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牲畜促进健康研究:肯尼亚北部牧民社区中针对牲畜干预措施以预防妇女和儿童急性营养不良的现场试验。

The Livestock for Health Study: A Field Trial on Livestock Interventions to Prevent Acute Malnutrition Among Women and Children in Pastoralist Communities in Northern Kenya.

机构信息

Paul G. Allen School for Global Health, Washington State University, Pullman, USA.

Center for Epidemiological Modelling and Analysis, University of Nairobi.

出版信息

Food Nutr Bull. 2023 Dec;44(2_suppl):S119-S123. doi: 10.1177/03795721231195427.

Abstract

BACKGROUND

Livestock-dependent communities in Africa's drylands disproportionately experience acute malnutrition, especially during drought seasons. We detail the design and implementation of the Livestock for Health (L4H) study aimed at determining the effect of providing livestock feed and nutritional counselling to prevent seasonal spikes of acute malnutrition.

METHODS

The L4H study employed a 3-arm cluster randomized controlled trial to compare households in pastoralist settings in northern Kenya receiving livestock feeds during critical dry periods, with or without nutritional counseling, with control households. Over 4 dry seasons, 2019 to 2021, the study collected data on household milk production, consumption patterns, mothers'/children's nutritional status, household socioeconomic status, herd dynamics, and human and animal health status every 6 weeks.

RESULTS

L4H recruited 1734 households, with 639, 585, and 510 households assigned to intervention arms 1 and 2 and control arm 3, respectively. From these households, 1734 women and 1748 children younger than 3 years were recruited. In total, 19 419 household visits were completed, obtaining anthropometric measures 9 times on average for each child and mother. Eighty-one households (5%) were lost from the study due to the mother's death, child's death, migration, and withdrawal for other reasons.

DISCUSSION

L4H's success in a challenging environment was possible due to strong community engagement, formative studies to inform trial design, collaboration with local authorities, and effective interdisciplinary collaboration. Subsequent manuscripts will report the study findings.

TRIAL REGISTRATION

The study was registered October 29, 2020, and is online at ClinicalTrials.gov (ID: NCT04608656).

摘要

背景

非洲干旱地区依赖牲畜的社区不成比例地经历急性营养不良,尤其是在干旱季节。我们详细介绍了 Livestock for Health(L4H)研究的设计和实施情况,该研究旨在确定提供牲畜饲料和营养咨询以预防季节性急性营养不良高峰的效果。

方法

L4H 研究采用 3 臂集群随机对照试验,比较了肯尼亚北部牧民环境中在关键干旱期接受牲畜饲料的家庭,这些家庭接受或不接受营养咨询,与对照组家庭进行比较。在 2019 年至 2021 年的 4 个旱季中,该研究每 6 周收集一次家庭牛奶产量、消费模式、母亲/儿童营养状况、家庭社会经济状况、畜群动态以及人类和动物健康状况的数据。

结果

L4H 招募了 1734 户家庭,其中 639 户、585 户和 510 户分别被分配到干预组 1 和 2 以及对照组 3。从这些家庭中招募了 1734 名妇女和 1748 名 3 岁以下儿童。总共完成了 19419 次家访,平均为每个孩子和母亲完成了 9 次人体测量测量。由于母亲死亡、儿童死亡、移民和因其他原因退出,有 81 户(5%)家庭从研究中流失。

讨论

L4H 在充满挑战的环境中取得成功,这是由于社区的大力参与、为试验设计提供信息的形成性研究、与地方当局的合作以及有效的跨学科合作。随后的论文将报告研究结果。

试验注册

该研究于 2020 年 10 月 29 日注册,可在 ClinicalTrials.gov 上在线查询(ID:NCT04608656)。

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