Comparison of Four Different Supplementary Foods in the Treatment of Moderate Acute Malnutrition (MAM) in Children in Sierra Leone: a Cluster-randomised, Controlled Clinical Effectiveness Trial

NCT ID: NCT02077907

Last Updated: 2015-02-04

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

TERMINATED

Clinical Phase

NA

Total Enrollment

1147 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-01-31

Brief Summary

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The objective of this study is to test and compare the effectiveness and cost-effectiveness of four supplementary foods for the treatment of moderate acute malnutrition (MAM) in normal programmatic settings in Sierra Leone. Study participants will receive one of four test foods varying in energy and nutrient density as well as amounts provided.

1. Super Cereal Plus (SC+) at 800 kcal/d, 215 g/d (Control group)
2. Super Cereal (SC) and oil and sugar at 998 kcal/d - 200 g SC and 20 g oil and 20 g sugar, per day
3. Corn-soy Blend 14 (CSB14) and oil at 978 kcal/day - 150 g CSB14 and 45 g oil, per day
4. Plumpy'Sup - 500 kcal/d, 92 g/d

This will be a prospective, randomised, controlled effectiveness trial.

Aims

1. (Impact) To compare the effectiveness of four supplementary foods in the treatment of moderate acute malnutrition (MAM) in normal programmatic settings in Sierra Leone.
2. (Cost) To estimate the relative cost-effectiveness (marginal cost per child recovered from MAM, relative to comparison group, SC+) of implementing the feeding program using each commodity, taking into consideration costs of procurement/production and distribution
3. (Process) To evaluate the determinants of effectiveness including: consumption adherence, preparation compliance, targeting/sharing of supplement, food components and preparation, adverse effects of foods, water contamination, hygiene and health behaviors, SES, food security, perceived barriers

Outcomes

1. Recovery from MAM

1. Percent of children recovered from MAM (defined as achieving mid-upper arm circumference (MUAC) ≥ 12.5 cm by 12 weeks once)
2. Percent default/non-response: children who do not recover after 12 weeks
3. Percent relapse: children who become MAM again within 6 months of recovery
2. Mean number of weeks to recovery

Hypothesis The children with MAM fed Super Cereal and oil and sugar, CSB14 and oil or Plumpy'Sup will have similar recovery outcomes to those children fed Super Cereal Plus.

Null: The children with MAM fed Super Cereal and oil and sugar, CSB14 and oil or Plumpy'Sup will have different recovery outcomes to those children fed Super Cereal Plus.

Detailed Description

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Conditions

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Moderate Acute Malnutrition (MAM)

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Super Cereal Plus (SC+)

800 kcal/d, 215 g/d

Current protocol for treating MAM is supplemental food distribution, often providing a fortified blended food (FBF) that requires cooking. In Sierra Leone, their FBF standard is Super Cereal Plus.

Group Type ACTIVE_COMPARATOR

Super Cereal Plus (SC+)

Intervention Type DIETARY_SUPPLEMENT

Super Cereal (SC) and oil and sugar

200 g SC and 20 g fortified oil and 15 g sugar, per day

Fortified blended food (FBF) Fortified Oil with Vitamins A \& D

Group Type EXPERIMENTAL

Super Cereal (SC), fortified oil, sugar

Intervention Type DIETARY_SUPPLEMENT

Corn Soy Blend 14 (CSB14) and fortified oil

978 kcal/day - 150 g CSB14 and 45 g oil, per day

Fortified blended food (FBF) Fortified Oil with Vitamins A \& D

Group Type EXPERIMENTAL

Corn Soy Blend 14 (CSB14) and fortified oil

Intervention Type DIETARY_SUPPLEMENT

Plumpy'Sup

500 kcal/d, 92 g/d

Ready-to-Use Supplementary Food (RUSF)

Group Type EXPERIMENTAL

Plumpy Sup

Intervention Type DIETARY_SUPPLEMENT

Interventions

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Super Cereal Plus (SC+)

Intervention Type DIETARY_SUPPLEMENT

Super Cereal (SC), fortified oil, sugar

Intervention Type DIETARY_SUPPLEMENT

Plumpy Sup

Intervention Type DIETARY_SUPPLEMENT

Corn Soy Blend 14 (CSB14) and fortified oil

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Beneficiary Mother/Caretaker whose child is diagnosed with MAM and enrolled to receive a ration from a feeding site
* Beneficiary Mother/Caretaker has no age restrictions for inclusion (Note: Mothers/caretakers will be asked to participate regardless of age and consented appropriately; it is possible some mothers may be minors)
* Subject who is voluntarily willing to participate and indicates by signing (or marking with a thumbprint) the consent form.


* Community Health Volunteers \& Health Development Committee Members serving within the catchment area for the PHUs
* Community Health Volunteers that have been present during the study period
* Subject who is voluntarily willing to participate and indicates by signing the consent form


* All staff members from Project Peanut Butter and the PHU who are directly involved in the feeding program

* Village elder/headmen in study commune

Exclusion Criteria

* Children with bipedal oedema
* Children receiving food rations from another organization (e.g. USAID or UNICEF)

Beneficiary Mothers/Caretakers (Mothers/Caretakers of Children 6 months to 59 months old)


• Beneficiary Mothers/Caretakers who participate in an interview, observation or FGD once for this study will not be eligible again for participation

* Staff members who joined too recently to have experience of the program change (new commodities)

* Village elder/headmen whose community is not involved in the feeding program
Minimum Eligible Age

6 Months

Maximum Eligible Age

59 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Washington University School of Medicine

OTHER

Sponsor Role collaborator

Project Peanut Butter

OTHER

Sponsor Role collaborator

United Nations World Food Programme (WFP)

OTHER

Sponsor Role collaborator

United States Agency for International Development (USAID)

FED

Sponsor Role collaborator

Tufts University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mark Manary, MD

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Beatrice Rogers, PhD

Role: PRINCIPAL_INVESTIGATOR

Tufts University, Friedman School of Nutrition

Other Identifiers

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USAID

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

AID-016-Sierra Leone

Identifier Type: -

Identifier Source: org_study_id

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