Different Strategies for Preventing Severe Acute Malnutrition in Niger

Study Overview
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Brief Summary
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Options for large-scale preventive distributions include fortified blended flours, ready-to-use foods and direct cash transfer either alone or in combination with family protective rations. Finding the most appropriate strategy is essential to prevent child malnutrition in countries like Niger with annual hunger gaps. Here, the investigators compare different preventive strategies on the incidence of acute malnutrition among children 6 to 23 months.

Official Title
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Different Strategies for Preventing Severe Acute Malnutrition in Niger: a Pragmatic Trial

Conditions
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Malnutrition

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: resident in selected villages height between 60 and 80 cm. Exclusion Criteria: refusal to participate

Ages Eligible for Study
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Minimum Age: 6 Months
Maximum Age: 24 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| RUSF (500kcal/day) and cash transfer<br>Monthly distributions of Ready-to-use Supplementary Food (RUSF) 500kcal per day associated with cash transfer during hunger gap (5 months) then RUSF 500kcal/day for 10 months | |
| Super Cereal Plus (SC+)<br>Monthly distributions of SC+ 800kcal per day during hunger gaps (5 months twice) and SC+ 400kcal per day in-between (5 months) | |
| RUSF<br>Monthly distributions of Ready-to-use Supplementary Food (RUSF) 500kcal per day during hunger gaps (5 months twice) and RUSF 250kcal per day in-between (5 months) | |
| RUSF (250kcal/day) and cash transfer<br>Monthly distributions of Ready-to-use Supplementary Food (RUSF) 250kcal per day associated with cash transfer during hunger gap (5 months) then RUSF 250kcal/day for 10 months | |
| SC+ and cash transfer<br>Monthly distributions of Super Cereal Plus (SC+) 800 kcal per day associated with cash transfer during hunger gap (5 months) | |
| SC+ and household ration<br>Monthly distributions of Super Cereal Plus (SC+) 800 kcal per day associated with food ration for household support during hunger gap (5 months) | |
| Cash transfer<br>Monthly distributions of cash transfer only during hunger gap (5 months) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of severe acute malnutrition | Severe acute malnutrition was defined as : Weight for Height Z-score (WHO Standards 2006)< -3 and/or mid-upper arm circumference (MUAC) < 115mm and/or bipedal oedema. MUAC was measured at the midpoint of a child's left arm with a plastic measuring tape with a precision of 1 mm. These indicators were evaluated monthly during the entire follow-up (15 months). | 15 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality | Mortality events include all reports for which the cause for absence from surveillance visits was reported to be death by a family member. | duration of follow-up (15 months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pediatrics, Ready-to-use Supplementary Food, corn soy blend, cash transfer, prevention of malnutrition, Niger