Effectiveness Trial of Thermal Jacket

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-01

Study Completion Date

2024-12-31

Brief Summary

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Globally, over 15 million neonates are born preterm each year. They account for approximately 30% of global neonatal deaths and 19% of total neonatal deaths in Bangladesh. They usually die because they cannot maintain normal temperature due to their weight, immature skin and underdeveloped thermal regulatory capacity of the brain.

Maintaining continuous Kangaroo Mother Care (KMC) for at least 16-20 hours/day, is sometimes not feasible for mothers or caregivers. In addition, we also have the challenge of keeping preterm or low birthweight (LBW) neonates warm during transportation.

The scientists at icddr,b, Johns Hopkins University, and George Mason University developed the thermal jacket for keeping preterm or LBW neonate warm. We have already completed the laboratory trial on mannquins and clinical safety trial among preterm or LBW neonates. Now, we propose to build on our previous work by systematically testing the effectiveness trial of the 'thermal jacket' among preterm or LBW neonates at clinical settings.

Hypothesis: Thermal jacket can increase the rate of euthermia among the preterm or LBW neonates in the selected health facilities in Bangladesh.

Objectives: The aim of this study is to test whether the thermal jacket can attain and maintain euthermia of preterm or LBW neonates in clinical settings of Bangladesh.

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Detailed Description

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We will equip a cluster-randomized stepped-wedge trial design. We will select and onboard hospitals randomly from three districts in pre-intervention period which eventually go into post-intervention period. The study will be conducted in three phases. The pre-intervention period for eight weeks for baseline data collection. Then intervention period (introduce thermal jackets) for another 24 weeks, and post-intervention period for endline data collection for eight weeks. In the control phase, all the eligible neonates enrolled in the hospitals whose parents agree to participate in the study will be observed and monitored for their thermal status (euthermia, hypothermia, and hyperthermia). Once the hospitals shift to case phase the eligible neonates will be given with thermal jacket. The icddr,b team will observe and monitor the enrolled neonates' thermal status throughout the event period. For this study, the definition of an event is the data from an individual enrolled infant on six hours' basis. Thus, every twenty-four hours, we can collect four events from a single neonate. During thermal care uptake, let it be with KMC or thermal jacket, the axillary temperature of the enrolled neonates will be recorded every 60 minutes. Feeding history will be recorded until discharge. According to the national newborn health SOP, during both control and case phases, mothers will be encouraged to provide KMC. The thermal jacket will be offered to mother when KMC will be ceased or not given by the neonate's family members. The thermal jacket intervention will be ceased for each neonate if mother wants to provide KMC or doesn't wish to put the neonate on the thermal jacket anymore. Thermal jacket will be provided for the time period as long as mother or legal guardian wishes to keep their neonate in the jacket without any time limitation. Mothers or caregivers of each neonate will be provided with training on KMC and thermal jacket and due support during the uptake of the KMC and thermal jacket will be provided as well. The data those will be collected during the pre-phase will be the control data and data that will be collected during the post-phase will be the intervention data.

Conditions

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Preterm Neonate Low Birthweight Neonate

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

FACTORIAL

Stepped wedge cluster randomised trial

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Thermal Jacket

As a intervention, the enrolled preterm or low birthweight neonates gets the thermal jacket as well as Kangaroo Mother Care for thermal care.

Group Type EXPERIMENTAL

Thermal Jacket

Intervention Type DEVICE

In the intervention group, the enrolled preterm or low birthweight eligible neonates gets the intervention Thermal Jacket as well as Kangaroo Mother Care.

Kangaroo Mother Care

Intervention Type PROCEDURE

Skin-to-Skin care, provided by primary caregiver.

Kangaroo Mother Care

As a control, the enrolled preterm or low birthweight neonates gets the conventional Kangaroo Mother Care only.

Group Type ACTIVE_COMPARATOR

Kangaroo Mother Care

Intervention Type PROCEDURE

Skin-to-Skin care, provided by primary caregiver.

Interventions

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Thermal Jacket

In the intervention group, the enrolled preterm or low birthweight eligible neonates gets the intervention Thermal Jacket as well as Kangaroo Mother Care.

Intervention Type DEVICE

Kangaroo Mother Care

Skin-to-Skin care, provided by primary caregiver.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. KMC eligible neonates
2. Heart rate 100-160 per minute
3. Capillary Refill Time ≤ 3 sec
4. Respiratory rate 30-59 per minute
5. Breaths comfortable
6. Pink in room air

Exclusion Criteria

1. In nasogastric tube
2. In oxygen therapy
3. In intravenous fluid
4. Sign of respiratory distress
5. Prolonged or frequent apnea
6. Major surgical problem
7. Gross congenital anomaly

Eligible Sex

ALL

Accepts Healthy Volunteers

No