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Asamane EA, Quinn L, Watson SI, Lilford RJ, Hemming K, Sidibe C, Rego RT, Bensassi S, Diarra Y, Diop S, Gautam OP, Islam MS, Jackson L, Jolly K, Kayentao K, Koita O, Manjang B, Tebbs S, Gale N, Griffiths P, Cairncross S, Toure O, Manaseki-Holland S. Protocol for a parallel group, two-arm, superiority cluster randomised trial to evaluate a community-level complementary-food safety and hygiene and nutrition intervention in Mali: the MaaCiwara study (version 1.3; 10 November 2022). Trials 2023; 24:68. [PMID: 36717923 PMCID: PMC9885702 DOI: 10.1186/s13063-022-06984-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 12/06/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Diarrhoeal disease remains a significant cause of morbidity and mortality among the under-fives in many low- and middle-income countries. Changes to food safety practices and feeding methods around the weaning period, alongside improved nutrition, may significantly reduce the risk of disease and improve development for infants. We describe a protocol for a cluster randomised trial to evaluate the effectiveness of a multi-faceted community-based educational intervention that aims to improve food safety and hygiene behaviours and enhance child nutrition. METHODS We describe a mixed-methods, parallel group, two-arm, superiority cluster randomised controlled trial with baseline measures. One hundred twenty clusters comprising small urban and rural communities will be recruited in equal numbers and randomly allocated in a 1:1 ratio to either treatment or control arms. The community intervention will be focussed around an ideal mother concept involving all community members during campaign days with dramatic arts and pledging, and follow-up home visits. Participants will be mother-child dyads (27 per cluster period) with children aged 6 to 36 months. Data collection will comprise a day of observation and interviews with each participating mother-child pair and will take place at baseline and 4 and 15 months post-intervention. The primary analysis will estimate the effectiveness of the intervention on changes to complementary-food safety and preparation behaviours, food and water contamination, and diarrhoea. Secondary outcomes include maternal autonomy, enteric infection, nutrition, child anthropometry, and development scores. A additional structural equation analysis will be conducted to examine the causal relationships between the different outcomes. Qualitative and health economic analyses including process evaluation will be done. CONCLUSIONS The trial will provide evidence on the effectiveness of community-based behavioural change interventions designed to reduce the burden of diarrhoeal disease in the under-fives and how effectiveness varies across different contexts. TRIAL REGISTRATION ISRCTN14390796. Registration date December 13, 2021.
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Affiliation(s)
- Evans A. Asamane
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Laura Quinn
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Samuel I. Watson
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Richard J. Lilford
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Karla Hemming
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Cheick Sidibe
- University of Science, Techniques and Technology Bamako, Bamako, Mali
| | - Ryan T. Rego
- grid.214458.e0000000086837370Center for Global Health Equity, University of Michigan, Ann Arbor, USA
| | - Sami Bensassi
- grid.6572.60000 0004 1936 7486Birmingham Business School, University of Birmingham, Birmingham, UK
| | - Youssouf Diarra
- University of Science, Techniques and Technology Bamako, Bamako, Mali
| | - Samba Diop
- University of Science, Techniques and Technology Bamako, Bamako, Mali
| | | | - Mohammad Sirajul Islam
- grid.414142.60000 0004 0600 7174International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Louise Jackson
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kate Jolly
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kassoum Kayentao
- University of Science, Techniques and Technology Bamako, Bamako, Mali
| | - Ousmane Koita
- University of Science, Techniques and Technology Bamako, Bamako, Mali
| | | | - Susan Tebbs
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Nicola Gale
- grid.6572.60000 0004 1936 7486School of Social Policy, Health Services Management Centre, University of Birmingham, Birmingham, UK
| | - Paula Griffiths
- grid.6571.50000 0004 1936 8542School of Sport, Exercise and Health Sciences Loughborough University, London, UK ,grid.11951.3d0000 0004 1937 1135Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, University of the Witwatersr, Johannesburg, South Africa
| | - Sandy Cairncross
- grid.8991.90000 0004 0425 469XFaculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Ousmane Toure
- University of Science, Techniques and Technology Bamako, Bamako, Mali
| | - Semira Manaseki-Holland
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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