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Child Health, Agriculture and Integrated Nutrition (CHAIN): protocol for a randomised controlled trial of improved infant and young child feeding in rural Zimbabwe
| Creador: | Smith, L.E. |
| Creador: | Chagwena, D. |
| Creador: | Bourke, C. |
| Creador: | Robertson, R.C. |
| Creador: | Fernando, S. |
| Creador: | Tavengwa, N.V. |
| Creador: | Cairns, J.E. |
| Creador: | Thokozile Ndhlela |
| Creador: | Matumbu, E. |
| Creador: | Brown, T. |
| Creador: | Datta, K. |
| Creador: | Mutasa, B. |
| Creador: | Tengende, A. |
| Creador: | Chidhanguro, D. |
| Creador: | Langhaug, L. |
| Creador: | Makanza, M. |
| Creador: | Chasekwa, B. |
| Creador: | Mutasa, K. |
| Creador: | Swann, J. |
| Creador: | Kelly, P. |
| Creador: | Ntozini, R. |
| Creador: | Prendergast, A. |
| Año: | 2022 |
| URI: | https://hdl.handle.net/10883/22383 |
| Lenguaje: | English |
| Editor: | BMJ Publishing Group |
| Copyright: | CIMMYT manages Intellectual Assets as International Public Goods. The user is free to download, print, store and share this work. In case you want to translate or create any other derivative work and share or distribute such translation/derivative work, please contact CIMMYT-Knowledge-Center@cgiar.org indicating the work you want to use and the kind of use you intend; CIMMYT will contact you with the suitable license for that purpose |
| Tipo: | Article |
| País de enfoque: | Zimbabwe |
| Lugar de publicación: | United Kingdom |
| Número: | 12 |
| Volumen: | 12 |
| DOI: | 10.1136/bmjopen-2021-056435 |
| Palabras Claves: | Nutrient Requirements |
| Palabras Claves: | Feeding Interventions Design |
| Palabras Claves: | Infant Growth |
| Descripción: | INTRODUCTION: Over one-quarter of children in sub-Saharan Africa are stunted; however, commercial supplements only partially meet child nutrient requirements, cannot be sustainably produced, and do not resolve physiological barriers to adequate nutrition (eg, inflammation, microbiome dysbiosis and metabolic dysfunction). Redesigning current infant and young child feeding (IYCF) interventions using locally available foods to improve intake, uptake and utilisation of nutrients could ameliorate underlying pathogenic pathways and improve infant growth during the critical period of complementary feeding, to reduce the global burden of stunting. METHODS AND ANALYSIS: Child Health Agriculture Integrated Nutrition is an open-label, individual household randomised trial comparing the effects of IYCF versus 'IYCF-plus' on nutrient intake during infancy. The IYCF intervention comprises behaviour change modules to promote infant nutrition delivered by community health workers, plus small-quantity lipid-based nutrient supplements from 6 to 12 months of age which previously reduced stunting at 18 months of age by ~20% in rural Zimbabwe. The 'IYCF-plus' intervention provides these components plus powdered NUA-45 biofortified sugar beans, whole egg powder, moringa leaf powder and provitamin A maize. The trial will enrol 192 infants between 5 and 6 months of age in Shurugwi district, Zimbabwe. Research nurses will collect data plus blood, urine and stool samples at baseline (5-6 months of age) and endline (9-11 months of age). The primary outcome is energy intake, measured by multipass 24-hour dietary recall at 9-11 months of age. Secondary outcomes include nutrient intake, anthropometry and haemoglobin concentration. Nested laboratory substudies will evaluate the gut microbiome, environmental enteric dysfunction, metabolic phenotypes and innate immune function. Qualitative substudies will explore the acceptability and feasibility of the IYCF-plus intervention among participants and community stakeholders, and the effects of migration on food production and consumption. ETHICS AND DISSEMINATION: This trial is registered at ClinicalTrials.gov (NCT04874688) and was approved by the Medical Research Council of Zimbabwe (MRCZ/A/2679) with the final version 1.4 approved on 20 August 2021, following additional amendments. Dissemination of trial results will be conducted through the Community Engagement Advisory Board in the study district and through national-level platforms. TRIAL REGISTRATION NUMBER: NCT04874688. |
| Agrovoc: | AGRICULTURE |
| Agrovoc: | CHILD HEALTH |
| Agrovoc: | FOOD SUPPLEMENTS |
| Agrovoc: | GROWTH DISORDERS |
| Agrovoc: | NUTRITION |
| Agrovoc: | PHYSIOLOGY |
| Agrovoc: | POWDERS |
| Agrovoc: | PROCEDURES |
| Elocator: | 056435 |
| ISSN: | 2044-6055 |
| Revista: | BMJ Open |
| Área de impacto CGIAR: | Nutrition, health & food security |
| Iniciativa CGIAR: | Accelerated Breeding |
| Área de acción CGIAR: | Genetic Innovation |
| Donante o financiador: | UK Global Challenges Research Fund |
| Identificador CGSpace: | https://hdl.handle.net/10568/137923 |
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