ClinicalTrials.gg
CompletedNCT02944149Updated Aug 3, 2017

Safety of Minilaparotomy Provided by Trained Clinical Officers and Assistant Medical Officers: a Non-inferiority Trial

An interventional study of tubal ligation by minilaparotomy in Sterilization, Tubal, sponsored by EngenderHealth. Completed at 7 sites in Tanzania. Open to female participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2017-08-03.

Sponsored by EngenderHealth · Not applicable, Interventional, and Health services research

Phase
Not applicable
Study type
Interventional
Enrollment
1,970
Allocation
Randomized
Ages
18 Years and older
Sex
Female
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Study summary

The study is a non-inferiority randomized controlled trial (RCT) that aims to demonstrate that tubal ligations by minilaparotomy (ML) conducted by trained clinical officers (COs) are no less safe as compared to those conducted by assistant medical officers (AMOs) in Tanzania. Participants will be randomized in a one to one ratio to ML by a CO and ML by an AMO. In addition to the screening and enrollment/ML visit, there will be three scheduled follow-up visits at 3, 7 and 42 days post-surgery.

Read the detailed description

The primary objective is to establish whether the safety of ML provided by trained COs is not inferior to the safety of ML provided by trained AMOs, as measured by rates of major adverse events (AEs) among women undergoing ML. The primary outcome is safety, defined by the overall rate of major AEs following ML. The investigators will address the primary objective by comparing the rate of major AEs observed following MLs conducted by COs vs. AMOs during the ML procedure and through 42 days follow-up. This study will be conducted among 1,970 women 18 years of age and older presenting at study sites for ML surgery. The duration of a woman's participation in the study is expected to be 6 weeks, unless additional follow-up beyond 42 days is clinically indicated due to complications or for other reasons. The study will be conducted in Arusha Region in northern Tanzania. The following health facilities will serve as study sites: Daraja Health Centre, Karatu Hospital, Kaloleni Health Centre, Levolosi Urban Health Centre, Longido Health Centre, Monduli Hospital, and Mto wa Mbu Health Centre.

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Conditions studied

  • Sterilization, Tubal
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In context

Lead sponsor

EngenderHealth is the lead sponsor of 4 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Aged 18 years and older;
  • Requested and consented to female sterilization AND additionally freely consents to participate in the study and signs a study form;
  • Is sound of mind, in good general health and deemed suitable to undergo female sterilization by ML in accordance with the Tanzania government guidelines;
  • Able to understand study procedures and requirements of study participation;
  • Agrees to return to the study site for the full schedule of follow-up visits after her ML procedure;
  • Agrees to provide the study staff with an address, phone number, close relative, and/or other locator information while participating in the research study.

Exclusion criteria

Exclusion Criteria:

  • Pregnancy
  • Between 8 and 42 days postpartum or postabortion
  • Known allergy or sensitivity to lidocaine or other local anesthesia
  • Takes a medication that would be a for elective surgery, such as an anticoagulant or
  • Previous abdominal or pelvic surgery
  • Local skin infection near area where incision will be made
  • Coagulation disorder
  • Hypertension (properly taken measurements; systolic ≥ 160 or diastolic ≥ 100 mm Hg)
  • Acute deep venous thrombosis/pulmonary embolism
  • Current ischemic heart disease
  • Unexplained vaginal bleeding
  • Malignant gestational trophoblastic disease
  • Cervical, endometrial and/or ovarian cancer
  • Pelvic inflammatory disease (current or within the last three months)
  • Current purulent cervicitis, chlamydial infection and/or gonorrhea
  • Current symptomatic gall bladder disease
  • Active viral hepatitis
  • Severe anemia (irrespective of type or etiology)
  • Tuberculosis of pelvic organs
  • Acute bronchitis or pneumonia
  • Systematic infection or gastroenteritis
  • Currently participating in another biomedical research study.
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

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Study design

Phase
Not applicable
Primary purpose
Health services research
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
1,970 participants (actual)

Study arms

  • Active comparator
    assistant medical officer (AMO)

    Assistant medical officers (AMO) are currently allowed to provide tubal ligation by minilaparotomy, however government regulations do not allow clinical officers (COs) to provide this service.

    Procedure: tubal ligation by minilaparotomy

  • Experimental
    clinical officer (CO)

    Experimental: clinical officer (CO) In Tanzania, COs are mid-level providers who offer diagnosis, treatment, and minor surgeries. They are more common in rural areas than medical officers (MOs) and assistant medical officers (AMOs) and are generally considered capable of performing minor surgery. Almost all facilities in Tanzania are understaffed, but COs vastly outnumber MOs and AMOs. COs are more prevalent in poorer and/or rural areas than other higher level cadres; thus, task-shifting to COs would increase access to tubal ligation by minilaparotomy for many women who are most in need.

    Procedure: tubal ligation by minilaparotomy

Interventions

  • Proceduretubal ligation by minilaparotomy

    Tubal ligation will be performed by minilaparotomy as per the Tanzanian government standards, with the standard family planning counseling and minilaparotomy surgical protocols used by the government being followed during the study.

    Also known as: female sterilization

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What researchers measure

Primary outcomes

  1. Safety: safety is defined by the overall rate of major adverse events (AEs) during and after the procedure. Rates of major AEs observed during and after procedures conducted by COs vs. AMOs will be compared.

    Time frame: During the minilaparotomy procedure and through 42 days follow-up

Secondary outcomes

  1. Performance

    Performance assessed by (e.g., procedure times, difficulties performing the procedure, inability to complete the procedure, need for assistance to complete the procedure, maximum reported pain experienced by the participant during the procedure) between procedures performed by COs and AMOs will be compared

    Time frame: During the minilaparotomy procedure

  2. Participant satisfaction

    Participant satisfaction with the minilaparotomy experience conducted by COs and AMOs will be compared.

    Time frame: During the minilaparotomy procedure and through 42 days follow-up

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Study locations

7 sites
  • Daraja Health Centre
    Arusha, Arusha Region, Tanzania
  • Kaloleni Health Centre
    Arusha, Arusha Region, Tanzania
  • Levolosi Health Centre
    Arusha, Arusha Region, Tanzania
  • Karatu Lutheran Hospital
    Karatu, Arusha Region, Tanzania
  • Longido Health Centre
    Longido, Arusha Region, Tanzania
  • Monduli District Hospital
    Monduli, Arusha Region, Tanzania
  • Mto Wa Mbu Health Center
    Monduli, Arusha Region, Tanzania
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References and documents

Publications

  • Barone MA, Mbuguni Z, Achola JO, Almeida A, Cordero C, Kanama J, Marquina A, Muganyizi P, Mwanga J, Ouma D, Shannon C, Tibyehabwa L. Safety of Tubal Occlusion by Minilaparotomy Provided by Trained Clinical Officers Versus Assistant Medical Officers in Tanzania: A Randomized, Controlled, Noninferiority Trial. Glob Health Sci Pract. 2018 Oct 4;6(3):484-499. doi: 10.9745/GHSP-D-18-00108. Print 2018 Oct 3. PubMed 30120168 ↗
  • Barone MA, Mbuguni Z, Achola JO, Cordero C, Kanama J, Muganyizi PS, Mwanga J, Shannon C, Tibyehabwa L. Safety of tubal ligation by minilaparotomy provided by clinical officers versus assistant medical officers: study protocol for a noninferiority randomized controlled trial in Tanzanian women. Trials. 2017 Oct 26;18(1):499. doi: 10.1186/s13063-017-2235-6. PubMed 29073928 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 3, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02944149
Lead sponsor
EngenderHealth
Collaborators
Tanzania Ministry of Health, Community Development, Gender, Elders, and Children, Association of Gynaecologists and Obstetricians of Tanzania, United States Agency for International Development (USAID)
Responsible party
Sponsor
First posted
Oct 25, 2016
Start date
Dec 2016
Primary completion
Jul 2017
Completion
Jul 2017
Last update
Aug 3, 2017

Study contacts

Mark A Barone, DVM, MS
principal investigator · EngenderHealth

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Aug 2017. You cannot join it, but the record below documents what was studied.

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