The Efficacy of Amino Acid Supplementation in Treating Environmental Enteric Dysfunction Among Children At Risk of Malnutrition

NCT06617130 | Not Yet Recruiting

• 1 other identifier: P.02/23/3992
• Study Type: interventional
• Target: 66
• Locations: 1 country
• Sites: 1

Brief Summary

A randomised controlled open label clinical trial to determine whether addition of indispensable amino acids (IAA) to standard complementary food will reduce occurrence of Environmental Enteric Dysfunction (EED) compared with provision of standard complementary food without IAA in healthy Malawian children aged 18-36 months with or without stunting.

Conditions

Amino Acid, Stunting, Environmental Enteric Dysfunction

Outcome Measures

Primary Outcomes (1)

• corn soy bean flour porridge with added indespensable amino acids

  Primary Efficacy Endpoint: We hypothesize that adding 12mg IAA to corn-soy blended flour porridge provided to Malawian children aged 18-36 months with or without stunting will reduce gut permeability as measured by the Lactulose:Rhamonse ratio test when provided over 30 days compared to corn-soy blended flour porridge without added IAA.

  30 days

Secondary Outcomes (1)

• Corn soy bean flour porridge

  30 days

Study Arms (2)

corn soy bean flour porridge with added indespensable amino acids

ACTIVE COMPARATOR

Children in the intervention arm will receive corn-soy blended flour porridge mixed with IAA. The CSB flour will be packed in 1kg packets while the IAA will be packed in small plastic bags. Parent/caretakers will be taught how to prepare complementary porridge and will be provided utensils to estimate amounts of porridge to give to the child. Pre-weighed IAA will be provided so that mothers can mix the IAA to the prepared CSB porridge. The amount of porridge to be given to the child is estimated at 75g cooked porridge or 5 tablespoons of porridge. Likuni porridge is estimated to provide 403kcal per 100g when prepared using a standard recipe (Malawi Food and Nutrient Database). Based on the age range of the participating children we aim to provide an average of 250-302 kcal per child per day.

Dietary Supplement: Corn soy bean blended flour porridge plus indispensable amino acid

Corn soy bean flour porridge

OTHER

Children in the control arm children will receive corn-soy blended flour porridge only. The CSB flour will be packed in 1kg packets. Parent/caretakers will be taught how to prepare complementary porridge and will be provided utensils to estimate amounts of porridge to give to the child. The amount of porridge to be given to the child is estimated at 75g cooked porridge or 5 tablespoons of porridge. Likuni porridge is estimated to provide 403kcal per 100g when prepared using a standard recipe (Malawi Food and Nutrient Database). Based on the age range of the participating children we aim to provide an average of 250-302 kcal per child per day.

Dietary Supplement: Corn soy bean blended flour porridge plus indispensable amino acid

Interventions

Corn soy bean blended flour porridge plus indispensable amino acid DIETARY_SUPPLEMENT

Protocol treatment will start within two weeks of enrollment to the study. Following the baseline study assessments, each participant will receive corn-soy bean blended flour porridge supplemented with IAAs (histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine) dosed at 12g/d and providing 1.5 times the estimated average requirement (EAR) for a healthy child (Intervention group). The porridge will provide 30% daily energy requirement. The study foods will be taken once daily by the child with at least three observed feeding sessions per week over the 4 weeks of the study to assess compliance. Children in the control arm will receive corn-soy blended flour porridge without added amino acids.

Corn soy bean flour porridge; corn soy bean flour porridge with added indespensable amino acids

Eligibility Criteria

• Age: 18 Months - 36 Months
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may not qualify if:

• In order to be eligible to participate in the study, an individual must meet all of the following criteria:
• months old (now agreed to by all countries)
• Stunted (LAZ\<-2)
• Of either sex
• Able and willing to undergo HIV testing
• Parent, carer, or guardian able and willing to give written, informed consent
• An individual who meets any of the following criteria will be excluded from participation in this study:
• Under 18 months of age
• Over 36 months old
• Wasted (weight-for-length Z-score less than -2)
• Overweight (weight-for-length Z-score greater than 2)
• Have had diarrhea (by self-report) in the preceding month
• Sibling or twin of another participating study child (2 children of different families in the same household are both eligible)
• Have any underlying condition other than HIV, which in the opinion of the investigator would put the subject at undue risk of failing study completion or would interfere with analysis of study results

Sponsors & Collaborators

• Kamuzu University of Health Sciences: lead
• University of Glasgow: collaborator

Study Sites (1)

Kamuzu University of Health Sciences

Blantyre, Malawi

Location

MeSH Terms

Conditions

Growth Disorders

Interventions

Amino Acids, Essential

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Amino Acids; Amino Acids, Peptides, and Proteins

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: We hypothesize that adding 12 mg/day of indispensable amino acids (IAA) to corn-soy blend blended flour porridge will reduce gut permeability amongst 6-36 month old rural Malawian children at risk of stunting compared to providing only corn-soy blended flour porridge without addition of indispensable amino acids for a period of 4 weeks. This will be a randomized, controlled open label parallel group efficacy clinical trial. Eligible children will be identified through a Demographic Surveillance System implemented by the study group at Mangochi district hospital. 66 children meeting set criteria will be randomised to receive corn-soy blended flour porridge (control group) or corn-soy blended flour porridge to which is added indispensable amino acids. The standard complementary food will provide 30% daily energy requirement while the amino acids in the intervention group will provide 1.5 times the estimated average requirement (EAR) for a healthy child.

Study Record Dates

• First Submitted: September 16, 2024
• First Posted: September 27, 2024
• Study Start: November 1, 2024
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: September 27, 2024

Record last verified: 2024-06

Locations

MA (1)