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CompletedNCT03407326Updated Jan 13, 2020

Comparison of an Alternative Therapeutic Food for the International Food Aid Market to a Standard Ready-to-use Therapeutic Food (RUTF) for the Treatment of Severe Acute Malnutrition in Children

An interventional study of Alternative RUTF and Standard RUTF in Malnutrition, sponsored by Washington University School of Medicine. Completed at 1 site in Sierra Leone. Open to participants aged 6 Months to 5 Years. Per ClinicalTrials.gov, last updated 2020-01-13.

Sponsored by Washington University School of Medicine · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
1,568
Allocation
Randomized
Ages
6 Months to 5 Years
Sex
All
01

Study summary

In this clinical non-inferiority trial, two foods will be compared for the treatment of SAM, testing the hypothesis that the difference in recovery rates and growth between the two test groups will be no greater than 5 percent.

Read the detailed description

This will be a randomised, triple-blinded, controlled clinical non-inferiority trial assessing the treatment of SAM with one of two therapeutic foods until the child is recovered or for a period of up to 12 weeks.

Subjects will be recruited from rural health clinics in the Western Rural Region and Pujehun District of Sierra Leone, due to the limited accessibility of treatment programs in this area; investigators believe a clinical trial in this district will be beneficial.

Sierra Leonean children aged 6-59 months with uncomplicated SAM (with WHZ \< -3, MUAC of \<11.5 cm, or bipedal edema) will be recruited at health clinics in the Western Rural Region and Pujehun District. A total of 1,300 children will be enrolled for a total sample size of 1,262 (631 per treatment) from 30 PHU centers, to detect a 5% difference in recovery rates between any two foods, with 95% sensitivity and 80% power, assuming that the standard recovery rate is 85% and a binary non-inferiority test.

After screening and enrolment, each child's participation will last up to 12 weeks. If a child recovers before the end of the 12-week period, a child's WHZ reaches and stays above -2 for two consecutive visits without edema, the child will graduate from the study. No study food products will be given to children after 12 weeks of participation; those who have not recovered will be taken for inpatient treatment. Children will enter the study on a rolling enrolment basis and will continue to be enrolled until 1,300 children complete the study.

Random allocation of food intervention will be conducted by nurses who will have the caregiver draw opaque envelopes containing one of 4 colours. Caretakers chose a sealed envelope that contains 1 of 4 colours: 2 of these colours correspond to the control food and 2 to the experimental food. The colour will be recorded separately from the child's clinical measurements and researchers involved in the randomization process do not know which colour corresponds to which food corresponding to one of the therapeutic foods. The code will be accessible only to the food distribution personnel, who do not assess participant outcomes or eligibility. Investigators performing clinical assessments and caretakers will be blinded to the child's assigned food group.

A sub-set of participants in the main study will undergo eye-tracking testing to evaluate neurocognitive function and recovery in children with severe acute malnutrition after receiving therapeutic food.

02

Conditions studied

  • Malnutrition

Keywords

  • severe acute malnutrition, SAM
03

Who can participate

Ages eligible
6 Months to 5 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria: Children aged 6-59 months with one or combination of the following

  • WHZ \< -3
  • MUAC \<11.5cm
  • bipedal edema

Exclusion Criteria:

  • children currently involved in another research trial or feeding program
  • developmentally delayed
  • chronic debilitating illness (such as cerebral palsy)
  • history of peanut or milk allergy
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Outcomes assessor)
Enrollment
1,568 participants (actual)

Study arms

  • Experimental
    Alternative

    Participants will receive approximately 190 kcal/kg/day of alternative RUTF till recovery or up to 12 weeks of treatment.

    Dietary Supplement: Alternative RUTF

  • Active comparator
    Standard

    Participants will receive approximately 190 kcal/kg/day of standard RUTF till recovery or up to 12 weeks of treatment.

    Dietary Supplement: Standard RUTF

Interventions

  • Dietary supplementAlternative RUTF

    The alternative RUTF contains oat, peanuts, sugar, milk powder, vegetable oil as well as premix containing concentrated minerals and vitamins and emulsifier.

  • Dietary supplementStandard RUTF

    Standard RUTF contains peanut paste, sugar, non-fat dried milk (NFDM), vegetable oil, a premix containing concentrated minerals and vitamins, and emulsifier.

05

What researchers measure

Primary outcomes

  1. Mid-upper-arm circumference

    MUAC ≥ 12.5

    Time frame: 2 to 12 weeks

  2. Weight-for-height z score

    WHZ≥-2

    Time frame: 2 to 12 weeks

Secondary outcomes

  1. Adverse symptoms

    stomach pain, vomiting, diarrhoea, rash or fever

    Time frame: 2 to 12 weeks

06

Study locations

1 site
  • Project Peanut Butter
    Freetown, Sierra Leone
07

References and documents

Publications

  • Hendrixson DT, Godbout C, Los A, Callaghan-Gillespie M, Mui M, Wegner D, Bryant T, Koroma A, Manary MJ. Treatment of severe acute malnutrition with oat or standard ready-to-use therapeutic food: a triple-blind, randomised controlled clinical trial. Gut. 2020 Dec;69(12):2143-2149. doi: 10.1136/gutjnl-2020-320769. Epub 2020 Mar 16. PubMed 32179568 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03407326
Lead sponsor
Washington University School of Medicine
Collaborators
The Children's Investment Fund Foundation
Responsible party
Sponsor
First posted
Jan 23, 2018
Start date
Oct 16, 2018
Primary completion
Sep 2, 2019
Completion
Sep 2, 2019
Last update
Jan 13, 2020

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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