The Pediatric HIV Nutrition Study in Uganda

NCT ID: NCT02421302

Last Updated: 2015-04-20

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-28

Study Completion Date

2016-04-30

Brief Summary

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This will be cohort study design with both qualitative and quantitative methods of data collection. The investigators are aiming to study 64 HIV positive children as healthy controls either initiating ART or already on ART and 86 malnourished HIV infected children on ART or naïve initiating ART and RUTF aged between 6 months to 12 years. Primary carers will be asked to provide informed consent whereby the children and primary carers will be enrolled into the study and followed up for 12 weeks.

Detailed Description

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BACKGROUND: Malnutrition and Human Immunodeficiency Virus (HIV) infection are intimately linked and present a serious health challenge in Africa. Approximately 30-50% of children in Uganda with severe acute malnutrition (SAM) are HIV infected. Studies on nutrition as a determinant of immune response and drug metabolism in malnourished children are unknown.

GAP: Clinicians have noted that certain patients deteriorate after starting ART and nutritional supplementation despite viralogical suppression and immunological improvement with a paradoxical emergence of certain opportunistic infections, electrolyte derangement and malnutrition hence IRIS or re-feeding syndrome (RF). There is paucity of data on nutrition as a determinant of immune and pharmacological response amongst HIV infected malnourished children despite malnutrition being common.

HYPOTHESIS: Well-nourished HIV infected children ART naïve or experienced will have a better nutritional, clinical, immunological and pharmacological outcome than malnourished children ART naïve or experienced.

METHODS: A cohort design studying 75 malnourished HIV infected children on ART and RUTF comparing them to 75 well-nourished children ART naive or experienced aged between 6 months to 12 years after primary carers have provided informed consent will be enrolled into the study and followed up for 12 weeks.

IMPACT: This study will endeavor to provide appropriate information that will enhance the management of malnourished HIV infected children in the context of both ART and RUTF and their impact on immune response and drug metabolism. The study will also generate other research questions that need to be addressed in order to optimize HIV services amongst malnourished children.

Conditions

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Child Nutrition Disorders

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Well-nourished HIV+ ART naive

These children aged between 6months-12years will be followed up for 12weeks to look at their nutrition, immune and pharmacological responses. They will receive routine nutritional and ART adherence counseling

Group Type NO_INTERVENTION

No interventions assigned to this group

Moderately-malnourished HIV+; RUTF

These children aged between 6months - 12years, ART naive or experienced, will be initiating ready-to-use-therapeutic(RUTF) food and will be followed up for 12 weeks to see the effect of nutrition supplementation on immune and pharmacological responses

Group Type ACTIVE_COMPARATOR

RUTF

Intervention Type DIETARY_SUPPLEMENT

This is ready-to-use-therapeutic-food

Severely acute-malnourished HIV+; RUTF

These children aged between 6months - 12years, ART naive or experienced, will be initiating ready-to-use-therapeutic(RUTF) food and will be followed up for 12 weeks to see the effect of nutrition supplementation on immune and pharmacological responses

Group Type ACTIVE_COMPARATOR

RUTF

Intervention Type DIETARY_SUPPLEMENT

This is ready-to-use-therapeutic-food

Interventions

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RUTF

This is ready-to-use-therapeutic-food

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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Ready-to-Use-Therapeutic-Food

Eligibility Criteria

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Inclusion Criteria

* HIV-infected children aged 6 months to 12 years, including Well Nourished (WN), Moderately Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM) patients initiating on ART within 2 weeks, whose carer is aged ≥18 years and has provided informed consent.
* Malnourished HIV-infected children aged 6 months to 12 years stabilized on ART for at least 6 months and initiating on RUTF, whose carer is aged ≥18 years and has provided informed consent.

Exclusion Criteria

1. Previous enrollment in a nutritional therapeutic program in the last 3 months
2. Children involved in an on-going nutrition study
3. Children who have previously received the tuberculin skin test (TST) or mantoux or purified protein derivative (PPD) in the last 3 months.
4. Children with clinically suspected or confirmed malignancy
5. Children exhibiting any specific food intolerance
6. Children who are vomiting profusely (over 3 times daily)
7. Children living outside 50 km radius from Infectious Diseases Institute at Mulago, Kampala
8. Children whose carers do not want to disclose their home address.
9. Children whose cause of malnutrition is compounded by congenital malformations, chromosomal disorders, metabolic disorders, congenital immune disorders, cerebral palsy
10. Children with a severe disability limiting the possibility of investigations
11. Children who plan to leave the catchment area in the next 6 months
Minimum Eligible Age

6 Months

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Dublin, Trinity College

OTHER

Sponsor Role collaborator

Infectious Diseases Institute

OTHER

Sponsor Role lead

Responsible Party

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Infectious Diseases Institute

PhD Candidate

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Judy Orikiiriza, MMED

Role: PRINCIPAL_INVESTIGATOR

PhD Candidate

Locations

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Infectious Diseases Institute

Kampala, Kampala, Uganda

Site Status RECRUITING

Mildmay International Centre Kampala

Kampala, Kampala, Uganda

Site Status RECRUITING

Countries

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Uganda

Central Contacts

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Judy Orikiiriza, MMED

Role: CONTACT

+256312307000 ext. 224

Allen M Mukhwana, MBA

Role: CONTACT

+256312307000 ext. 242

Facility Contacts

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Mohammed Lamorde, PhD

Role: primary

+256312307000 ext. 320

Allen M Mukhwana, MBA

Role: backup

+256312307000 ext. 242

Judy Orikiiriza, MMED

Role: primary

+256307000 ext. 244

Jane Nakaweesi, MMED

Role: backup

+256 312 210 200

Other Identifiers

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ST/0110/15

Identifier Type: REGISTRY

Identifier Source: secondary_id

ST/0110/15

Identifier Type: -

Identifier Source: org_study_id

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