Please select the eligibility criteria that correspond to the clinical trial below.
Title: Efficacy of Lipid-based Nutrient Supplements (LNS) for Pregnant and Lactating Women and Their Infants
Brief Summary: In Ghana, low micronutrient intakes among pregnant women are a major problem. The standard nutritional intervention during pregnancy is iron-folic acid tablets, but adherence is low. The investigators have pioneered the use of multiple micronutrient-fortified semi-solid pastes called Lipid-based Nutrient Supplements (LNS) (made using vegetable oil, groundnut, milk, sugar, and micronutrients), and the investigators' previous studies show that the approach could have great potential for use by pregnant and lactating women.

This study aims to evaluate the effects of LNS-P\&L designed for pregnant and lactating women and LNS-20gM designed for infants. Pregnant women (n=864) randomly selected from ante-natal clinics in Yilo and Manya Krobo districts of Ghana will be randomized to receive daily (a) Group 1: Iron/ Folic Acid tablets during pregnancy, and a tablet containing calcium (Ca) only (akin to a placebo) during lactation (6 mo), (b) Group 2: Multiple Micronutrient tablets during pregnancy and the first six months of lactation, or (c) Group 3: LNS-P\&L during pregnancy and lactation, whilst their infants receive LNS-20gM daily from 6 to 18 months. There are two primary outcomes namely:

1. Maternal primary outcome: Birth length
2. Child primary outcome: Child length-for-age z-score at 18 mo.

The investigators hypothesize that a) mean birth length and length-for-age at 18 mo will be greater in children whose mothers are in Group 2 than those whose mothers are in Group 1, and b) children whose mothers are in Group 3 will have greater birth length and length-for-age at 18 mo than the children in either of the other two groups.


Options:
A: 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
B: Inclusion Criteria:

(1) Infants (target child) will be eligible to participate in the study if they are:

1. They are in utero at the baseline survey
2. Their parents/guardians are planning to stay in the study village for the next 12 months (if a mother is planning to give birth at her natal home and then return, she will still be a candidate for enrollment)

(2) Children \< 36 months old at baseline that are living in the compound of a target child will be eligible to participate in diarrhea measurement if:

1. They are \< 36 months old at the baseline survey
2. Their parents/guardians are planning to stay in the study village for the next 12 months

(3) Children 18 - 27 months old at baseline that are living in the compound of a target child will be eligible to participate in intestinal parasite specimen collection if:

1. They are 18 - 27 months old at the baseline survey
2. Their parents/guardians are planning to stay in the study village for the next 12 months
C: Inclusion Criteria:

* 9.0 to 9.9 mo of age

Exclusion Criteria:

* severe anemia
* severely malnourished
* presence of bipedal oedema
* severe illness
* congenital abnormalities
* chronic medical condition
* known HIV infection of mother or infant
* history of peanut allergy
* history of anaphylaxis or serious allergic reaction to any substance
D: Inclusion Criteria:

* At least 18 years of age
* No more than 20 wk of gestation
* Given Ante-natal Cards of the Ghana Health Service
* Completed the initial routine ante-natal examination at the clinics
* HIV negative or status unknown (as from the Ante-natal card)
* Free from chronic disease e.g. malignancy requiring frequent medical attention (as from the Ante-natal card)
* Residing in the Manya Krobo or Yilo Krobo district
* Prepared to sign an informed consent
* Living in the area throughout the duration of the study
* Acceptance of home visitors

Exclusion Criteria:

* Known asthmatic or history of allergy towards peanut or milk products
* Concurrent participation in another clinical trial
* Severe illness warranting hospital referral

Answer: D