Evaluation of Zinc and / or Micronutrient Supplementation on Intestinal Flora, Diarrheal Disease Burden, Intestinal Mucosal Integrity and Growth Among Children of Pakistan
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Purpose
Information on the mechanisms of zinc is still in developing phase. Ecological and biological implications of long term zinc supplementation at population level requires assessment. The trial aims to assess the impact of routine supplementation of zinc among young growing children and evaluate its impact on intestinal microbial flora and relationship with gut mucosa integrity and co-morbidities.
| Condition | Intervention | Phase |
|---|---|---|
|
Malnutrition Diarrhea Pneumonia Growth |
Dietary Supplement: Micronutrient Supplementation without Zinc Dietary Supplement: Micronutrient Supplementation with Zinc Other: Nutritional Counselling and Education |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Prospective Cluster Randomized Controlled Evaluation of the Impact of Zinc and / or Micronutrient Supplementation on Intestinal Flora, Diarrheal Disease Burden, Intestinal Mucosal Integrity and Growth Among Cohorts of Children in Pakistan |
- Episodes of Diarrhea and additional morbidity such as acute lower respiratory tract infection, pneumonia and days with severe illness. [ Time Frame: 2 years ] [ Designated as safety issue: No ]
| Enrollment: | 2745 |
| Study Start Date: | November 2008 |
| Study Completion Date: | July 2012 |
| Primary Completion Date: | June 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: A
This group will not receive any of the intervention supplements. The group will only receive nutritional counselling and education, and treatment provided for any encountered illness according to IMCI guidelines.
|
Other: Nutritional Counselling and Education
This will contain Nutritional Counselling and Education.
|
|
Experimental: B
This group will receive micronutrient supplements containing microencapsulated Iron, Vitamin C, Vitamin A, Vitamin D, and Folic Acid. This group will also receive Nutritional Counselling and Education and treatment according to IMCI Guidelines for any serious illness. |
Dietary Supplement: Micronutrient Supplementation without Zinc
This will contain Micronutrient Supplements containing Microencapsulated Iron, Vitamin C, Vitamin A, Vitamin D and Folic Acid
|
|
Experimental: C
This group will receive Micronutrient Supplements containing Microencapsulated Iron, Vitamin C, Vitamin A, Vitamin D, Folic Acid, and Zinc. This group will also receive nutritional counselling, education and treatment according to IMCI Guidelines in case of any untoward illness. |
Dietary Supplement: Micronutrient Supplementation with Zinc
This will contain Microencapsulated Iron, Vitamin C, Vitamin A, Vitamin D, and Folic Acid. Additionally, this will also contain 10 mg elemental Zinc Sulphate.
|
Detailed Description:
WHO has recommended the use of zinc for the treatment of acute diarrhea. Literature supports up-scaling of zinc supplementation programs to prevent childhood illnesses, such as diarrhea and respiratory infections, and its subsequent co-morbid conditions. As the potential mechanisms of action of zinc still remains to be established, this trial is proposed to evaluate the relationship of intestinal microbial flora, intestinal permeability, morbidity patterns and response to various enteric pathogens in a representative birth cohort randomly allocated to receive daily zinc and micronutrients from 6-18 months of age, and a control population.
Eligibility| Ages Eligible for Study: | up to 6 Months |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Children of ages 2 weeks to 6 months for recruitment into the Trial. Children of ages 6 months and onwards would eligible to receive intervention (in the form of Micronutrient Sprinkles)
Exclusion Criteria:
- Children with obvious congenital anomalies.
Contacts and Locations| Pakistan | |
| The Aga Khan University | |
| Karachi, Sindh, Pakistan, 75300 | |
| Project Office, Matiari | |
| Matiari, Sindh, Pakistan, 75300 | |
| Principal Investigator: | Zulfiqar ZB Bhutta, MBBS, PhD | The Aga Khan University |
More Information
No publications provided
| Responsible Party: | Dr Zulfiqar Ahmed Bhutta, Professor and Founding Chair, Division of Women and Child Health, Aga Khan University |
| ClinicalTrials.gov Identifier: | NCT00705445 History of Changes |
| Other Study ID Numbers: | 752-Peds/ERC-07 |
| Study First Received: | June 25, 2008 |
| Last Updated: | August 27, 2012 |
| Health Authority: | Pakistan: Ministry of Health |
Keywords provided by Aga Khan University:
|
Malnutrition Diarrhea Pneumonia |
Growth Zinc Supplements Microbiome |
Additional relevant MeSH terms:
|
Diarrhea Pneumonia Malnutrition Signs and Symptoms, Digestive Signs and Symptoms Lung Diseases Respiratory Tract Diseases Respiratory Tract Infections |
Nutrition Disorders Micronutrients Zinc Trace Elements Growth Substances Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 17, 2013