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Omphalitis Community Based Algorithm Validation Study (OCAVS)

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ClinicalTrials.gov Identifier: NCT01687621
Recruitment Status : Completed
First Posted : September 19, 2012
Last Update Posted : July 22, 2015
Sponsor:
Collaborators:
Bill and Melinda Gates Foundation
Thrasher Research Fund
Information provided by (Responsible Party):
Julie M Herlihy, Boston University

Brief 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.


Condition or disease Intervention/treatment
Omphalitis Procedure: Diagnostic Algorithm for Community Based Worker for Omphalitis

Study Type : Observational
Actual Enrollment : 1009 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Omphalitis Community Based Algorithm Validation Study
Study Start Date : September 2012
Actual Primary Completion Date : July 2013
Actual Study Completion Date : July 2013

Group/Cohort Intervention/treatment
Neonates, 1 to 10 days old
Neonates between day 1-10 of life presenting to hospitals and community health centers in Southern Province, Zambia, with no prior diagnosis of omphalitis, whose guardian, aged 15 and above, is willing to allow their newborn to participate in the study.
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.



Primary Outcome Measures :
  1. Validity of the omphalitis algorithm [ Time Frame: 10 months ]
    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.



Information from the National Library of Medicine

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Ages Eligible for Study:   up to 10 Days   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Neonate between day 1-10 of life presenting to Livingstone and Mazabuka district hospitals and community health centers in Southern Province, Zambia
Criteria

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

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01687621


Locations
Zambia
Hospitals & Community Health Centers
Livingstone, Southern Province, Zambia
Sponsors and Collaborators
Boston University
Bill and Melinda Gates Foundation
Thrasher Research Fund
Investigators
Principal Investigator: Julie M Herlihy, MD MPH Boston University

Additional Information:
Responsible Party: Julie M Herlihy, Assistant Professor, Boston University
ClinicalTrials.gov Identifier: NCT01687621     History of Changes
Other Study ID Numbers: OCAVS
First Posted: September 19, 2012    Key Record Dates
Last Update Posted: July 22, 2015
Last Verified: July 2015

Keywords provided by Julie M Herlihy, Boston University:
Omphalitis
Neonate
Zambia
Neonatal mortality
Umbilical cord infection