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Trials ; 19(1): 666, 2018 Dec 04.
Article in English | MEDLINE | ID: mdl-30514364

ABSTRACT

BACKGROUND: The aim of this open-label, randomized controlled trial conducted in four African countries (Madagascar, Niger, Central African Republic, and Senegal) is to compare three strategies of renutrition for moderate acute malnutrition (MAM) in children based on modulation of the gut microbiota with enriched flours alone, enriched flours with prebiotics or enriched flours coupled with antibiotic treatment. METHODS: To be included, children aged between 6 months and 2 years are preselected based on mid-upper-arm circumference (MUAC) and are included based on a weight-for-height Z-score (WHZ) between - 3 and - 2 standard deviations (SD). As per current protocols, children receive renutrition treatment for 12 weeks and are assessed weekly to determine improvement. The primary endpoint is recovery, defined by a WHZ ≥ - 1.5 SD after 12 weeks of treatment. Data collected include clinical and socioeconomic characteristics, side effects, compliance and tolerance to interventions. Metagenomic analysis of gut microbiota is conducted at inclusion, 3 months, and 6 months. The cognitive development of children is evaluated in Senegal using only the Developmental Milestones Checklist II (DMC II) questionnaire at inclusion and at 3, 6, and 9 months. The data will be correlated with renutrition efficacy and metagenomic data. DISCUSSION: This study will provide new insights for the treatment of MAM, as well as original data on the modulation of gut microbiota during the renutrition process to support (or not) the microbiota hypothesis of malnutrition. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03474276 Last update 28 May 2018.


Subject(s)
Anti-Bacterial Agents/administration & dosage , Azithromycin/administration & dosage , Flour , Food, Fortified , Gastrointestinal Microbiome/drug effects , Infant Nutrition Disorders/therapy , Infant Nutritional Physiological Phenomena , Malnutrition/therapy , Nutritional Status , Prebiotics/administration & dosage , Acute Disease , Africa , Age Factors , Albendazole/administration & dosage , Anti-Bacterial Agents/adverse effects , Antiparasitic Agents/administration & dosage , Azithromycin/adverse effects , Child Development , Child, Preschool , Female , Flour/adverse effects , Food, Fortified/adverse effects , Humans , Infant , Infant Nutrition Disorders/diagnosis , Infant Nutrition Disorders/microbiology , Infant Nutrition Disorders/physiopathology , Male , Malnutrition/diagnosis , Malnutrition/microbiology , Malnutrition/physiopathology , Multicenter Studies as Topic , Prebiotics/adverse effects , Randomized Controlled Trials as Topic , Time Factors , Treatment Outcome
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