Evidence map›Paper›PMID 41673929›Full record

ArticleTrials2026

Intervention to optimise body mass index in adolescents and address the triple burden of malnutrition-the Ntshembo (Hope) trial in rural and urban South Africa study: a study protocol for a randomised controlled trial.

S A Norris, L K Micklesfield, N J Christofides, S H Crouch, D E Mathatha, C Desmond, S J Sharp, K K Ong, S M Tollman, K Kahn

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

S A NorrisSAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, 26 Chris Hani Road, Soweto, Johannesburg, South Africa. shane.norris@wits.ac.za.
L K MicklesfieldSAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, 26 Chris Hani Road, Soweto, Johannesburg, South Africa.
N J ChristofidesSchool of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
S H CrouchSAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, 26 Chris Hani Road, Soweto, Johannesburg, South Africa.
D E MathathaSAMRC Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
C DesmondSchool of Economics and Finance, Faculty of Commerce, Law and Management, University of the Witwatersrand, Johannesburg, South Africa.
S J SharpMRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
K K OngMRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
S M TollmanSAMRC Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
K KahnSAMRC Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Funding

Joint Global Health Trials UK; MR/V005790/2
6 · The paper itself

Abstract

introductionSouth Africa faces a complex health burden with burgeoning non-communicable diseases against a background of prevalent infection. The triple burden of malnutrition, comprising undernutrition alongside overweight/obesity and micronutrient deficiencies, is widespread and imposes risks for non-communicable diseases along the life course, especially among adolescent girls. We hypothesise that, by optimising nutrition and body mass index (BMI) of at-risk adolescent girls, we can realise a triple return on investment: improved nutritional status, reduced metabolic risk, and moderated pre-conception exposures to offset transgenerational risk for cardiometabolic disease. METHODS AND ANALYSIS: We will enrol 1248 girls 14-19 years with either underweight or overweight defined using age-sex-appropriate BMI cut-offs living either in rural or urban South Africa. After baseline assessments and randomisation, participants will be reassessed at 18-24 months follow-up. If a participant becomes pregnant, further assessments will be conducted during pregnancy (< 28 weeks) and postnatally. We will include both process and economic evaluations. The primary outcome is change in BMI standard deviation score from baseline to follow-up aligned to the target direction, i.e. increase in BMI for underweight, decrease in BMI for overweight. Community health workers will deliver the intervention with both household and individual components. A conditional cash transfer will be provided to the household with guidance to improve dietary diversity. Health literacy material, a multi-micronutrient supplement, health screening and support management (for example anaemia; blood pressure; HIV; depression), and facilitating behaviour change to optimise nutrition, physical and mental health will be provided to the adolescent girl.

trial registrationThe trial has been registered with the Pan African Clinical Trials Registry; identifier: PACTR202201638897606. Registered on 1st August 2022. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=14656 .

Indexed as

Body Mass IndexMalnutritionPediatric ObesityThinnessAdolescentFemaleHumansNutritional StatusPregnancyRandomized Controlled Trials as TopicRural HealthSouth AfricaTime FactorsYoung AdultAdolescenceMalnutritionRuralSouth AfricaUrban

Identifiers

PMID41673929
PMCPMC12998280

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Registered trials

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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.