Child Health, Agriculture and Integrated Nutrition (CHAIN): protocol for a randomised controlled trial of improved infant and young child feeding in rural Zimbabwe
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 m...
| Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | Journal Article |
| Lenguaje: | Inglés |
| Publicado: |
BMJ
2022
|
| Materias: | |
| Acceso en línea: | https://hdl.handle.net/10568/137923 |
| _version_ | 1855525203554074624 |
|---|---|
| author | Smith, Laura E. Chagwena, Dexter Bourke, Claire Robertson, Ruairi C. Fernando, Shamiso Tavengwa, Naume V. Cairns, Jill E. Thokozile Ndhlela Matumbu, Exhibit Brown, Tim Datta, Kavita Mutasa, Batsirai Tengende, Alice Chidhanguro, Dzivaidzo Langhaug, Lisa Makanza, Maggie Chasekwa, Bernard Mutasa, Kuda Swann, Jonathan Kelly, Paul Ntozini, Robert Prendergast, Andrew |
| author_browse | Bourke, Claire Brown, Tim Cairns, Jill E. Chagwena, Dexter Chasekwa, Bernard Chidhanguro, Dzivaidzo Datta, Kavita Fernando, Shamiso Kelly, Paul Langhaug, Lisa Makanza, Maggie Matumbu, Exhibit Mutasa, Batsirai Mutasa, Kuda Ntozini, Robert Prendergast, Andrew Robertson, Ruairi C. Smith, Laura E. Swann, Jonathan Tavengwa, Naume V. Tengende, Alice Thokozile Ndhlela |
| author_facet | Smith, Laura E. Chagwena, Dexter Bourke, Claire Robertson, Ruairi C. Fernando, Shamiso Tavengwa, Naume V. Cairns, Jill E. Thokozile Ndhlela Matumbu, Exhibit Brown, Tim Datta, Kavita Mutasa, Batsirai Tengende, Alice Chidhanguro, Dzivaidzo Langhaug, Lisa Makanza, Maggie Chasekwa, Bernard Mutasa, Kuda Swann, Jonathan Kelly, Paul Ntozini, Robert Prendergast, Andrew |
| author_sort | Smith, Laura E. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | 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. |
| format | Journal Article |
| id | CGSpace137923 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | BMJ |
| publisherStr | BMJ |
| record_format | dspace |
| spelling | CGSpace1379232025-12-08T09:54:28Z Child Health, Agriculture and Integrated Nutrition (CHAIN): protocol for a randomised controlled trial of improved infant and young child feeding in rural Zimbabwe Smith, Laura E. Chagwena, Dexter Bourke, Claire Robertson, Ruairi C. Fernando, Shamiso Tavengwa, Naume V. Cairns, Jill E. Thokozile Ndhlela Matumbu, Exhibit Brown, Tim Datta, Kavita Mutasa, Batsirai Tengende, Alice Chidhanguro, Dzivaidzo Langhaug, Lisa Makanza, Maggie Chasekwa, Bernard Mutasa, Kuda Swann, Jonathan Kelly, Paul Ntozini, Robert Prendergast, Andrew agriculture child health food supplements growth disorders nutrition physiology powders procedures 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. 2022-12 2024-01-17T21:36:50Z 2024-01-17T21:36:50Z Journal Article https://hdl.handle.net/10568/137923 en Open Access application/pdf BMJ Smith, L. E., Chagwena, Dexter. T., Bourke, C., Robertson, R., Fernando, S., Tavengwa, N. V., Cairns, J., Ndhlela, T., Matumbu, E., Brown, T., Datta, K., Mutasa, B., Tengende, A., Chidhanguro, D., Langhaug, L., Makanza, M., Chasekwa, B., Mutasa, K., Swann, J., … Prendergast, A. (2022). Child Health, Agriculture and Integrated Nutrition (CHAIN): protocol for a randomised controlled trial of improved infant and young child feeding in rural Zimbabwe. BMJ Open, 12(12), e056435. https://doi.org/10.1136/bmjopen-2021-056435 |
| spellingShingle | agriculture child health food supplements growth disorders nutrition physiology powders procedures Smith, Laura E. Chagwena, Dexter Bourke, Claire Robertson, Ruairi C. Fernando, Shamiso Tavengwa, Naume V. Cairns, Jill E. Thokozile Ndhlela Matumbu, Exhibit Brown, Tim Datta, Kavita Mutasa, Batsirai Tengende, Alice Chidhanguro, Dzivaidzo Langhaug, Lisa Makanza, Maggie Chasekwa, Bernard Mutasa, Kuda Swann, Jonathan Kelly, Paul Ntozini, Robert Prendergast, Andrew Child Health, Agriculture and Integrated Nutrition (CHAIN): protocol for a randomised controlled trial of improved infant and young child feeding in rural Zimbabwe |
| title | Child Health, Agriculture and Integrated Nutrition (CHAIN): protocol for a randomised controlled trial of improved infant and young child feeding in rural Zimbabwe |
| title_full | Child Health, Agriculture and Integrated Nutrition (CHAIN): protocol for a randomised controlled trial of improved infant and young child feeding in rural Zimbabwe |
| title_fullStr | Child Health, Agriculture and Integrated Nutrition (CHAIN): protocol for a randomised controlled trial of improved infant and young child feeding in rural Zimbabwe |
| title_full_unstemmed | Child Health, Agriculture and Integrated Nutrition (CHAIN): protocol for a randomised controlled trial of improved infant and young child feeding in rural Zimbabwe |
| title_short | Child Health, Agriculture and Integrated Nutrition (CHAIN): protocol for a randomised controlled trial of improved infant and young child feeding in rural Zimbabwe |
| title_sort | child health agriculture and integrated nutrition chain protocol for a randomised controlled trial of improved infant and young child feeding in rural zimbabwe |
| topic | agriculture child health food supplements growth disorders nutrition physiology powders procedures |
| url | https://hdl.handle.net/10568/137923 |
| work_keys_str_mv | AT smithlaurae childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT chagwenadexter childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT bourkeclaire childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT robertsonruairic childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT fernandoshamiso childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT tavengwanaumev childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT cairnsjille childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT thokozilendhlela childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT matumbuexhibit childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT browntim childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT dattakavita childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT mutasabatsirai childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT tengendealice childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT chidhangurodzivaidzo childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT langhauglisa childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT makanzamaggie childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT chasekwabernard childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT mutasakuda childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT swannjonathan childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT kellypaul childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT ntozinirobert childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe AT prendergastandrew childhealthagricultureandintegratednutritionchainprotocolforarandomisedcontrolledtrialofimprovedinfantandyoungchildfeedinginruralzimbabwe |