Evidence map›Paper›PMID 27406638›Full record

Trial reportBMJ open2016

Randomised controlled trial testing the effect of cotrimoxazole prophylaxis on morbidity and mortality outcomes in breastfed HIV-exposed uninfected infants: study protocol.

Anna Coutsoudis, Brodie Daniels, Eshia Moodley-Govender, Noluthando Ngomane, Linda Zako, Elizabeth Spooner, Photini Kiepiela, Shabashini Reddy, Louise Kuhn, Gita Ramjee

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Observational
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Anna CoutsoudisDepartment of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa.
Brodie DanielsDepartment of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa.
Eshia Moodley-GovenderDepartment of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa.
Noluthando NgomaneeThekwini Health Unit, eThekwini Municipality, Durban, South Africa.
Linda ZakoeThekwini Health Unit, eThekwini Municipality, Durban, South Africa.
Elizabeth SpoonerDepartment of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa.
Photini KiepielaHIV Prevention Research Unit, Medical Research Council of South Africa, Durban, South Africa.
Shabashini ReddyHIV Prevention Research Unit, Medical Research Council of South Africa, Durban, South Africa.
Louise KuhnDepartment of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.
Gita RamjeeHIV Prevention Research Unit, Medical Research Council of South Africa, Durban, South Africa.
University of KwaZulu-Natal · ZASouth African Medical Research Council · ZAeThekwini Municipality · ZAColumbia University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNo randomised controlled trial (RCT) has examined the efficacy of cotrimoxazole (CTX) prophylaxis in HIV-exposed uninfected (HEU) infants during the breastfeeding period, in this new era of effective prevention of mother-to-child transmission (PMTCT) prophylaxis. The efficacy of CTX prophylaxis has presently been demonstrated only in HIV-infected children. The absence of proven benefits in HEU breastfed infants associated with infectious diseases justifies an RCT as proposed. Herewith lies the rationale for conducting the proposed study.

methodsA partially blinded RCT is proposed to evaluate the efficacy of CTX prophylaxis administered from 6 weeks of age to HEU infants receiving a PMTCT regimen. A non-inferiority design will be used, randomising 1298 infants to receive CTX or not to receive CTX. Participants will be reviewed at the following time points: 6 weeks (enrolment and randomisation), 10 weeks, 14 weeks, 4 months and monthly thereafter until 12 months of age. They will be evaluated for anthropometric growth, interval illness, CTX adherence, signs and symptoms of study drug toxicity, concomitant medication use, breastfeeding status and HIV infection status. The study will compare the incidence of grade 3 and grade 4 common childhood illnesses (focusing on pneumonia and diarrhoea) and all-cause mortality until 12 months of age. In a subset of participants, we will compare grade 3 and grade 4 haemoglobin and alanine aminotransferase results as well as investigate gut integrity. ETHICS AND DISSEMINATION: The study has ethical approval from the University of KwaZulu-Natal Biomedical Research Ethics Committee (BFC212/13). TRIAL REGISTRATION NUMBERS: PACTR201311000621110 and DOH-27-0614-4728; Pre-results.

Indexed as

Breast FeedingInfant HealthInfant MortalityAnti-Bacterial AgentsAnti-HIV AgentsCause of DeathDiarrheaFemaleGrowth DisordersHIVHIV InfectionsHumansIncidenceInfantInfectious Disease Transmission, VerticalMaleAnti-Bacterial AgentsAnti-HIV AgentsTrimethoprim, Sulfamethoxazole Drug Combinationcotrimoxazole prophylaxisexclusive breastfeedingHIV-exposed uninfected infants

Identifiers

PMID27406638
PMCPMC4947798
OpenAlexW2466299856

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.