Multiple micronutrient supplementation improves growth and hemoglobin of infants in Gaza Strip, Palestine

ISRCTN ISRCTN57594793
DOI https://doi.org/10.1186/ISRCTN57594793
Secondary identifying numbers N/A
Submission date
02/01/2018
Registration date
20/03/2018
Last edited
07/12/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Nutritional, Metabolic, Endocrine
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Growth faltering (slower than expected rate of growth) is a common form of undernutrition in developing countries. A lack of micronutrients including vitamin A, vitamin D, iron, and zinc has been associated with undernutrition in young children, particularly growth retardation. The aim of this study is to determine the impact of micronutrient powder supplementation on the nutritional status of infants in Gaza Strip, Palestine.

Who can participate?
Infants aged 6 months

What does the study involve?
The infants are randomly allocated into two groups to receive either the National Micronutrient Supplement or both a micronutrient powder and the National Micronutrient Supplement. Weight, length, circumference of head, waist and mid-upper arm, triceps and subscapular skinfolds (for body fat determination), and blood haemoglobin are measured. Information on the infants’ nutrient intakes is also obtained from their mothers.

What are the possible benefits and risks of participating?
The infants' nutritional status is expected to improve. No risks are expected from the blood samples or the supplements.

Where is the study run from?
Two healthcare clinics of the United Nations Relief and Works Agency (UNRWA) in the middle area governorate of Gaza Strip, Palestine

When is the study starting and how long is it expected to run for?
September 2015 to January 2017

Who is funding the study?
Universiti Putra Malaysia

Who is the main contact?
Ali Albelbeisi
Alialbelbeisi@gmail.com

Contact information

Mr Ali Albelbeisi
Scientific

Jalan SPS5/5, Off Persiaran Serdang Perdana
43300 Seri Kembangan, Selangor
Kuala Lumpur
0060
Malaysia

Phone +60 (0)173186913
Email Alialbelbeisi@gmail.com

Study information

Study designRandomized community trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Community
Study typePrevention
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleMultiple micronutrient supplementation improves growth and hemoglobin of infants in Gaza Strip, Palestine: a randomized community trial
Study hypothesisMicronutrient supplements in powder form improves the nutritional status of Palestinian infants.
Ethics approval(s)Helsinki Committee for Ethical Approval, 15/09/2014, ref: PHRC/HC/27/14
ConditionNutritional status including growth parameters, biomedical measures, and dietary intakes
InterventionUpon screening, 200 children were randomly selected (50% male and 50% female) using a table of random numbers. The random allocation procedures were employed to assign children to experimental and control groups. To avoid selection bias and reduce the chances of imbalance between groups, sealed opaque envelope method was used to assign children to groups. The infants were randomly assigned into two groups:
1. Control (National Micronutrient Supplement)
2. Experimental (micronutrient powder with National Micronutrient Supplement)

The micronutrient powder contains 15 vitamins and minerals. The National Micronutrient Supplement consists of vitamin A, vitamin D and iron. Micronutrient powder (Mix meTM) was produced by DSM Nutritional Products Europe, Switzerland. The study protocol scheduled administration of micronutrient powder for 12 months as 3 sachets per week (every other day).

Weight, length, circumferences of head, waist and mid-upper arm, triceps and subscapular skinfolds, and blood hemoglobin were measured. Information on children’s nutrient intakes was also obtained from the mothers.
Intervention typeSupplement
Primary outcome measure1. Anthropometric measures, including body weight, length, circumferences of the head, waist, and mid-upper arm, and triceps and subscapular skinfold thickness, measured at baseline and throughout the study period (every 3 to 6 months). Z scores of these measures calculated by the WHO Anthro software, version 3.2.2, waist circumference z scores calculated based on the reference data obtained from Turkish under-six years children
2. Hemoglobin concentration: finger or heel prick blood obtained by the lab technician of the UNRWA clinic and analyzed for hemoglobin level using spectrophotometer (colorimeter) at baseline, end of the intervention, and 3 months after the end of intervention period
Secondary outcome measuresCalorie and nutrient intakes, including energy, carbohydrate, fat, protein, iron, vitamin A, and vitamin D, assessed using one day of 24-hour diet recall at baseline, 6 months of intervention, and at the end of the intervention period
Overall study start date04/09/2015
Overall study end date30/01/2017

Eligibility

Participant type(s)Healthy volunteer
Age groupChild
Lower age limit5 Months
SexBoth
Target number of participants200 (100 for each group)
Total final enrolment200
Participant inclusion criteria1. Male or female infants
2. Aged 5 months + 2 weeks
3. Have normal z scores (>-2 to <+2 SD) of Wt/age, Lt/age and Hc/age
4. Have birth weight ≥ 2.5 to ≤ 4 kg
5. Have appropriate for gestational age (between the 10th and 90th percentile)
6. Have blood level of hemoglobin ≥ 11 gram per deciliter
7. Breastfed for at least 4 months
8. Visited the UNRWA clinics for vaccination and/or routine child's growth follow up
Participant exclusion criteria1. Preterm infants (˂37 weeks)
2. Infants who have a history of chronic diseases (e.g. failure to thrive and metabolic or endocrine disorders)
3. Infants of diabetic mothers
4. Have a history of complications during delivery (aspiration, trauma)
5. Have a history of congenital and/or acquired neurological diagnosis (e.g., Down syndrome or cerebral palsy)
Recruitment start date01/10/2015
Recruitment end date01/01/2017

Locations

Countries of recruitment

  • Palestine, State of

Study participating centre

Two health care clinics of the UNRWA
Middle Area Governorate, Gaza Strip
00972
Palestine, State of

Sponsor information

University Putra Malaysia
University/education

Faculty of Medicine and Health Sciences
43400 UPM Serdang, Selangor Daruh Ehsan
Kuala Lumpur
0060
Malaysia

Phone +60 (0)389472606
Email chinys@upm.edu.my
Website http://www.medic.upm.edu.my/research-431
ROR logo "ROR" https://ror.org/02e91jd64

Funders

Funder type

University/education

Universiti Putra Malaysia
Government organisation / Universities (academic only)
Alternative name(s)
University Putra Malaysia, UPM
Location
Malaysia

Results and Publications

Intention to publish date23/06/2018
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication in a high impact peer reviewed journal.
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from Ali H.A. Albelbeisi (Alialbelbeisi@gmail.com).

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 05/12/2020 07/12/2020 Yes No

Editorial Notes

07/12/2020: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.