Clinical trial NCT04640389: Rural-urban Disparities in the Nutritional Status of Younger Adolescents in Tanzania.
Official title: Rural-urban Disparities in the Nutritional Status of Younger Adolescents in Tanzania.
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Undernutrition
Stunting
Adolescent Development
Lead sponsor: University of Massachusetts, Amherst
Sponsor class: OTHER
Collaborators: name: UNICEF
name: Harvard University
name: Tufts University
First posted: 2020-11-23
Enrollment: 1125
Sex: ALL
Minimum age (years): 10
Maximum age (years): 14
Standard ages: CHILD
Accepts healthy volunteers: yes
Observational model: ECOLOGIC_OR_COMMUNITY
Time perspective: CROSS_SECTIONAL
Sampling method: PROBABILITY_SAMPLE
Study population: This cross-sectional study merged and analyzed two independent samples of adolescents living in Tanzania. One study was conducted in Tanzania by Cordeiro et al. (2012) and the other was conducted in an urban setting by Carlson, Brennan, and Earls (2012); both conducted in 2004. The Kilosa/rural dataset was derived from a two-stage sampling plan for selection of villages and adolescents. The Moshi/urban dataset was derived from a two-stage sampling plan for a cluster randomized control trial (CRCT). From a total combined sample of 1476 adolescents aged 10-19 years across both datasets, 1237 met the age criterion for younger adolescents (10-14 years). The analytical sample for this study was 1125.

Brief summary: Africa faces rapid urbanization, has the second highest population growth rate, makes up one-fifth of the world's youth population, and experiences stagnant rates of undernutrition. These challenges point to the need for country-specific data on rural-urban health disparities to inform development policies. This cross-sectional study examined disparities in body mass index-for-age-and-sex (BAZ) and height-for-age-and-sex z-scores (HAZ) among 1125 adolescents in Tanzania. Rural-urban disparities in nutritional status were significant and gendered. Findings confirm place of residence as a key determinant of BAZ, HAZ, and stunting among adolescents in Tanzania. Targeted gender-sensitive interventions among adolescents, particularly in rural areas, are needed to limit growth faltering and improve health outcomes.

Detailed description: Africa faces rapid urbanization, has the second highest population growth rate, makes up one-fifth of the world's youth population, and experiences stagnant rates of undernutrition. These challenges point to the need for country-specific data on rural-urban health disparities to inform development policies. This cross-sectional study examined disparities in body mass index-for-age-and-sex (BAZ) and height-for-age-and-sex z-scores (HAZ) among 1125 adolescents in Tanzania. Pearson's chi-square tested associations between rural/urban residence and undernutrition (BAZ \<-2SD), stunting (HAZ \<-2SD), anthropometric, socioeconomic, and health indicators. Multivariate linear regression identified predictors of BAZ and HAZ.

Funding: UNICEF/ Tanzania; United States National Institute of Mental Health (R01 MH66801).

Eligibility criteria: Inclusion Criteria:

* Adolescents between 10 and 14 years of age

Exclusion Criteria:

* Adolescents living away from the districts and not physically present at the time of the study

Primary outcomes:
measure: Body Mass Index for age and gender z-scores
timeFrame: Two measures collected consequentially during a 30 minute time frame on the date of survey administration.
measure: Height for age and gender z-scores
timeFrame: Two measures collected consequentially during a 30 minute time frame on the date of survey administration.
measure: Undernutrition
timeFrame: Height and weight measures collected twice consequentially during a 30 minute time frame on the date of survey administration.
measure: Stunting
timeFrame: Two measures of height in meters collected consequentially during a 30 minute time frame on the date of survey administration.
Secondary outcomes:
Other outcomes:
Locations:
city: Amherst
country: United States
facility: University of Massachusetts Amherst
state: Massachusetts
Study officials:
affiliation: University of Massachusetts, Amherst
name: Lorraine Cordeiro, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Cordeiro LS, Wilde PE, Semu H, Levinson FJ. Household food security is inversely associated with undernutrition among adolescents from Kilosa, Tanzania. J Nutr. 2012 Sep;142(9):1741-7. doi: 10.3945/jn.111.155994. Epub 2012 Jul 18.
citation: Carlson M, Brennan RT, Earls F. Enhancing adolescent self-efficacy and collective efficacy through public engagement around HIV/AIDS competence: a multilevel, cluster randomized-controlled trial. Soc Sci Med. 2012 Sep;75(6):1078-87. doi: 10.1016/j.socscimed.2012.04.035. Epub 2012 May 24.