NCT04067284

Brief Summary

Stunting contributes substantially to child mortality and disease burden in low-income countries. In Bangladesh the prevalence of stunting among children \<5-years of age is high (36%) reaching 50% in slum areas. The pathogenesis of stunting is multifaceted, yet nutritional inadequacy and repeated infections are established risk factors of stunting. A three-arm randomized controlled trial in Dhaka's slum area is proposed. The children will be recruited from vaccination clinics. Infants at risk of stunting (-1 SD length-for-age z-score, LAZ) aged around 5 months are eligible for the study. Eligible children will be randomized to receive: 1) nutrition education on dietary diversity; 2) a combination of similar education plus daily supplementation of homemade yogurt; 3) a 'usual care' (control) group. The investigators will recruit 120 children (40 per arm). Intervention will be initiated a month before starting of complementary feeding with an educational session and will last 7 months during which a monthly educational session will be delivered at participant's household. The homemade yogurt supplementation will start a week after beginning of 6 months of age once the child is introduced to solid foods of the mother's choice. The yogurt will be supplied to the mothers every day at time of feeding. Feeding behaviors will be self-monitored using a pictorial calendar. Primary outcome (LAZ) and secondary outcomes (fecal bio-markers, WAZ, head circumference, and food diversity scores), will be measured at baseline (6 months), 9 months and 12 months of child age. Supplementation with homemade yogurt is a novel approach with the potential to improve infant gut environment, improve food absorption and thus potentially prevent stunting.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
120

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Sep 2019

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 19, 2019

Completed
7 days until next milestone

First Posted

Study publicly available on registry

August 26, 2019

Completed
6 days until next milestone

Study Start

First participant enrolled

September 1, 2019

Completed
7 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 31, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 31, 2020

Completed
Last Updated

March 8, 2022

Status Verified

August 1, 2021

Enrollment Period

7 months

First QC Date

August 19, 2019

Last Update Submit

March 6, 2022

Conditions

Outcome Measures

Primary Outcomes (1)

  • Change from baseline (6 months) length for age z-score (LAZ) at 9 months and 12 months of child age.

    Child length converted to z-score

    Will be measured at baseline (6 months), 9 months and 12 months of child age

Secondary Outcomes (4)

  • Change from baseline (6 months) weight for age z-score (WAZ) at 9 months and 12 months of child age.

    Will be measured at baseline (6 months), 9 months and 12 months of child age

  • Change from baseline (6 months) mean head circumference at 9 months and 12 months of child age.

    Will be measured at baseline (6 months), 9 months and 12 months of child age

  • Change from baseline (6 months) mean concentration of fecal bio-markers at 9 months and 12 months of child age.

    Will be measured at baseline (6 months), 9 months and 12 months of child age

  • Change from baseline (6 months) proportion of children meeting food diversity scores at 9 months and 12 months of child age.

    Will be measured at baseline (6 months), 9 months and 12 months of child age

Study Arms (3)

Education

ACTIVE COMPARATOR

Nutrition education on dietary diversity.

Behavioral: Nutrition education

Yogurt

EXPERIMENTAL

A combination of similar education plus daily supplementation of homemade yogurt

Dietary Supplement: Homemade yogurt supplementation

Control

ACTIVE COMPARATOR

Control group.

Other: Usual care

Interventions

Nutrition Education on * Continued breastfeeding until two years of age * Food groups * Balanced diet * Introduction to locally available nutritious and low-cost foods * Amount and frequency of complementary feeding * Safe water, and * Handwashing with soap before feeding

Education

The homemade yogurt supplementation will start a week after beginning of 6 months of age once the child is introduced to solid foods of the mother's choice. The yogurt will be supplied to the mothers every day at time of feeding.

Yogurt

No intervention/ control group

Control

Eligibility Criteria

Age4 Months - 6 Months
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • Infants at risk of developing stunting aged 5 months (-1SD LAZ)
  • All gender, religion, language and ethnicity
  • Infants born through normal delivery or cesarean section
  • Breastfeeding or non-breastfeeding

You may not qualify if:

  • Stunting or wasting (\<-2SD LAZ)
  • Infants with any major congenital abnormality or any chronic conditions (e.g., rheumatic heart disease)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Dr. Mahbubur Rahman

Dhaka, 1212, Bangladesh

Location

MeSH Terms

Conditions

Child Nutrition Disorders

Interventions

Nutrition Assessment

Condition Hierarchy (Ancestors)

Nutrition DisordersNutritional and Metabolic Diseases

Intervention Hierarchy (Ancestors)

Data CollectionEpidemiologic MethodsInvestigative TechniquesHealth Care Evaluation MechanismsQuality of Health CareHealth Care Quality, Access, and EvaluationEpidemiologic MeasurementsPublic HealthEnvironment and Public Health

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Model Details: A three-arm randomized controlled trial in Dhaka's slum area is proposed. Infants at risk of stunting (-1 SD length-for-age z-score, LAZ) aged around 5 months are eligible for the study. Eligible children will be randomised to receive: 1) nutrition education on dietary diversity; 2) a combination of similar education plus daily supplementation of homemade yogurt; 3) a 'usual care' (control) group. We will recruit 120 children (40 per arm).
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 19, 2019

First Posted

August 26, 2019

Study Start

September 1, 2019

Primary Completion

March 31, 2020

Study Completion

March 31, 2020

Last Updated

March 8, 2022

Record last verified: 2021-08

Locations