ClinicalTrials.gg
RecruitingNCT06382857Updated Aug 27, 2024

Effectiveness of a Microbiome-directed Food to Promote Programmatic and Sustained Nutritional Recovery Among Children With Uncomplicated Acute Malnutrition

An interventional study of MDF and RUTF in Malnutrition, Child, sponsored by Epicentre. Recruiting at 1 site in Niger. Open to participants aged 6 Months to 23 Months. Per ClinicalTrials.gov, last updated 2024-08-27.

Sponsored by Epicentre · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Nov 2025, 1 year ago, but the record still lists the study as recruiting.
  • Started May 2024; still recruiting 2 years 6 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
7,356
Allocation
Randomized
Ages
6 Months to 23 Months
Sex
All
01

Study summary

This study is an individually randomized controlled trial comparing microbiome-directed foods to standard nutritional therapy among children aged 6 to \< 24 months with uncomplicated acute malnutrition in terms of programmatic recovery by 12 weeks from admission and sustained recovery at 24 weeks from admission.

02

Conditions studied

  • Malnutrition, Child

Keywords

  • Malnutrition
  • SAM
  • MAM
  • Child
  • MDF
  • Microbiome
03

In context

Child Nutrition Disorders

167 studies on the registry are indexed under Child Nutrition Disorders; 36 are open to participants now.

This study's planned enrollment of 7,356 is above the median of 402 across 132 interventional studies indexed under Child Nutrition Disorders.

Browse Child Nutrition Disorders studies →

Lead sponsor

Epicentre is the lead sponsor of 49 studies on the registry; 6 are open to participants now.

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

04

Who can participate

Ages eligible
6 Months to 23 Months
Sexes eligible
All
Accepts healthy volunteers
No

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

  • for children with Severe Acute Malnutrition (SAM): MUAC \< 115 mm and/or WLZ \< -3 and/or mild (+) or moderate (++) edema
  • for children with Moderate Acute Malnutrition (MAM): 115 mm ≤ MUAC \< 125 mm and/or -3 ≤ WHZ \< -2
  • Caregiver providing

Exclusion criteria

Exclusion Criteria:

  • Medical complications requiring inpatient treatment, as identified by the national protocol
  • Not eating/lack of appetite (as informed by appetite test and investigator judgement)
  • Re-admission into the program within 2 months of previous default
  • for children with Severe Acute Malnutrition (SAM): Referral from inpatient care (therapeutic feeding center, TFC) or supplementary feeding program (SFP)
  • for children with Moderate Acute Malnutrition (MAM): Referral from SAM treatment (TFC or OTP)
  • Presence of congenital abnormality or underlying chronic disease that may affect growth or risk of infection
  • Known / /allergy to study interventions (chickpea/soy flour, banana, peanut)
  • Residence outside the study catchment area or in a non-fixed (e.g. nomadic) community
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.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
7,356 participants (estimated)

Study arms

  • Experimental
    Microbiome directed food (MDF)

    The MDF in this study was developed by the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,B). This MDF is the lead icddr,B prototype that has demonstrated the strongest increase in biomarkers critical to growth, including growth hormone receptor and leptin, and re-establishment of the maturity of the microbiome among moderately malnourished children. Ingredients include chickpea flour, soy flour, peanut paste, green banana powder, sugar, oil, and micronutrients. The same MDF is provided for the treatment of SAM and MAM at modified doses.

    Dietary Supplement: MDF

  • Active comparator
    Standard nutritional treatment (RUTF/RUSF)

    The standard RUTF used in this study for the treatment of SAM is Plumpy'Nut (Nutriset France). RUTF is a specialized therapeutic food that can be consumed without preparation and meets the nutritional requirements for the recovery of SAM. Ingredients include oil, peanut, skimmed milk powder, sugar and micronutrients. The standard RUSF used in this study is Plumpy'Sup (Nutriset France). RUSF is a lipid-based nutritional supplement with a high vitamin and mineral content, specifically designed for the treatment of MAM. Ingredients include oil, peanut, skimmed milk powder, sugar and micronutrients.

    Dietary Supplement: RUTF · Dietary Supplement: RUSF

Interventions

  • Dietary supplementMDF

    MDF will be provided to children on a weekly basis for children with SAM and bi-weekly basis for children with MAM at the health center until programmatic recovery but not thereafter.

  • Dietary supplementRUTF

    RUTF will be provided to all children on a weekly basis at the health center until programmatic recovery but not thereafter

    Also known as: Standard RUTF

  • Dietary supplementRUSF

    RUSF will be provided on a biweekly basis at the health center until programmatic recovery but not thereafter

    Also known as: Standard RUSF

06

What researchers measure

Primary outcomes

  1. Programmatic recovery by 12 weeks from admission

    Defined as the proportion of SAM and MAM children achieving a WLZ ≥ -2 AND MUAC ≥ 125mm AND no edema during 2 consecutive visits

    Time frame: 12 weeks

  2. Sustained recovery at 24 weeks from admission

    Proportion of recovered SAM and MAM children with WLZ ≥ -2 AND MUAC ≥ 125mm AND no edema

    Time frame: 24 weeks

Secondary outcomes

  1. Default

    Defined as 2 consecutive missed scheduled program visits

    Time frame: 12 weeks

  2. Non-response

    Defined as WLZ \< -2 or MUAC \< 125 mm during 2 consecutive visits, or for SAM children only: persistent edema at 12 weeks

    Time frame: 12 weeks

  3. Time to recovery

    Measured as days from admission to programmatic recovery among recovered children

    Time frame: 12 weeks

  4. For MAM children: Deterioration to SAM

    Weight-for-height z-score (WHZ) inferior to -3

    Time frame: 24 weeks

  5. Change in weight gain

    Change in g/kg/day

    Time frame: From enrollment to 4, 8 and 12 weeks

  6. Change in weight-for-length Z (WLZ)

    Change in WLZ calculated using the 2006 WHO Growth Standards

    Time frame: From enrollment to 4, 8 and 12 weeks

  7. Change in length-for-age Z (LAZ)

    Change in LAZ calculated using the 2006 WHO Growth Standards

    Time frame: From enrollment to 4, 8 and 12 weeks

  8. Change in weight-for-age Z (WAZ)

    Change in WAZ calculated using the 2006 WHO Growth Standards

    Time frame: From enrollment to 4, 8 and 12 weeks

  9. Change in MUAC

    Change in mm

    Time frame: From enrollment to 4, 8 and 12 weeks

  10. Serious adverse events

    Combined safety endpoint, including hospitalization and death

    Time frame: 24 weeks

  11. Hospitalization

    Inpatient stay \> 24h

    Time frame: 24 weeks

  12. Death

    All-cause mortality

    Time frame: 24 weeks

  13. Motor, cognitive, language, social-emotional, and mental health skills

    As measured by the Caregiver Reported Early Development Instrument (CREDI)

    Time frame: 24 weeks

  14. Cost effectiveness

    As defined by the incremental cost per child recovered and per child sustained recovered

    Time frame: 24 weeks

  15. Dietary intake

    As measured by 24h recall

    Time frame: 24 weeks

  16. Adherence

    Defined as the sum of sachets returned used divided by the total number of sachets distributed

    Time frame: 12 weeks

  17. Microbiome profile at enrollment, week 4, program discharge, and study discharge

    Defined as PCR-confirmed enteric viral, bacterial, and protozoan pathogens present

    Time frame: 24 weeks

  18. Plasma proteome profile at enrollment, week 4, program discharge, and study discharge

    Defined as circulating plasma proteins (IGFBP-2, thrombospondin-5, granulysin, GDF-15, and MMP-8)

    Time frame: 24 weeks

  19. Environmental enteric dysfunction at enrollment, program discharge, and study discharge

    Measured by anti-LPS IgA and IgG; anti-flagellin IgA and IgG; sCD14; I-FABP; myeloperoxidase (MPO); and calprotectin

    Time frame: 24 weeks

  20. Change of fat mass and fat-free mass at program discharge and study discharge

    Measured by deuterium dilution

    Time frame: 24 weeks

  21. Micronutrient status at enrollment, program discharge and study discharge

    Defined as ferritin; soluble transferrin binding protein; alpha-tocopherol; retinol; folate; and vitamin B12

    Time frame: 24 weeks

  22. Immuno-sufficiency at week 2, week 4, program discharge, week 12 and study discharge (SAM only)

    As defined by T-cell receptor excision circles (TRECs) and kappa-receptor excision circles (KRECs)

    Time frame: 24 weeks

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 27, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06382857
Lead sponsor
Epicentre
Collaborators
Epicentre, Niger, National Nutrition Direction, Niger, Ministry of Public Health and Social Affairs, Niger, Regional Direction of Public Health, Maradi
Responsible party
Sheila Isanaka (Associate Professor, Harvard School of Public Health (HSPH)) — Principal investigator
First posted
Apr 24, 2024
Start date
May 2, 2024
Primary completion
Nov 1, 2025 (estimated)
Completion
Feb 1, 2026 (estimated)
Last update
Aug 27, 2024

Study contacts

Sheila Isanaka, ScD
Contact
sisanaka@hsph.harvard.edu
Rebecca Grais, PhD
study chair · Epicentre

Oversight

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

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