Pneumonia Clinical Trial
Official title:
Routine Administration of Folic Acid and Vitamin B12 to Prevent Childhood Infections in Young Indian Children
Hypothesis: Supplementation of two recommended daily allowances (RDA) of folic acid with or
without simultaneous administration of vitamin B12 reduces the rates of acute lower
respiratory tract infections (ALRI), clinical pneumonia and diarrhea.
Design/Methods We will conduct a preventive randomized placebo controlled clinical trial of
folic acid and vitamin B12 supplementation in 1000 children aged 6 to 30 months living in a
low to middle-income socioeconomic setting in New Delhi, India. Children aged 6-30 months
will be identified through a survey. Eligible and willing Children aged 6-30 months will be
randomized to 4 treatment groups. Trial to enrollment informed consent will be obtained by
the Study Physician/Supervisor. At enrollment a baseline form will be filled and the child
weight and length taken. The baseline blood samples will be collected. The supplements will
be given daily for 6 months. Morbidity will be ascertained through biweekly home visits by
field workers.
Pneumonia and diarrhea are among the leading causes of poor health and death in young
children of developing countries.
Many of these children have inadequate intakes of several vitamins and minerals. Folate and
vitamin B12 are important for normal function of the immune system. Deficiencies of these
vitamins are often part of general malnutrition and might be responsible for the excess
morbidity and mortality seen in malnourished children. In a recent cohort study in almost
2,500 Indian children we demonstrated that those with poor folate status had higher rates of
diarrhea and pneumonia. This study also showed that children that were not breastfed had
poor folate status and our analyses suggested that the effect of breastfeeding in preventing
respiratory and gastrointestinal infections could be explained by the folate content of
breast milk. The finding that poor folate status is related to increased susceptibility to
childhood infections needs to be confirmed in well conducted clinical trials in populations
where folate deficiency is prevalent.
This trial aims to examine whether daily supplementation of 2 recommended doses of folate or
vitamin B12 or both will lessen the incidence of acute lower respiratory tract infections
and diarrhea. We will also measure if the supplementation improves the weight and length of
supplemented children.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Prevention
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