Micronutrient Deficiency Clinical Trial
Official title:
Impact of the Consumption of an M+ Fortified Premix (Chapuditos®) in 4 Rural Municipalities in the Department of La Libertad, El Salvador in Children From 6 to 59 Months.
Adequate nutrition during the first years of life is essential to reach full body and brain development potential. Children under the age of 5 in Central America and El Salvador suffer from micronutrient deficiencies. In El Salvador, ~ 20% of children under the age of 5 suffer from chronic undernutrition which is reflected in low length-for-their age Z-scores and anemia. This trial will examine the impact on health and growth in young children that will receive either a 21 micronutrient fortified cereal/legume mix manufactured in Guatemala or the current standard of nutritional care. The ultimate goal is to identify other feasible and effective alternatives to prevent micronutrient deficiencies through culturally acceptable vehicles.
A two-arm nutritional intervention trial utilizing a cluster-randomized design will be
implemented in the Department of La Libertad, El Salvador, in children from 6 to 59 months of
age for 5 years. One arm of the trial will receive a cereal/legume extruded premix fortified
with 21 micronutrients (amounts described in Intervention Type section) and the other arm
will continue to receive the current standard of nutritional care that consist of a fortified
cereal mix, vitamin A capsules, and prophylactic iron drops.
The monitoring and evaluation of this trial will be integrated to an ongoing program
implemented by a local NGO (FUSAL) that aims to reduce poverty and micronutrient deficiencies
through a variety of strategies. The nutrition products for children under 24 months of age
will be provided by El Salvadoran government health workers at the government's health
facilities. FUSAL will also be in charge of distributing food products to children from 24 to
59 months of age on a monthly basis at the community sites.
The trial design includes clusters (census subdivisions with a unique number used by the
Government of El Salvador to perform the country's census) that were randomized into one of
the two treatments. To evaluate the impact of the nutrition interventions, the trial will
have two different types of experimental designs:
1. A repeated cross sectional design: to compare outcomes between groups after 1 year and
on a yearly basis until the study is completed.
2. Longitudinal design: children will be followed up over time for at least one year, until
they turn 60 months and/or the study is completed, to evaluate incidence and recurrence
of anemia, undernutrition and morbidity, and other outcomes.
The investigators will test the following hypotheses:
1. Children receiving the 21 micronutrient fortified supplement will have better health and
growth than children receiving the nutritional standard of care.
2. Those who receive the 21 micronutrient fortified supplement until 59 months of age
continuously will have better health and growth compared to those who received the
nutritional standard of care.
3. The effect of the interventions will be most notable in those children who are
stunted/anemic.
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