to Test the Growth-Promoting Effect of Fortified Spreads When Used as Complementary Food for Infants
Lungwena Child Nutrition Intervention Study 3, LCNI-3. A Single-Centre Intervention Trial in Rural Malawi, Testing the Anthropometric and Health Benefits of Provision of Ready to - Use - Therapeutic Food RUTF as a Complementary Food
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
Childhood undernutrition is very common in rural Malawi, like in many other countries in Sub-Saharan Africa. Usually, undernutrition develops between 6 and 24 months of age. By two years of age, 30-50% of all children in rural Malawi are undernourished, predisposing them to subsequent morbidity, developmental delay and mortality. Urgent interventions are needed but the magnitude of the problem precludes a hospital-based management strategy. Therefore, emphasis must be on prevention and early home-based rehabilitation of children with mild-to-moderate malnutrition. However, the options for community based approaches are not as developed as those for institutional management of undernutrition.
The present study tests a recently developed nutrient -dense spread, ready-to use- therapeutic food (RUTF), which offers a potential solution to home based nutrition rehabilitation. The concept has previously been shown to work not only in therapeutic feeding of undernourished children in nutrition rehabilitation units in Malawi but also home based supplementation of undernourished children in Mangochi District, southern Malawi. In the present study the investigators will test the efficacy in growth promotion and other health benefits of this product when provided as a complementary food to infants between 6 and 18 months of age.
The study will be conducted in Lungwena area, Mangochi District, rural Malawi. A total of 180 6-month old infants will be enrolled and randomised to three groups receiving different daily food supplements for 12 months. Children in group-one (control group) will receive 75g of maize/soy flour daily. Children in group-two will receive 25g RUTF daily and children in group-three will receive 50g RUTF daily for a period of 12 months. The food supplements will be delivered to the participant's home at weekly intervals.
All children will undergo medical and anthropometric examinations at 4-monthly intervals and disease symptoms monitoring every week. Dietary intake assessments will be conducted at 12 and 15 months of age. A random sample of 36 children will undergo breast milk intake assessments before the start of food supplementation and during food supplementation. A blood sample will be collected at the beginning and end of the study to measure blood haemoglobin and serum ferritin concentrations and test human immunodeficiency virus [HIV] (at 6 and 18 months).
The impact of the dietary interventions will be primarily assessed by comparing weight gain in the three intervention groups. Secondary outcomes include length gain, incidence of moderate underweight, stunting and wasting, cognitive and motor development at the end of trial and changes in blood haemoglobin and serum ferritin concentration. The study will also produce descriptive data on morbidity and intake of breast milk and other foods during the intervention.
Studietyp
Inskrivning
Fas
- Fas 3
Kontakter och platser
Studieorter
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Mangochi District
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Mangochi, Mangochi District, Malawi
- College of Medicine, University of Malawi
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- Signed informed consent from at least one guardian
- Ages 5.50 months to 6.49 months
- Availability during the period of the study
- Permanent resident of the area
Exclusion Criteria:
- WHZ < -2.0 z-scores or presence of oedema
- History of peanut allergy
- Severe illness warranting hospital referral
- Concurrent participation of the child in another clinical trial with intervention to the child
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Förebyggande
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Enda
Vad mäter studien?
Primära resultatmått
Resultatmått |
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Weight gain during the 12-month follow-up (in grams)
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Sekundära resultatmått
Resultatmått |
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Length gain during the study period (cm)
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Cognitive and motor developmental score at the end of trial
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Förändring i blodets hemoglobinkoncentration under studieperioden (g/l)
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Förändring i serumferritinkoncentrationen under studieperioden (µg/l)
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Genomsnittlig förändring i antropometriska index (vikt-för-ålder z-poäng [WAZ], vikt-för-höjd z-poäng [WHZ] och höjd-för-ålder z-poäng [HAZ])
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Incidence of undernutrition, stunting and wasting (WAZ, WHZ or HAZ < -2.0)
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Samarbetspartners och utredare
Sponsor
Utredare
- Studierektor: Per Ashorn, MD, PhD, University of Tampere, Medical School
- Huvudutredare: Kenneth Maleta, MBBS, PhD, Kamuzu University of Health Sciences
Publikationer och användbara länkar
Allmänna publikationer
- Phuka JC, Maleta K, Thakwalakwa C, Cheung YB, Briend A, Manary MJ, Ashorn P. Postintervention growth of Malawian children who received 12-mo dietary complementation with a lipid-based nutrient supplement or maize-soy flour. Am J Clin Nutr. 2009 Jan;89(1):382-90. doi: 10.3945/ajcn.2008.26483. Epub 2008 Dec 3.
- Phuka JC, Maleta K, Thakwalakwa C, Cheung YB, Briend A, Manary MJ, Ashorn P. Complementary feeding with fortified spread and incidence of severe stunting in 6- to 18-month-old rural Malawians. Arch Pediatr Adolesc Med. 2008 Jul;162(7):619-26. doi: 10.1001/archpedi.162.7.619. Erratum In: Arch Pediatr Adolesc Med. 2008 Oct;162(10):942.
Användbara länkar
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- SA-1200720-3
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Kliniska prövningar på fortified spread (RUTF)
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International Centre for Diarrhoeal Disease Research...UNICEF; NutrisetAvslutadAllvarlig akut undernäring i barndomenBangladesh
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Washington University School of MedicineProject Peanut Butter, Sierra Leone; Ministry of Health and Sanitation,...AvslutadUndernäring, barnSierra Leone
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Aga Khan UniversityJohn Snow, Inc.; Pakistan Ministry of HealthAvslutad
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EpicentreEpicentre, Niger; National Nutrition Direction, Niger; Ministry of Public... och andra samarbetspartnersAvslutad
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Aga Khan UniversityInternational Atomic Energy AgencyAvslutadUndernäring | BarnPakistan
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Washington University School of MedicineThe Children's Investment Fund FoundationAvslutad
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Washington University School of MedicineCornell University; Kamuzu University of Health Sciences; University of Texas...AvslutadSvår akut undernäringMalawi
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International Rescue CommitteeMinistry of health, Mali; University of the Sciences, Techniques and Technologies...Aktiv, inte rekryterandeAkut undernäring i barndomen | Undervikt | Akut undernäring i spädbarnsåldernMali
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EpicentreMédecins Sans Frontières, FranceAvslutad