Evidence map›Paper›PMID 28376725›Full record

Trial reportBMC pediatrics2017

Improving feeding and growth of HIV-positive children through nutrition training of frontline health workers in Tanga, Tanzania.

Bruno F Sunguya, Linda B Mlunde, David P Urassa, Krishna C Poudel, Omary S Ubuguyu, Namala P Mkopi, Germana H Leyna, Anna T Kessy, Keiko Nanishi, Akira Shibanuma and 2 more

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC pediatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 30% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. 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

12 authors at 4 institutions in 3 countries.

Bruno F SunguyaSchool of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O Box 65489, Dar es Salaam, Tanzania. sunguya@gmail.com.
Linda B MlundeDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
David P UrassaSchool of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O Box 65489, Dar es Salaam, Tanzania.
Krishna C PoudelDepartment 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.
Omary S UbuguyuMuhimbili National Hospital, P.O. Box 65000, Dar es Salaam, Tanzania.
Namala P MkopiMuhimbili National Hospital, P.O. Box 65000, Dar es Salaam, Tanzania.
Germana H LeynaSchool of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O Box 65489, Dar es Salaam, Tanzania.
Anna T KessySchool of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O Box 65489, Dar es Salaam, Tanzania.
Keiko NanishiDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Akira ShibanumaDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Junko YasuokaDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Masamine JimbaDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
The University of Tokyo · JPMuhimbili University of Health and Allied Sciences · TZMuhimbili National Hospital · TZUniversity of Massachusetts Amherst · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNutrition training can boost competence of health workers to improve children's feeding practices. In this way, child undernutrition can be ameliorated in general populations. However, evidence is lacking on efficacy of such interventions among Human Immunodeficiency Virus (HIV)-positive children. We aimed to examine the efficacy of a nutrition training intervention to improve midlevel providers' (MLPs) nutrition knowledge and feeding practices and the nutrition statuses of HIV-positive children in Tanga, Tanzania.

methodsThis cluster-randomized controlled trial was conducted in 16 out of 32 care and treatment centers (CTCs) in Tanga. Eight CTCs were assigned to the intervention arm and a total of 16 MLPs received nutrition training and provided nutrition counseling and care to caregivers of HIV-positive children. A total of 776 pairs of HIV-positive children and their caregivers were recruited, of whom 397 were in the intervention arm. Data were analyzed using instrumental variable random effects regression with panel data to examine the efficacy of the intervention on nutrition status through feeding practices.

resultsMean nutrition knowledge scores were higher post-training compared to pre-training among MLPs (37.1 vs. 23.5, p < 0.001). A mean increment weight gain of 300 g was also observed at follow-up compared to baseline among children of the intervention arm. Feeding frequency and dietary diversity improved following the intervention and a 6 months follow-up (p < 0.001). An increase in each unit of feeding frequency and dietary diversity were associated with a 0.15-unit and a 0.16-unit respectively decrease in the child underweight (p < 0.001).

conclusionsNutrition training improved nutrition knowledge among MLPs caring for HIV-positive children attending CTCs in Tanga, Tanzania. Caregivers' feeding practices also improved, which in turn led to a modest weight gain among HIV-positive children. To sustain weight gain, efforts should be made to also improve households' food security and caregivers' education in addition to inservice nutrition trainings. The protocol was registered on 15/02/2013, before the recruitment at ISRCTN trial registry with the trial registration number: ISRCTN65346364.

Indexed as

AdolescentChildChild CareChild Nutritional Physiological PhenomenaChild, PreschoolClinical CompetenceCommunity Health WorkersFemaleFollow-Up StudiesGrowth DisordersHealth PromotionHIV InfectionsHumansInfantLogistic ModelsMaleFeeding practicesHIV/AIDSMidlevel providersNutrition statusNutrition training

Identifiers

PMID28376725
PMCPMC5379502
OpenAlexW2604910442

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.