Please select the eligibility criteria that correspond to the clinical trial below.
Title: Strengthening and Evaluating the "Preventing Malnutrition in Children Under Two Years of Age Approach" (PM2A) in Guatemala and Burundi
Brief Summary: A study conducted by IFPRI in Haiti provided the first programmatic evidence, using a cluster randomized evaluation design, that preventing child undernutrition in children under two years of age (PM2A) through an integrated program providing food rations, BCC and preventive health and nutrition services is both feasible and highly effective. The study's principal aim was to compare a newly designed preventive approach with the traditional (recuperative) food assisted MCHN program approach, and therefore included only two comparison groups: one group of communities that was randomly assigned to the preventive approach and another group assigned to the recuperative approach. For logistical and financial reasons, the study did not include a randomized control group receiving no intervention.

The Haiti study design was well-suited to achieve its main goal - i.e. to test whether the preventive approach was more effective than the recuperative approach at preventing child undernutrition - but it left a number of questions unanswered.

The present study will address several of these questions, which will allow to further refine the PM2A approach, facilitate its replication in different contexts, and maximize its impact and cost-effectiveness in future programming. The study will be conducted in Guatemala and Burundi. The key research objectives are:

1. Impact and cost effectiveness: Assess the impact and cost effectiveness of PM2A on child nutritional status.
2. Optimal composition and size of food rations in PM2A: Assess the differential and absolute impact of varying the size and types of foods incorporated in the food ration of the PM2A. More specifically, assess the differential effect of different sizes of family food rations, and assess the impact of substituting the individual food ration with new micronutrient-rich products such as lipid-based nutrient supplements (LNS) or micronutrient Sprinkles.
3. Optimal timing and duration of PM2A: Assess the differential and absolute impact of varying the timing and duration of exposure to PM2A on child nutritional status.


Options:
A: Inclusion Criteria:

* Confirmed maternal HIV-infection
* Age 5.5-6.5 months at intervention start
* Weight-for-length z-score \> -3 SD (WHO 2006 reference)

Exclusion Criteria:

* Confirmed or suspected allergy to peanuts
* Participation in a concurrent clinical trial at GHESKIO
B: Inclusion Criteria:

* WH≥80% of median of NCHS reference without bilateral pitting oedema;
* Age ≥ 6 months and ≤36 months;
* Member of a household with a dependency ratio \>4;
* Not planning to leave the study zone for the coming 5 months;

Exclusion Criteria:

* Not showing appetite;
* Age \< 6 months or age \> 36 months
* Weight-for-Height Z-score \<-2 and/or the presence of bilateral pitting oedema in children 6-36 months;
* Member of a household with a dependency ration ≤ 4;
* Clinical complications
* Presence of chronic illness, cardiac disease, congenital abnormalities, cancer;
* Being allergic to one of the ingredients of the RUF.
C: Inclusion Criteria:

* Guatemala: pregnant mothers and subsequently their born children up to the age of 24 months;
* Burundi: cross-sectional study: children 0 to 42 of age.

Exclusion Criteria:

* none
D: Cross-sectional study (baseline and endline) (n=2,310)

Inclusion Criteria:

* At least one index child 0-17 months of age in the household
* Mother should be living in the study area since the index child's delivery
* Singleton infants

Exclusion Criteria:

- Index child should not present congenital deformations that hamper anthropometric measurements

Longitudinal study (n=2,180)

Inclusion Criteria:

* child 0-1.4 months of age;
* Mother should be living in the study area since the index child's delivery
* Singleton infants

Exclusion Criteria:

* Congenital malformations that make anthropometric measurements impossible
* Mother planning to leave the study area in the coming year
* Children of 1.5 month of age or older at study inclusion
* WHZ\<-2 both at enrollment and at the first follow-up.

Answer: C