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Active, not recruitingNCT06069869MID-ACTUpdated May 8, 2026

Multiple Micronutrient Supplementation (MMS) Iron Dose Acceptability Crossover Trial

A Phase 3 interventional study of Multiple Micronutrient Supplements with 30 mg of elemental iron and Multiple Micronutrient Supplements with 45 mg of elemental iron in Pregnancy Related, sponsored by George Washington University. Active, not recruiting at 1 site in Tanzania. Open to female participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-05-08.

Sponsored by George Washington University · Phase 3, Interventional, and Prevention

From the registry’s dates

  • Primary completion was expected by Jun 2026, 3 months ago, but the record still lists the study as active, not recruiting.
Phase
Phase 3
Study type
Interventional
Enrollment
156
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

This is an individually randomized cross-over trial to assess acceptability, preference, and perceived side effects of MMS formulations with 30 mg, 45 mg and 60 mg of iron.

02

Conditions studied

  • Pregnancy Related

Keywords

  • Acceptability
  • Multiple Micronutrient Supplementation
  • Iron
  • Tanzania
03

In context

Lead sponsor

George Washington University is the lead sponsor of 187 studies on the registry; 34 are open to participants now.

Of its 13 completed or terminated interventional studies of FDA-regulated products, 11 (85%) have results posted.

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

04

Who can participate

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

Inclusion criteria

  • Attending first ANC visit at the study clinic
  • Pregnant women ≤ 15 weeks of gestation
  • Aged ≥ 18 years
  • Intending to stay in Dar es Salaam for the duration of study
  • Provides informed consent

Exclusion criteria

Exclusion Criteria:

  • Severe anemia (defined as Hb \<8.5 g/dL per Tanzania standard of care)
  • Sickle cell disease (SS,SC, CC genotype) as tested by HemoTypeSC
  • Concurrent participation in other nutritional supplementation trial
  • Pregnant women with disability or condition which would impair their ability to provide informed consent and complete study procedures.
05

Study design

Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
156 participants (estimated)

Study arms

  • Experimental
    MM 30mg; then MMS 45mg; then MMS 60mg

    Participants first receive MMS with 30 mg for one month, then MMS with 45 mg of iron for one month, then MMS with 60 mg of iron for one month

    Dietary Supplement: Multiple Micronutrient Supplements with 30 mg of elemental iron · Dietary Supplement: Multiple Micronutrient Supplements with 45 mg of elemental iron · Dietary Supplement: Multiple Micronutrient Supplements with 60 mg of elemental iron

  • Experimental
    MM 30mg; then MMS 60mg; then MMS 45mg

    Participants first receive MMS with 30mg for one month, then MMS with 60mg of iron for one month, then MMS with 45 mg of iron for one month

    Dietary Supplement: Multiple Micronutrient Supplements with 30 mg of elemental iron · Dietary Supplement: Multiple Micronutrient Supplements with 45 mg of elemental iron · Dietary Supplement: Multiple Micronutrient Supplements with 60 mg of elemental iron

  • Experimental
    MM 45mg; then MMS 30mg; then MMS 60mg

    Participants first receive MMS with 45 mg for one month, then MMS with 30 mg of iron for one month, then MMS with 60 mg of iron for one month

    Dietary Supplement: Multiple Micronutrient Supplements with 30 mg of elemental iron · Dietary Supplement: Multiple Micronutrient Supplements with 45 mg of elemental iron · Dietary Supplement: Multiple Micronutrient Supplements with 60 mg of elemental iron

  • Experimental
    MM 45 mg; then MMS 60mg; then MMS 30mg

    Participants first receive MMS with 45 mg for one month, then MMS with 60 mg of iron for one month, then MMS with 30 mg of iron for one month

    Dietary Supplement: Multiple Micronutrient Supplements with 30 mg of elemental iron · Dietary Supplement: Multiple Micronutrient Supplements with 45 mg of elemental iron · Dietary Supplement: Multiple Micronutrient Supplements with 60 mg of elemental iron

  • Experimental
    MM 60mg; then MMS 30mg; then MMS 45mg

    Participants first receive MMS with 60 mg for one month, then MMS with 30 mg of iron for one month, then MMS with 45 mg of iron for one month

    Dietary Supplement: Multiple Micronutrient Supplements with 30 mg of elemental iron · Dietary Supplement: Multiple Micronutrient Supplements with 45 mg of elemental iron · Dietary Supplement: Multiple Micronutrient Supplements with 60 mg of elemental iron

  • Experimental
    MM 60mg; then MMS 45mg; then MMS 30mg

    Participants first receive MMS with 60 mg for one month, then MMS with 45 mg of iron for one month, then MMS with 30 mg of iron for one month

    Dietary Supplement: Multiple Micronutrient Supplements with 30 mg of elemental iron · Dietary Supplement: Multiple Micronutrient Supplements with 45 mg of elemental iron · Dietary Supplement: Multiple Micronutrient Supplements with 60 mg of elemental iron

Interventions

  • Dietary supplementMultiple Micronutrient Supplements with 30 mg of elemental iron

    MMS with 30 mg iron is the active comparator group. The standard UNIMMAP MMS formulation includes 30 mg of iron which will be taken orally once daily for one month.

  • Dietary supplementMultiple Micronutrient Supplements with 45 mg of elemental iron

    MMS with 45 mg iron is an intervention group. MMS with 45 mg of iron plus standard UNIMMAP formulation for other 14 micronutrients will be taken orally once daily for one month.

  • Dietary supplementMultiple Micronutrient Supplements with 60 mg of elemental iron

    MMS with 60 mg iron is an intervention group. MMS with 60 mg of iron plus standard UNIMMAP formulation for other 14 micronutrients will be taken orally once daily for one month.

06

What researchers measure

Primary outcomes

  1. Acceptability of MMS formulations

    Participant reported acceptability of each MMS formulation using Likert scales ranging from 1 (disliked a lot) to 5 (liked a lot).

    Time frame: At one month of taking each regimen, up to 3 months

Secondary outcomes

  1. Most preferred MMS formulation

    Participant's reported preference for MMS formulations with 30 mg, 45 mg, or 60 mg of iron by asking which supplement participant likes the best.

    Time frame: At three months (after taking all three regimens)

  2. Least preferred MMS formulation

    Participant's reported preference for MMS formulations with 30 mg, 45 mg, or 60 mg of iron by asking which supplement participant likes the least.

    Time frame: At three months (after taking all three regimens)

  3. Identification of MMS iron dosage

    Percentage of participants that correctly identify their iron dose treatment order

    Time frame: At three months (after taking all three regimens)

  4. Side effects of MMS formulations

    The percentage of patients experiencing any side effect (diarrhea, heartburn, constipation, vomiting, nausea, leg cramps, lower back/pelvic pain) during each intervention period

    Time frame: At one month of taking each regimen, up to 3 months

  5. Adherence

    The percentage of days a participant takes a MMS pill out of the total number of days in the intervention period

    Time frame: At one month of taking each regimen, up to 3 months

Other outcomes

  1. Diarrhea

    The percentage of patients with self-reported diarrhea symptoms during each intervention period

    Time frame: At one month of taking each regimen, up to 3 months

  2. Heartburn

    The percentage of patients with self-reported heartburn symptoms during each intervention period

    Time frame: At one month of taking each regimen, up to 3 months

  3. Constipation

    The percentage of patients with self-reported constipation symptoms during each intervention period

    Time frame: At one month of taking each regimen, up to 3 months

  4. Vomiting

    The percentage of patients with self-reported vomiting during each intervention period

    Time frame: At one month of taking each regimen, up to 3 months

  5. Nausea

    The percentage of patients with self-reported nausea symptoms during each intervention period

    Time frame: At one month of taking each regimen, up to 3 months

  6. Leg cramps

    The percentage of patients with self-reported leg cramp symptoms during each intervention period

    Time frame: At one month of taking each regimen, up to 3 months

  7. Lower back/pelvic pain

    The percentage of patients with self-reported lower back/pelvic painsymptoms during each intervention period

    Time frame: At one month of taking each regimen, up to 3 months

07

Study locations

1 site
  • Muhimbili University of Health and Allied Sciences
    Dar es Salaam, Tanzania
08

References and documents

Publications

  • Sudfeld CR, Muhihi A, Sylvetsky AC, Metta E, Brownlee VS, Oakley EM, Bakari M, Fawzi WW, Kinyogoli S, Kuiper JR, Mugusi S, Pan Q, Sando MM, Wylie BJ, Masanja H, Smith ER, Pembe AB. Effect of iron dose in maternal multiple micronutrient supplement on perceived side effects, adherence, acceptability and preferences: protocol for a randomised crossover trial. BMJ Open. 2026 May 27;16(5):e118725. doi: 10.1136/bmjopen-2026-118725. PubMed 42203269 ↗

Individual participant data

Plan to share: Yes — deidentified analytical dataset supporting published research

Supporting information: Study protocol, Sap, Icf, Analytic code

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 8, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06069869
Lead sponsor
George Washington University
Collaborators
Ifakara Health Institute, Harvard School of Public Health (HSPH), Muhimbili University of Health and Allied Sciences, Africa Academy for Public Health, Columbia University
Responsible party
Emily Smith (Principal Investigator, George Washington University) — Principal investigator
First posted
Oct 6, 2023
Start date
Sep 26, 2025
Primary completion
Jun 24, 2026 (estimated)
Completion
Jun 24, 2026 (estimated)
Last update
May 8, 2026

Study contacts

Blair Wylie, MD, MPH
principal investigator · Columbia University
Honorati Masanja, PhD
principal investigator · Ifakara Health Institute
Alfa Muhihi, PhD
principal investigator · Africa Academy for Public Health
Andreas Pembe, MD, MMed, PhD, FCOG
principal investigator · Muhimbili University of Health and Allied Sciences
Emily R Smith, ScD, MPH
principal investigator · The George Washington University
Christopher R Sudfeld, ScD, ScM
principal investigator · Harvard University

Oversight

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

Not currently enrolling

This study is active, not recruiting, as verified in May 2026. You cannot join it, but the record below documents what was studied.

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