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| Name | Class |
|---|---|
| University of Western Sydney | OTHER |
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Stunting contributes substantially to child mortality and disease burden in low-income countries. In Bangladesh the prevalence of stunting among children <5-years of age is high (36%) reaching 50% in slum areas. The pathogenesis of stunting is multifaceted, yet nutritional inadequacy and repeated infections are established risk factors of stunting.
A three-arm randomized controlled trial in Dhaka's slum area is proposed. The children will be recruited from vaccination clinics. Infants at risk of stunting (-1 SD length-for-age z-score, LAZ) aged around 5 months are eligible for the study. Eligible children will be randomized to receive: 1) nutrition education on dietary diversity; 2) a combination of similar education plus daily supplementation of homemade yogurt; 3) a 'usual care' (control) group. The investigators will recruit 120 children (40 per arm). Intervention will be initiated a month before starting of complementary feeding with an educational session and will last 7 months during which a monthly educational session will be delivered at participant's household. The homemade yogurt supplementation will start a week after beginning of 6 months of age once the child is introduced to solid foods of the mother's choice. The yogurt will be supplied to the mothers every day at time of feeding. Feeding behaviors will be self-monitored using a pictorial calendar. Primary outcome (LAZ) and secondary outcomes (fecal bio-markers, WAZ, head circumference, and food diversity scores), will be measured at baseline (6 months), 9 months and 12 months of child age. Supplementation with homemade yogurt is a novel approach with the potential to improve infant gut environment, improve food absorption and thus potentially prevent stunting.
Hypothesis:
The investigators hypothesize that, continued breastfeeding, adequate complimentary feeding and supplementation with homemade yogurt have the potential to reduce stunting.
Primary objective:
The present study is aimed to assess the impact of low-cost nutritional strategies to prevent childhood malnutrition in Bangladesh.
Specific objectives:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Education | Active Comparator | Nutrition education on dietary diversity. |
|
| Yogurt | Experimental | A combination of similar education plus daily supplementation of homemade yogurt |
|
| Control | Active Comparator | Control group. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nutrition education | Behavioral | Nutrition Education on
|
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline (6 months) length for age z-score (LAZ) at 9 months and 12 months of child age. | Child length converted to z-score | Will be measured at baseline (6 months), 9 months and 12 months of child age |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline (6 months) weight for age z-score (WAZ) at 9 months and 12 months of child age. | Child weight converted to z-score | Will be measured at baseline (6 months), 9 months and 12 months of child age |
| Change from baseline (6 months) mean head circumference at 9 months and 12 months of child age. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dr. Mahbubur Rahman | Dhaka | 1212 | Bangladesh |
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| ID | Term |
|---|---|
| D015362 | Child Nutrition Disorders |
| ID | Term |
|---|---|
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D015596 | Nutrition Assessment |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
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A three-arm randomized controlled trial in Dhaka's slum area is proposed. Infants at risk of stunting (-1 SD length-for-age z-score, LAZ) aged around 5 months are eligible for the study. Eligible children will be randomised to receive: 1) nutrition education on dietary diversity; 2) a combination of similar education plus daily supplementation of homemade yogurt; 3) a 'usual care' (control) group. We will recruit 120 children (40 per arm).
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|
| Homemade yogurt supplementation | Dietary Supplement | The homemade yogurt supplementation will start a week after beginning of 6 months of age once the child is introduced to solid foods of the mother's choice. The yogurt will be supplied to the mothers every day at time of feeding. |
|
| Usual care | Other | No intervention/ control group |
|
Child head circumference |
| Will be measured at baseline (6 months), 9 months and 12 months of child age |
| Change from baseline (6 months) mean concentration of fecal bio-markers at 9 months and 12 months of child age. | Concentration of neopterin, myeloperoxidase, and alpha 1 antitrypsin in stool samples. | Will be measured at baseline (6 months), 9 months and 12 months of child age |
| Change from baseline (6 months) proportion of children meeting food diversity scores at 9 months and 12 months of child age. |
| Will be measured at baseline (6 months), 9 months and 12 months of child age |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D015991 | Epidemiologic Measurements |
| D011634 | Public Health |
| D004778 | Environment and Public Health |