Management of Children With Moderate Acute Malnutrition in Mali

NCT ID: NCT01015950

Last Updated: 2019-08-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1260 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-05-31

Study Completion Date

2012-12-31

Brief Summary

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The objectives of the study are to assess the impact of different dietary strategies for the management of children with MAM on: the children's continued participation in the nutritional rehabilitation program and their physical growth, recovery from MAM, and change in micronutrient status and body composition. The specific dietary regimens that will be compared are: 1) a ready-to-use, lipid-based supplementary food (Plumpy'Sup, Nutriset, Inc.), providing \~500 kcal/d for 12 weeks; 2) specially formulated CSB for malnourished children, providing \~ 500 kcal/d for 12 weeks; 3) Misola, a locally produced, micronutrient-fortified, cereal-legume blend, providing \~500 kcal/d for 12 weeks; or 4) packaged, home available foods (millet and cowpea flour, sugar, vegetable oil) and a multiple micronutrient powder ("Mix Me") for 12 weeks, as is currently recommended by the national CMAM protocol when special foods are not available.

Detailed Description

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Conditions

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Moderate Acute Malnutrition (MAM)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Pumpy'Sup

Lipid-based nutrient supplement

Group Type EXPERIMENTAL

Plumpy'Sup

Intervention Type DIETARY_SUPPLEMENT

Lipid-based (vegetable oil, peanut paste, soy protein-containing) fortified nutrient supplement to provide 500 kcal/d

SCSB

Processed, fortified, cereal-based food blend (SCSB for malnourished children)

Group Type EXPERIMENTAL

SCSB

Intervention Type DIETARY_SUPPLEMENT

Processed, fortified, corn-soy-milk-based food blend (SCSB for malnourished children, to be supplied by the World Food Program) to provide an additional 500 kcal/day

Misola

Locally processed, fortified food blend (Misola)

Group Type EXPERIMENTAL

Misola

Intervention Type DIETARY_SUPPLEMENT

Locally produced, millet-soy-peanut-based fortified complementary food (Misola)

Local food supplement

Local foods (millet flour, cowpea flour, sugar, oil) and a multiple micronutrient powder ("Mix-Me") are provided to simulate the currently recommended enhanced home-prepared rehabilitation food mixture ("farines enrchies") according to the national Mali CMAM protocol.

Group Type ACTIVE_COMPARATOR

Local food supplement

Intervention Type DIETARY_SUPPLEMENT

Local foods (millet flour, cowpea flour, sugar, vegetable oil) and a multiple micronutrient powder ("Mix Me") are provide, according to the national Mali CMAM protocol when special processed foods are not available.

Interventions

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Plumpy'Sup

Lipid-based (vegetable oil, peanut paste, soy protein-containing) fortified nutrient supplement to provide 500 kcal/d

Intervention Type DIETARY_SUPPLEMENT

Local food supplement

Local foods (millet flour, cowpea flour, sugar, vegetable oil) and a multiple micronutrient powder ("Mix Me") are provide, according to the national Mali CMAM protocol when special processed foods are not available.

Intervention Type DIETARY_SUPPLEMENT

Misola

Locally produced, millet-soy-peanut-based fortified complementary food (Misola)

Intervention Type DIETARY_SUPPLEMENT

SCSB

Processed, fortified, corn-soy-milk-based food blend (SCSB for malnourished children, to be supplied by the World Food Program) to provide an additional 500 kcal/day

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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Plumpy'Sup, Supplementary Plumpy, Nutriset, France Misola, Mali World Food Program

Eligibility Criteria

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Inclusion Criteria

* age from 6 to 35 months,
* MUAC \<12.5 cm and \>11.0 cm, and weight-for-length (WLZ) Z-score \> -3.0 (WHO standard, 2006); or WLZ \<-2.0 and \>-3.0 and MUAC \>11.0 cm
* absence of bi-pedal edema
* absence of current diseases requiring inpatient care
* expected availability during the period of the study
* residency within the study communities
* acceptance of home visitors, and
* written consent of a parent or guardian

Exclusion Criteria

* age \<6 months or \>36 months
* MUAC \>12.5 cm and WLZ \>-2.0; or MUAC \<11.0 cm; or WLZ \<-3.0
* presence of bi-pedal edema,
* severe anemia (defined as hemoglobin \<50 g/L),
* other acute illnesses requiring inpatient treatment,
* congenital abnormalities or underlying chronic diseases, including known HIV . infection, that may affect growth or risk of infection
* history of allergy towards peanuts or previous serious allergic reaction to . any substance, requiring emergency medical care
* concurrent participation in any other clinical trial
Minimum Eligible Age

6 Months

Maximum Eligible Age

35 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Bamako

OTHER

Sponsor Role collaborator

University of California, Davis

OTHER

Sponsor Role collaborator

UNICEF

OTHER

Sponsor Role collaborator

United Nations World Food Programme (WFP)

OTHER

Sponsor Role collaborator

Helen Keller International

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kenneth H Brown, MD

Role: PRINCIPAL_INVESTIGATOR

Helen Keller International

Locations

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Helen Keller International

Bamako, , Mali

Site Status

Countries

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Mali

References

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Isanaka S, Barnhart DA, McDonald CM, Ackatia-Armah RS, Kupka R, Doumbia S, Brown KH, Menzies NA. Cost-effectiveness of community-based screening and treatment of moderate acute malnutrition in Mali. BMJ Glob Health. 2019 Apr 28;4(2):e001227. doi: 10.1136/bmjgh-2018-001227. eCollection 2019.

Reference Type DERIVED
PMID: 31139441 (View on PubMed)

McDonald CM, Ackatia-Armah RS, Doumbia S, Kupka R, Duggan CP, Brown KH. Percent Fat Mass Increases with Recovery, But Does Not Vary According to Dietary Therapy in Young Malian Children Treated for Moderate Acute Malnutrition. J Nutr. 2019 Jun 1;149(6):1089-1096. doi: 10.1093/jn/nxz037.

Reference Type DERIVED
PMID: 30968123 (View on PubMed)

Ackatia-Armah RS, McDonald CM, Doumbia S, Erhardt JG, Hamer DH, Brown KH. Malian children with moderate acute malnutrition who are treated with lipid-based dietary supplements have greater weight gains and recovery rates than those treated with locally produced cereal-legume products: a community-based, cluster-randomized trial. Am J Clin Nutr. 2015 Mar;101(3):632-45. doi: 10.3945/ajcn.113.069807. Epub 2015 Jan 7.

Reference Type DERIVED
PMID: 25733649 (View on PubMed)

Other Identifiers

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200917501-1, 200917501-2

Identifier Type: -

Identifier Source: org_study_id

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