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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01687621
Other study ID # OCAVS
Secondary ID
Status Completed
Phase N/A
First received September 7, 2012
Last updated July 20, 2015
Start date September 2012
Est. completion date July 2013

Study information

Verified date July 2015
Source Boston University
Contact n/a
Is FDA regulated No
Health authority United States: Institutional Review BoardZambia: Research Ethics Committee
Study type Observational

Clinical Trial Summary

The objective of this study is to develop and test a simple community-based diagnostic algorithm for omphalitis in sub-Saharan Africa. To date, there has been no validated community-based algorithms developed and tested in the sub-Saharan context where the manifestations of omphalitis presentation may vary and diagnosis could be potentially more challenging in infants with darker skin color. Given the current attention to cord care at the global and national policy level, validated community-based algorithms will be needed to allow primary health workers to identify cord infections and reduce associated morbidity.

After obtaining guardian informed consent, newborns aged 1-10 days presenting to the health facility for routine or sick visits will undergo two independent, parallel evaluations; first, by a community level worker and second, by a Zambian medical doctor (gold standard). A third independent assessment of a photo of the cord will be performed remotely by a board-certified pediatrician. Using the on-site clinician as the gold standard, the community-based algorithm and the photo assessment will be tested for concordance and the sensitivity and specificity of the algorithm will be generated. Likewise, the remote pictorial assessment will be compared to the gold standard to determine reliability of diagnosis from photographs alone.


Recruitment information / eligibility

Status Completed
Enrollment 1009
Est. completion date July 2013
Est. primary completion date July 2013
Accepts healthy volunteers Accepts Healthy Volunteers
Gender Both
Age group N/A to 10 Days
Eligibility Inclusion Criteria:

- Neonate between day 1-10 of life presenting to Livingstone and Mazabuka district hospitals and community health centers in Southern Province, Zambia

- No prior diagnosis of omphalitis

- Guardian willing to allow their newborn to participate in the study

- Guardian aged 15 and above

Study Design

Observational Model: Cohort, Time Perspective: Prospective


Related Conditions & MeSH terms


Intervention

Procedure:
Diagnostic Algorithm for Community Based Worker for Omphalitis
After obtaining guardian informed written consent, newborns aged 1-10 days presenting to the health facility for routine or sick visits would undergo 2 independent, parallel evaluations; first, by a ZamCAT Field Monitor (community level worker from our existing study) and the second by a Zambian medical doctor (gold standard). A US board of pediatrics-certified pediatrician will perform a third independent assessment of a photo of the cord remotely. Using the on-site clinician as the gold standard, the community-based algorithm and the photo assessment will be tested for concordance and the sensitivity and specificity of the algorithm will be generated. Likewise, the remote pictorial assessment will be compared to the gold standard to determine reliability of diagnosis from photographs alone.

Locations

Country Name City State
Zambia Hospitals & Community Health Centers Livingstone Southern Province

Sponsors (3)

Lead Sponsor Collaborator
Boston University Bill and Melinda Gates Foundation, Thrasher Research Fund

Country where clinical trial is conducted

Zambia, 

Outcome

Type Measure Description Time frame Safety issue
Primary Validity of the omphalitis algorithm The primary outcome of the study is a measure of validity (concordance) of the the omphalitis algorithm generated by inter-observer kappa statistics to evaluate diagnostic concordance between the field monitors and the gold standard cord health expert on specific algorithmic questions. Questions that demonstrate high concordance will be selected for inclusion in the final algorithm. Sensitivity and specificity of the final algorithm will be generated. 10 months No
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