Infant Malnutrition Clinical Trial
Official title:
The Mazira Project: An Evaluation of Eggs During Complementary Feeding in Rural Malawi
The Mazira Project is a study of the effect of egg consumption on growth, development and gut health of infants in Malawi. The study randomly assigns infants to receive one egg per day over six months or to receive an equivalent value of food at the end of six months. Growth, achievement of developmental milestones, gut microbiome composition and other measures of nutritional status are compared between the two groups to determine whether regular egg consumption benefits Malawian infants.
The aim of the Mazira Project is to determine whether daily consumption of an egg improves
the growth and development of infants in rural Malawi. In Malawi, 37% of children under five
years old are stunted, or shorter than expected for their age (1). Most stunting occurs when
children are less than 2 years old. Stunting is a sign of long-term undernutrition and is
associated with delayed cognitive development. Eggs provide protein, fatty acids, vitamin
B12, choline and other nutrients that may support healthy growth and cognitive development.
In a previous trial in Ecuador, infants who were provided eggs for daily consumption showed
improved growth and lower rates of stunting than infants who were not provided eggs (2).
Investigators are assessing whether children who consume eggs regularly over six months
starting when they are 6 to 9 months old have higher height-for-age scores and lower rates of
stunting than children who do not consume eggs regularly. Investigators are also assessing
whether egg consumption improves Malawian infants' cognitive development. Because gut health
is important for good nutrition, they are testing whether eggs have positive effects on
measures of gut health and the gut microbiome. Finally, they are exploring the various
metabolic pathways by which the nutrients available in eggs may influence infant growth and
development.
Participants are individually, randomly assigned to the egg intervention group or the control
group. The mothers of infants who are randomly assigned to the egg intervention group receive
14 eggs each week and are asked to feed the infant one egg each day. Extra eggs are provided
because sharing of food is common in Malawian households. The mothers of infants who are
randomly assigned to the control group receive a package of foods at the end of the study
that is equal in value to the eggs. Each mother/infant pair participates in the study for six
months.
When infants are enrolled, a baseline assessment is completed. This assessment includes a
blood draw plus testing for anemia and malaria, anthropometric measurements, developmental
assessments, 24-hour dietary recall interview, infant health history questionnaire. Mothers'
heights and weights are also measured, and each mother is asked about socio-economic and
demographic indicators and food security in her household. The anthropometric, dietary and
development assessments are repeated after 3 months. At the end of the six month study
period, anthropometric, dietary and development assessments are repeated, along with another
blood draw.
Additional data collected during the course of the study include: repeat 24-hour dietary
recalls and monthly stool sample collection among a subsample of 200 children; twice-weekly
observations of the index infant's egg consumption in the egg group or short questionnaire
about the index infant's most recent meal in the control group; weekly morbidity history and
animal source food consumption questionnaire among all infants; and focus groups and key
informant interviews about production, availability and consumption of eggs among communities
in the study area.
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