scholarly journals Community-based Malaria Screening and Treatment for Pregnant Women Receiving Standard Intermittent Preventive Treatment With Sulfadoxine-Pyrimethamine: A Multicenter (The Gambia, Burkina Faso, and Benin) Cluster-randomized Controlled Trial

2018 ◽  
Vol 68 (4) ◽  
pp. 586-596 ◽  
Author(s):  
◽  
Susana Scott ◽  
Umberto D’Alessandro ◽  
Lindsay Kendall ◽  
John Bradley ◽  
...  
2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Morseda Chowdhury ◽  
Michael Dibley ◽  
Ashraful Alam ◽  
Patrick J Kelly ◽  
Camille Raynes-Greenow

Abstract Objectives Low birthweight (LBW) is strongly associated with neonatal mortality. Evidence that nutrition education improves diet during pregnancy and reduces LBW is still weak. We investigated the effect of a nutrition education intervention for pregnant women in improving birthweight of infants. Our primary hypothesis was that women who receive the ‘balanced plate nutrition education’ during pregnancy would deliver babies 100 g heavier than those who receive standard nutrition education. Methods We conducted a parallel, two-arm, cluster-randomized controlled trial in Bangladesh, in which we randomly assigned 36 clusters in equal ratio to intervention or standard care. Participants in the intervention clusters received ‘balanced plate nutrition education’ with a practical demonstration from community health workers 4–7 times starting from the first trimester of pregnancy. The participants in the control clusters received standard nutrition education delivered by healthcare providers during antenatal care. Eligible participants were pregnant women of 12 weeks gestation or less. The primary outcome was mean birthweight and incidence of LBW (defined as birthweight less than 2500 gm). The trial is registered with number ACTRN12616000080426. Results We included all assigned participants in the intervention (445) and comparison (448) groups in the analyses (Figure 1). Baseline characteristics were balanced between the treatment groups (Table 1). The mean birthweight increased by 125.3 g (95% confidence interval (CI) 5·7, 244·9; P = 0·04) and the risk of LBW was reduced by 54% (relative risk (RR) 0·46; 95% CI 0·28, 0·78; P = 0·004) in the intervention compared to the comparison group (Table 2). In post hoc analyses amongst adolescent mothers we observed a significant improvement in birthweight and reduction in LBW (mean difference 297·3 g; 95% CI 85·0, 509·6; P = 0·006 and RR 0·31; 95% CI 0·12, 0·77; P = 0·01). Conclusions A community-based balanced plate nutrition education was effective in increasing birthweight and reducing the incidence of LBW in a rural population of Bangladesh. A community-based, balanced-plate nutrition education was effective in increasing birthweight and reducing the incidence of low birthweight in a rural population of Bangladesh. Funding Sources James P. Grant School of Public Health; Bangladesh, and Sydney Medical School; Australia. Supporting Tables, Images and/or Graphs


2019 ◽  
Vol 2 ◽  
pp. 56 ◽  
Author(s):  
Mark M. Kabue ◽  
Lindsay Grenier ◽  
Stephanie Suhowatsky ◽  
Jaiyeola Oyetunji ◽  
Emmanuel Ugwa ◽  
...  

Background: Antenatal care (ANC) in many low- and middle-income countries is under-utilized and of sub-optimal quality. Group ANC (G-ANC) is an intervention designed to improve the experience and provision of ANC for groups of women (cohorts) at similar stages of pregnancy. Methods: A two-arm, two-phase, cluster randomized controlled trial (cRCT) (non-blinded) is being conducted in Kenya and Nigeria. Public health facilities were matched and randomized to either standard individual ANC (control) or G-ANC (intervention) prior to enrollment. Participants include pregnant women attending first ANC at gestational age <24 weeks, health care providers, and sub-national health managers. Enrollment ended in June 2017 for both countries. In the intervention arm, pregnant women are assigned to cohorts at first ANC visit and receive subsequent care together during five meetings facilitated by a health care provider (Phase 1). After birth, the same cohorts meet four times over 12 months with their babies (Phase 2). Data collection was performed through surveys, clinical data extraction, focus group discussions, and in-depth interviews. Phase 1 data collection ended in January 2018 and Phase 2 concludes in November 2018. Intention-to-treat analysis will be used to evaluate primary outcomes for Phases 1 and 2: health facility delivery and use of a modern method of family planning at 12 months postpartum, respectively. Data analysis and reporting of results will be consistent with norms for cRCTs. General estimating equation models that account for clustering will be employed for primary outcome analyzes. Results: Overall 1,075 and 1,013 pregnant women were enrolled in Nigeria and Kenya, respectively. Final study results will be available in February 2019. Conclusions: This is the first cRCT on G-ANC in Africa. It is among the first to examine the effects of continuing group care through the first year postpartum. Registration: Pan African Clinical Trials Registry PACTR201706002254227 May 02, 2017


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