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研究方案:以本地食材为基础的补充食品替代玉米-大豆混合物加辅食治疗 6 至 59 月龄儿童中度急性营养不良:在沃莱塔的一项随机对照非劣效性试验

Research protocol local ingredients-based supplementary food as an alternative to corn-soya blends plus for treating moderate acute malnutrition among children aged 6 to 59 months: a randomized controlled non-inferiority trial in Wolaita.

机构信息

Hawassa University, School of Public and Environmental Health, PO Box 5, Hawassa, Ethiopia.

Centre for International Health, University of Bergen, PO Box 7800, 5020, Bergen, Norway.

出版信息

BMC Public Health. 2019 Dec 16;19(1):1689. doi: 10.1186/s12889-019-8031-3.

Abstract

BACKGROUND

In Ethiopia, 12.5% of children below 5 years are wasted, and 9.7% are moderately wasted. The present strategy for the management of moderate acute malnutrition (MAM) is a supplementary feeding program; however, this is only provided to chronically food-insecure areas. This randomized controlled non-inferiority trial examines if Local ingredients-based supplement (LIBS) is as effective as corn-soya blends plus (CSB+) in treating moderate acute malnutrition among children aged 6-59 months.

METHODS

A randomized controlled non-inferiority trial will be conducted with moderately wasted children aged 6 to 59 months in Wolaita, Ethiopia. The calculated sample size is 324 (i.e. with 162 children in each of two arms, to be assigned by randomization). The daily ration will be: 100 g of LIBS plus 25.2 g of sugar with 8 ml oil in the intervention group, and 150 g of CSB+ with 16 ml of oil in the control group. These interventions will be provided for a maximum period of 12 weeks, with follow-up performed on a weekly basis. Data analysis will be done using SPSS and STATA software. Both intention-to-treat and per protocol analyses will be done. Hazard ratio and Kaplan-Meier (log rank) curves of survival analysis will be done to predict the probability of recovery rate. Logistic regression will be used to test for interactions between independent and dependent variables. Analysis of variances, t-tests, fisher's exact test and chi-square tests will be used to assess baseline characteristics.

CONCLUSIONS

This paper will introduce to the existing research locally available nutritious foods which have the potential to enhance recovery from moderate acute malnutrition and to reduce the burden of malnutrition. The perceptions of mothers on feeding children with local ingredient-based supplementary food to assist recovery from moderate acute malnutrition will be the focus of in a qualitative study to follow; this will provide a further contribution in an evolving area of research.

TRIAL REGISTRATION

Pan-African Clinical Trial Registration number: PACTR201809662822990, retrospectively registered on 11/09/2018.

摘要

背景

在埃塞俄比亚,5 岁以下儿童中有 12.5%消瘦,9.7%为中度消瘦。目前,中度急性营养不良(MAM)的管理策略是补充喂养计划;然而,这仅提供给长期食物不安全的地区。本随机对照非劣效性试验研究了以当地食材为基础的补充剂(LIBS)与玉米-大豆混合物加(CSB+)治疗 6-59 月龄儿童中度急性营养不良的效果。

方法

在埃塞俄比亚的沃尔塔,将对 6-59 月龄中度消瘦的儿童进行一项随机对照非劣效性试验。计算出的样本量为 324 人(即每组 162 人,通过随机分组分配)。每日剂量为:干预组 100 克 LIBS 加 25.2 克糖和 8 毫升油,对照组 150 克 CSB+加 16 毫升油。这些干预措施将持续最长 12 周,每周进行随访。数据分析将使用 SPSS 和 STATA 软件进行。将进行意向治疗和方案分析。将进行生存分析的风险比和 Kaplan-Meier(对数秩)曲线来预测恢复率的概率。将使用逻辑回归检验独立和因变量之间的交互作用。方差分析、t 检验、Fisher 确切检验和卡方检验将用于评估基线特征。

结论

本文将介绍现有的研究中当地可获得的有营养的食物,这些食物有可能提高从中度急性营养不良中恢复的速度,并减轻营养不良的负担。后续将进行一项定性研究,重点关注母亲对用基于当地食材的补充食品喂养儿童以帮助从中度急性营养不良中恢复的看法;这将在一个不断发展的研究领域做出进一步贡献。

试验注册

泛非临床试验注册中心编号:PACTR201809662822990,于 2018 年 9 月 11 日回顾性注册。

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