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Single-Dose Postpartum Vitamin A Supplementation of Mothers and Neonates
This study is ongoing, but not recruiting participants.
First Received: September 12, 2005   No Changes Posted
Sponsor: Johns Hopkins Bloomberg School of Public Health
Collaborators: McGill University Health Center
University of Zimbabwe
Harare City Health Department, Harare, Zimbabwe
United States Agency for International Development (USAID)
Bill and Melinda Gates Foundation
Rockefeller Foundation
BASF
SARA and Linkages Projects, Academy for Educational Development, Washington DC.
University of Montreal
Information provided by: Johns Hopkins Bloomberg School of Public Health
ClinicalTrials.gov Identifier: NCT00198718
  Purpose

The ZVITAMBO PROJECT is testing whether giving mothers and infants a single large dose of vitamin A during the immediate post partum period will reduce:

  1. Infant Mortality Can oral administration of a single 50,000 IU dose of vitamin A to newborn infants, a single 400,000 IU dose of vitamin A given to their lactating mothers, or supplementation of both the mother and infant during the immediate post partum period reduce infant mortality by at least 30%?
  2. Mother to Child HIV transmission during breast feeding Can oral administration of a single large dose of vitamin A given during the immediate post partum period to HIV seropositive lactating women and/or their babies reduce HIV transmission via breast feeding by at least 30%?
  3. Sexually transmitted HIV infection of post partum women Can a single 400,000 IU dose of vitamin A given during the immediate post partum period to HIV seronegative women reduce their likelihood of becoming HIV infected during the post partum year by at least 25%?
  4. Infant feeding in the context of HIV: An operational research study was initiated mid-way through the trial to determine how UNAIDS Guidelines on infant feeding in the context of HIV could be effectively implemented and to measure the impact of such a program on infant feeding practices and postnatal HIV transmission.

Substudies:

Random subsamples of maternal and infant blood were evaluated for anemia and iron status to determine the effect of vitamin A on hematopoiesis and serum and breast milk retinol (mothers) and modified relative dose response test (infants) to determine the effect of vitamin A on vitamin A status.

A subsample of maternal and infant blood samples were evaluated for the presence of HLA-E, HLA-G, and TAP polymorphisms and their relation to prevalent HIV infection in mothers and risk of mother to child transmission.


Condition Intervention Phase
Vitamin A Deficiency
HIV
Drug: Vitamin A (retinyl palmitate)
Phase II

Study Type: Interventional
Study Design: Treatment, Randomized, Double-Blind, Placebo Control, Factorial Assignment, Efficacy Study
Official Title: Vitamin A Supplementation of Breast Feeding Mothers and Their Neonates at Delivery: Impact on Mother to Child Transmission of HIV During Lactation, HIV Infection Among Women During the Postpartum Year, and Infant Mortality.

Resource links provided by NLM:


Further study details as provided by Johns Hopkins Bloomberg School of Public Health:

Primary Outcome Measures:
  • 1. HIV infection rate among baseline HIV-negative babies born to HIV-positive mothers at 24 months
  • 2. Infant mortality rate among all infants, infants born to HIV-negative mothers, and infants born to HIV-positive mothers at 6 months
  • 3. HIV infection rates among baseline HIV-negative mothers at 24 months

Secondary Outcome Measures:
  • 1. HIV infection or death rate among baseline HIV-negative babies born to HIV-positive mothers at 6, 12, and 18 months
  • 2. HIV infection or death rate among 6-wk HIV-negative babies born to HIV-positive mothers at 6, 12, 18, 24 months
  • 3. Serum and breast milk retinol concentration among women at 12 months
  • 4. Modified relative dose response ratios among infants at 6 wk, and 3, 6, 9, and 12 months.
  • 5. Viral load among HIV-positive women at 6 wk, and 3, 6, 9, and 12 months.
  • 6. Weight for age among infants at 12 months
  • 7. Weight for length among infants at 12 months
  • 8. Length for age among infants at 12 months

Estimated Enrollment: 28000
Study Start Date: November 1997
Estimated Study Completion Date: May 2001
  Show Detailed Description

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • mothers and their neonates delivering at a study recruitment site during the recruitment period

Exclusion Criteria:

  • mother in intensive care unit
  • mother not fully conscious
  • maternal temperature > 39˚
  • Mother is ‘nil per mouth’ (NPO)
  • Mother is terminally ill as indicated in medical notes
  • Infant is NPO
  • Infant is terminally ill as indicated in medical notes
  • Infant birth weight <1500 g
  • Infant is a twin or triplet delivery
  • Regular place of residence is outside Harare.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00198718

Sponsors and Collaborators
Johns Hopkins Bloomberg School of Public Health
McGill University Health Center
University of Zimbabwe
Harare City Health Department, Harare, Zimbabwe
United States Agency for International Development (USAID)
Bill and Melinda Gates Foundation
Rockefeller Foundation
BASF
SARA and Linkages Projects, Academy for Educational Development, Washington DC.
University of Montreal
Investigators
Principal Investigator: Jean H Humphrey, ScD Johns Hopkins Bloomberg School of Pubic Health
  More Information

Publications:
Zijenah LS, Humphrey J, Nathoo K, Malaba L, Zvandasara P, Mahomva A, Iliff P, Mbizvo MT. Evaluation of the prototype Roche DNA amplification kit incorporating the new SSK145 and SKCC1B primers in detection of human immunodeficiency virus type 1 DNA in Zimbabwe. J Clin Microbiol. 1999 Nov;37(11):3569-71.
Zijenah LS, Moulton LH, Iliff P, Nathoo K, Munjoma MW, Mutasa K, Malaba L, Zvandasara P, Ward BJ, Humphrey J; ZVITAMBO Study Group. Timing of mother-to-child transmission of HIV-1 and infant mortality in the first 6 months of life in Harare, Zimbabwe. AIDS. 2004 Jan 23;18(2):273-80.
Malaba LC, Iliff PJ, Nathoo KJ, Marinda E, Moulton LH, Zijenah LS, Zvandasara P, Ward BJ, Humphrey JH; the ZVITAMBO Study Group. Effect of postpartum maternal or neonatal vitamin A supplementation on infant mortality among infants born to HIV-negative mothers in Zimbabwe. Am J Clin Nutr. 2005 Feb;81(2):454-60.
Iliff PJ, Piwoz EG, Tavengwa NV, Zunguza CD, Marinda ET, Nathoo KJ, Moulton LH, Ward BJ, Humphrey JH; ZVITAMBO study group. Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival. AIDS. 2005 Apr 29;19(7):699-708.
Piwoz EG, Iliff PJ, Tavengwa N, Gavin L, Marinda E, Lunney K, Zunguza C, Nathoo KJ, Humphrey JH. An education and counseling program for preventing breast-feeding-associated HIV transmission in Zimbabwe: design and impact on maternal knowledge and behavior. J Nutr. 2005 Apr;135(4):950-5.
Miller MF, Stoltzfus RJ, Mbuya NV, Malaba LC, Iliff PJ, Humphrey JH; ZVITAMBO Study Group. Total body iron in HIV-positive and HIV-negative Zimbabwean newborns strongly predicts anemia throughout infancy and is predicted by maternal hemoglobin concentration. J Nutr. 2003 Nov;133(11):3461-8.
Humphrey JH, Rice AL. Vitamin A supplementation of young infants. Lancet. 2000 Jul 29;356(9227):422-4.
Humphrey J, Iliff P. Is breast not best? Feeding babies born to HIV-positive mothers: bringing balance to a complex issue. Nutr Rev. 2001 Apr;59(4):119-27. Review.
Miller M, Humphrey J, Johnson E, Marinda E, Brookmeyer R, Katz J. Why do children become vitamin A deficient? J Nutr. 2002 Sep;132(9 Suppl):2867S-2880S.
Miller M, Iliff P, Stoltzfus RJ, Humphrey J. Breastmilk erythropoietin and mother-to-child HIV transmission through breastmilk. Lancet. 2002 Oct 19;360(9341):1246-8.
Stoltzfus RJ, Humphrey JH. Vitamin A and the nursing mother-infant dyad: evidence for intervention. Adv Exp Med Biol. 2002;503:39-47. Review.

Additional publications automatically indexed to this study by National Clinical Trials Identifier (NCT ID):
Study ID Numbers: (CIDA) (R/C Project 690/M3688)
Study First Received: September 12, 2005
Last Updated: September 12, 2005
ClinicalTrials.gov Identifier: NCT00198718     History of Changes
Health Authority: United States: Institutional Review Board;   Zimbabwe: Medical Research Council;   Canada: Ethical Review Board of the Research Institute of McGill University Health Centers

Keywords provided by Johns Hopkins Bloomberg School of Public Health:
Vitamin A supplementation
HIV
Mother to child transmission of HIV
Breastfeeding

Additional relevant MeSH terms:
Anticarcinogenic Agents
Vitamin A Deficiency
Night Blindness
Antioxidants
Vision Disorders
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Avitaminosis
Eye Diseases
Growth Substances
Physiological Effects of Drugs
Protective Agents
Pharmacologic Actions
Malnutrition
Retinol palmitate
Therapeutic Uses
Vitamin A
Vitamins
Nutrition Disorders
Micronutrients
Deficiency Diseases

ClinicalTrials.gov processed this record on February 08, 2010