A multicenter, randomized controlled comparison of three renutrition strategies for the management of moderate acute malnutrition among children aged from 6 to 24 months (the MALINEA project)

Muriel Vray; Boris G Hedible; Pierrick Adam; Laura Tondeur; Alexandre Manirazika; Rindra Randremanana; Halima Mainassara; André Briend; Cecile Artaud; Cassandre Von Platen; Mathias Altmann; Ronan Jambou

doi:10.1186/s13063-018-3027-3

A multicenter, randomized controlled comparison of three renutrition strategies for the management of moderate acute malnutrition among children aged from 6 to 24 months (the MALINEA project)

Muriel Vray, Boris G Hedible, Pierrick Adam, Laura Tondeur, Alexandre Manirazika, Rindra Randremanana, Halima Mainassara, André Briend, Cecile Artaud, Cassandre Von Platen, Mathias Altmann, Ronan Jambou^*

^*Corresponding author for this work

Lifecourse Nutrition & Health

2 Citations (Scopus)

39 Downloads (Pure)

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.

Original language	English
Article number	666
Journal	Trials
Volume	19
Number of pages	11
ISSN	1745-6215
DOIs	https://doi.org/10.1186/s13063-018-3027-3
Publication status	Published - 2018

Keywords

Azithromycin
Metagenomic
Microbiota
Moderate acute malnutrition
Prebiotic
Study protocol

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Vray et al_Trials_2018_Vol 19_666_(Study protocol)Final published version, 737 KBLicence: CC BY

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Vray, M., Hedible, B. G., Adam, P., Tondeur, L., Manirazika, A., Randremanana, R., Mainassara, H., Briend, A., Artaud, C., Von Platen, C., Altmann, M., & Jambou, R. (2018). A multicenter, randomized controlled comparison of three renutrition strategies for the management of moderate acute malnutrition among children aged from 6 to 24 months (the MALINEA project). Trials, 19, [666]. https://doi.org/10.1186/s13063-018-3027-3

Vray, M, Hedible, BG, Adam, P, Tondeur, L, Manirazika, A, Randremanana, R, Mainassara, H, Briend, A, Artaud, C, Von Platen, C, Altmann, M & Jambou, R 2018, 'A multicenter, randomized controlled comparison of three renutrition strategies for the management of moderate acute malnutrition among children aged from 6 to 24 months (the MALINEA project)', Trials, vol. 19, 666. https://doi.org/10.1186/s13063-018-3027-3

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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.",

keywords = "Azithromycin, Metagenomic, Microbiota, Moderate acute malnutrition, Prebiotic, Study protocol",

author = "Muriel Vray and Hedible, {Boris G} and Pierrick Adam and Laura Tondeur and Alexandre Manirazika and Rindra Randremanana and Halima Mainassara and Andr{\'e} Briend and Cecile Artaud and {Von Platen}, Cassandre and Mathias Altmann and Ronan Jambou",

note = "CURIS 2018 NEXS 427",

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doi = "10.1186/s13063-018-3027-3",

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T1 - A multicenter, randomized controlled comparison of three renutrition strategies for the management of moderate acute malnutrition among children aged from 6 to 24 months (the MALINEA project)

AU - Vray, Muriel

AU - Hedible, Boris G

AU - Adam, Pierrick

AU - Tondeur, Laura

AU - Manirazika, Alexandre

AU - Randremanana, Rindra

AU - Mainassara, Halima

AU - Briend, André

AU - Artaud, Cecile

AU - Von Platen, Cassandre

AU - Altmann, Mathias

AU - Jambou, Ronan

N1 - CURIS 2018 NEXS 427

PY - 2018

Y1 - 2018

N2 - 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.

AB - 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.

KW - Azithromycin

KW - Metagenomic

KW - Microbiota

KW - Moderate acute malnutrition

KW - Prebiotic

KW - Study protocol

U2 - 10.1186/s13063-018-3027-3

DO - 10.1186/s13063-018-3027-3

M3 - Journal article

C2 - 30514364

AN - SCOPUS:85057759730

SN - 1745-6215

VL - 19

JO - Trials

JF - Trials

M1 - 666

ER -

A multicenter, randomized controlled comparison of three renutrition strategies for the management of moderate acute malnutrition among children aged from 6 to 24 months (the MALINEA project)

Abstract

Keywords

UN SDGs

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