Efficacy of in-service nutrition training for mid-level providers to improve feeding practices among HIV-positive children in Tanga, Tanzania: study protocol for a cluster randomized controlled trial
Identifieur interne : 002885 ( Main/Merge ); précédent : 002884; suivant : 002886Efficacy of in-service nutrition training for mid-level providers to improve feeding practices among HIV-positive children in Tanga, Tanzania: study protocol for a cluster randomized controlled trial
Auteurs : Bruno F. Sunguya [Japon] ; Krishna C. Poudel [États-Unis] ; Linda B. Mlunde [Japon] ; David P. Urassa [Tanzanie] ; Masamine Jimba [Japon] ; Junko Yasuoka [Japon]Source :
- Trials [ 1745-6215 ] ; 2013.
Abstract
Feeding practices and child undernutrition can be improved when trained health workers provide proper nutrition counseling to caregivers. However, this important management component is difficult to achieve in countries where trained health workers are limited; Tanzania is no exception. In rural and semi-urban areas, mid-level providers (MLPs) are left to manage diseases such as HIV/AIDS.
Training health workers in nutrition has been shown to be an effective intervention among HIV-negative children elsewhere, but no studies have been conducted among HIV-positive children. Furthermore, in Tanzania and other countries with MLPs, no evidence currently exists demonstrating an improvement in nutrition among children who receive health services given by MLPs. This study thus aims to examine the efficacy of nutrition training of MLPs on feeding practices and the nutrition status of HIV-positive children in Tanga, Tanzania.
We will conduct a cluster randomized controlled trial in care and treatment centers (CTCs) in Tanga, Tanzania. The CTCs will be the unit of randomization. We will select 16 CTCs out of 32 for this study, of which we will randomly assign 8 to the intervention arm and 8 to the control arm by coin flipping. From the selected CTCs we will attempt to recruit a total of 800 HIV-positive children aged 6 months to 14 years, half of whom will be receiving care and/or treatment in the CTCs of the intervention arm, and the other half of whom will be receiving care and/or treatment in the CTCs of the control arm (400 children in each condition).
We will provide nutrition training to MLPs of the CTCs selected for the intervention arm. In this intervention, we will use the World Health Organization guidelines on nutrition training of health workers for HIV-positive children aged 6 months to 14 years. The trained MLPs will then provide tailored nutrition counseling to caregivers of children being treated at the 8 CTCs of the intervention arm. We will measure nutrition status and child feeding practices monthly for a total of six months.
Results of this trial will help expanding undernutrition interventions among HIV-positive children in Tanzania and other countries.
Current Controlled Trials:
Url:
DOI: 10.1186/1745-6215-14-352
PubMed: 24156500
PubMed Central: 4015912
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Efficacy of in-service nutrition training for mid-level providers to improve feeding practices among HIV-positive children in Tanga, Tanzania: study protocol for a cluster randomized controlled trial</title><author><name sortKey="Sunguya, Bruno F" sort="Sunguya, Bruno F" uniqKey="Sunguya B" first="Bruno F" last="Sunguya">Bruno F. Sunguya</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Poudel, Krishna C" sort="Poudel, Krishna C" uniqKey="Poudel K" first="Krishna C" last="Poudel">Krishna C. Poudel</name><affiliation wicri:level="4"><nlm:aff id="I2">Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts Amherst, Arnold House, 715 North Pleasant St, Amherst, MA 01003-9304, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts Amherst, Arnold House, 715 North Pleasant St, Amherst, MA 01003-9304</wicri:regionArea><placeName><region type="state">Massachusetts</region><settlement type="city">Amherst (Massachusetts)</settlement></placeName><orgName type="university">Université du Massachusetts à Amherst</orgName></affiliation></author><author><name sortKey="Mlunde, Linda B" sort="Mlunde, Linda B" uniqKey="Mlunde L" first="Linda B" last="Mlunde">Linda B. Mlunde</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Urassa, David P" sort="Urassa, David P" uniqKey="Urassa D" first="David P" last="Urassa">David P. Urassa</name><affiliation wicri:level="1"><nlm:aff id="I3">School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65489, Dar es Salaam, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65489, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation></author><author><name sortKey="Jimba, Masamine" sort="Jimba, Masamine" uniqKey="Jimba M" first="Masamine" last="Jimba">Masamine Jimba</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Yasuoka, Junko" sort="Yasuoka, Junko" uniqKey="Yasuoka J" first="Junko" last="Yasuoka">Junko Yasuoka</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24156500</idno><idno type="pmc">4015912</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4015912</idno><idno type="RBID">PMC:4015912</idno><idno type="doi">10.1186/1745-6215-14-352</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">001473</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001473</idno><idno type="wicri:Area/Pmc/Curation">001472</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001472</idno><idno type="wicri:Area/Pmc/Checkpoint">001995</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001995</idno><idno type="wicri:Area/Ncbi/Merge">002434</idno><idno type="wicri:Area/Ncbi/Curation">002434</idno><idno type="wicri:Area/Ncbi/Checkpoint">002434</idno><idno type="wicri:Area/Main/Merge">002885</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Efficacy of in-service nutrition training for mid-level providers to improve feeding practices among HIV-positive children in Tanga, Tanzania: study protocol for a cluster randomized controlled trial</title><author><name sortKey="Sunguya, Bruno F" sort="Sunguya, Bruno F" uniqKey="Sunguya B" first="Bruno F" last="Sunguya">Bruno F. Sunguya</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Poudel, Krishna C" sort="Poudel, Krishna C" uniqKey="Poudel K" first="Krishna C" last="Poudel">Krishna C. Poudel</name><affiliation wicri:level="4"><nlm:aff id="I2">Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts Amherst, Arnold House, 715 North Pleasant St, Amherst, MA 01003-9304, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts Amherst, Arnold House, 715 North Pleasant St, Amherst, MA 01003-9304</wicri:regionArea><placeName><region type="state">Massachusetts</region><settlement type="city">Amherst (Massachusetts)</settlement></placeName><orgName type="university">Université du Massachusetts à Amherst</orgName></affiliation></author><author><name sortKey="Mlunde, Linda B" sort="Mlunde, Linda B" uniqKey="Mlunde L" first="Linda B" last="Mlunde">Linda B. Mlunde</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Urassa, David P" sort="Urassa, David P" uniqKey="Urassa D" first="David P" last="Urassa">David P. Urassa</name><affiliation wicri:level="1"><nlm:aff id="I3">School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65489, Dar es Salaam, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65489, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation></author><author><name sortKey="Jimba, Masamine" sort="Jimba, Masamine" uniqKey="Jimba M" first="Masamine" last="Jimba">Masamine Jimba</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Yasuoka, Junko" sort="Yasuoka, Junko" uniqKey="Yasuoka J" first="Junko" last="Yasuoka">Junko Yasuoka</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author></analytic><series><title level="j">Trials</title><idno type="eISSN">1745-6215</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Feeding practices and child undernutrition can be improved when trained health workers provide proper nutrition counseling to caregivers. However, this important management component is difficult to achieve in countries where trained health workers are limited; Tanzania is no exception. In rural and semi-urban areas, mid-level providers (MLPs) are left to manage diseases such as HIV/AIDS.</p><p>Training health workers in nutrition has been shown to be an effective intervention among HIV-negative children elsewhere, but no studies have been conducted among HIV-positive children. Furthermore, in Tanzania and other countries with MLPs, no evidence currently exists demonstrating an improvement in nutrition among children who receive health services given by MLPs. This study thus aims to examine the efficacy of nutrition training of MLPs on feeding practices and the nutrition status of HIV-positive children in Tanga, Tanzania.</p></sec><sec><title>Methods/Design</title><p>We will conduct a cluster randomized controlled trial in care and treatment centers (CTCs) in Tanga, Tanzania. The CTCs will be the unit of randomization. We will select 16 CTCs out of 32 for this study, of which we will randomly assign 8 to the intervention arm and 8 to the control arm by coin flipping. From the selected CTCs we will attempt to recruit a total of 800 HIV-positive children aged 6 months to 14 years, half of whom will be receiving care and/or treatment in the CTCs of the intervention arm, and the other half of whom will be receiving care and/or treatment in the CTCs of the control arm (400 children in each condition).</p><p>We will provide nutrition training to MLPs of the CTCs selected for the intervention arm. In this intervention, we will use the World Health Organization guidelines on nutrition training of health workers for HIV-positive children aged 6 months to 14 years. The trained MLPs will then provide tailored nutrition counseling to caregivers of children being treated at the 8 CTCs of the intervention arm. We will measure nutrition status and child feeding practices monthly for a total of six months.</p></sec><sec><title>Conclusions</title><p>Results of this trial will help expanding undernutrition interventions among HIV-positive children in Tanzania and other countries.</p></sec><sec><title>Trial registration</title><p>Current Controlled Trials: <ext-link ext-link-type="uri" xlink:href="http://www.controlled-trials.com/ISRCTN65346364">ISRCTN65346364</ext-link>.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Sunguya, Bf" uniqKey="Sunguya B">BF Sunguya</name></author><author><name sortKey="Poudel, Kc" uniqKey="Poudel K">KC Poudel</name></author><author><name sortKey="Otsuka, K" uniqKey="Otsuka K">K Otsuka</name></author><author><name sortKey="Yasuoka, J" uniqKey="Yasuoka J">J Yasuoka</name></author><author><name sortKey="Mlunde, Lb" uniqKey="Mlunde L">LB Mlunde</name></author><author><name sortKey="Urassa, Dp" uniqKey="Urassa D">DP Urassa</name></author><author><name sortKey="Mkopi, Np" uniqKey="Mkopi N">NP Mkopi</name></author><author><name sortKey="Jimba, M" uniqKey="Jimba M">M Jimba</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Santos, I" uniqKey="Santos I">I Santos</name></author><author><name sortKey="Victora, Cg" uniqKey="Victora C">CG Victora</name></author><author><name sortKey="Martines, J" uniqKey="Martines J">J Martines</name></author><author><name sortKey="Goncalves, H" uniqKey="Goncalves H">H Gonçalves</name></author><author><name sortKey="Gigante, Dp" uniqKey="Gigante D">DP Gigante</name></author><author><name sortKey="Valle, Nj" uniqKey="Valle N">NJ Valle</name></author><author><name sortKey="Pelto, G" uniqKey="Pelto G">G Pelto</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pelto, Gh" uniqKey="Pelto G">GH Pelto</name></author><author><name sortKey="Santos, I" uniqKey="Santos I">I Santos</name></author><author><name sortKey="Goncalves, H" uniqKey="Goncalves H">H Gonçalves</name></author><author><name sortKey="Victora, C" uniqKey="Victora C">C Victora</name></author><author><name sortKey="Martines, J" uniqKey="Martines J">J Martines</name></author><author><name sortKey="Habicht, Jp" uniqKey="Habicht J">JP Habicht</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Mcdonald, Cm" uniqKey="Mcdonald C">CM McDonald</name></author><author><name sortKey="Kupka, R" uniqKey="Kupka R">R Kupka</name></author><author><name sortKey="Manji, Kp" uniqKey="Manji K">KP Manji</name></author><author><name sortKey="Okuma, J" uniqKey="Okuma J">J Okuma</name></author><author><name sortKey="Bosch, Rj" uniqKey="Bosch R">RJ Bosch</name></author><author><name sortKey="Aboud, S" uniqKey="Aboud S">S Aboud</name></author><author><name sortKey="Kisenge, R" uniqKey="Kisenge R">R 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uniqKey="Gebremeskel T">T Gebremeskel</name></author><author><name sortKey="Mebrahtu, G" uniqKey="Mebrahtu G">G Mebrahtu</name></author><author><name sortKey="Mufunda, J" uniqKey="Mufunda J">J Mufunda</name></author><author><name sortKey="Abdulmumini, U" uniqKey="Abdulmumini U">U Abdulmumini</name></author><author><name sortKey="Ogbamariam, A" uniqKey="Ogbamariam A">A Ogbamariam</name></author><author><name sortKey="Kosia, A" uniqKey="Kosia A">A Kosia</name></author><author><name sortKey="Gebremichael, A" uniqKey="Gebremichael A">A Gebremichael</name></author><author><name sortKey="Gunawardena, D" uniqKey="Gunawardena D">D Gunawardena</name></author><author><name sortKey="Ghebrat, Y" uniqKey="Ghebrat Y">Y Ghebrat</name></author><author><name sortKey="Okbaldet, Y" uniqKey="Okbaldet Y">Y Okbaldet</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Howe, Dl" uniqKey="Howe D">DL Howe</name></author><author><name sortKey="Hargreaves, Rj" uniqKey="Hargreaves R">RJ Hargreaves</name></author><author><name sortKey="Huttly, Rs" uniqKey="Huttly R">RS Huttly</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gwatkin, Dr" uniqKey="Gwatkin D">DR Gwatkin</name></author><author><name sortKey="Rutstein, S" uniqKey="Rutstein S">S Rutstein</name></author><author><name sortKey="Johnson, K" uniqKey="Johnson K">K Johnson</name></author><author><name sortKey="Pande, Rp" uniqKey="Pande R">RP Pande</name></author><author><name sortKey="Wagstaff, A" uniqKey="Wagstaff A">A Wagstaff</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vyas, S" uniqKey="Vyas S">S Vyas</name></author><author><name sortKey="Kumaranayake, L" uniqKey="Kumaranayake L">L Kumaranayake</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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