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The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) Trial: Protocol for school-age follow-up

  • Joseph D. Piper
  • , Clever Mazhanga
  • , Marian Mwapaura
  • , Gloria Mapako
  • , Idah Mapurisa
  • , Tsitsi Mashedze
  • , Eunice Munyama
  • , Maria Kuona
  • , Thombizodwa Mashiri
  • , Kundai Sibanda
  • , Dzidzai Matemavi
  • , Monica Tichagwa
  • , Soneni Nyoni
  • , Asinje Saidi
  • , Manasa Mangwende
  • , Dzivaidzo Chidhanguro
  • , Eddington Mpofu
  • , Joice Tome
  • , Batsirai Mutasa
  • , Bernard Chasekwa
  • Melanie Smuk, Laura E. Smith, Handrea Njovo, Chandiwana Nyachowe, Mary Muchekeza, Kuda Mutasa, Virginia Sauramba, Lisa F. Langhaug, Naume V. Tavengwa, Melissa J. Gladstone, Jonathan C. Wells, Elizabeth Allen, Jean H. Humphrey, Robert Ntozini, Andrew J. Prendergast
  • Queen Mary University of London
  • Zvitambo Institute for Maternal and Child Health Research
  • Ministry of Health and Child Care, Zimbabwe
  • University of Liverpool
  • University College London
  • London School of Hygiene and Tropical Medicine
  • Johns Hopkins University

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: There is a need for follow-up of early-life stunting intervention trials into childhood to determine their long-term impact. A holistic school-age assessment of health, growth, physical and cognitive function will help to comprehensively characterise the sustained effects of early-life interventions. Methods: The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe assessed the effects of improved infant and young child feeding (IYCF) and/or improved water, sanitation and hygiene (WASH) on stunting and anaemia at 18 months. Among children enrolled to SHINE, 1,275 have been followed up at 7-8 years of age (1,000 children who have not been exposed to HIV, 268 exposed to HIV antenatally who remain HIV negative and 7 HIV positive children). Children were assessed using the School-Age Health, Activity, Resilience, Anthropometry and Neurocognitive (SAHARAN) toolbox, to measure their growth, body composition, cognitive and physical function. In parallel, a caregiver questionnaire assessed household demographics, socioeconomic status, adversity, nurturing, caregiver support, food and water insecurity. A monthly morbidity questionnaire is currently being administered by community health workers to evaluate school-age rates of infection and healthcare-seeking. The impact of the SHINE IYCF and WASH interventions, the early-life ‘exposome’, maternal HIV, and contemporary exposures on each school-age outcome will be assessed. We will also undertake an exploratory factor analysis to generate new, simpler metrics for assessment of cognition (COG-SAHARAN), growth (GROW-SAHARAN) and combined growth, cognitive and physical function (SUB-SAHARAN). The SUB-SAHARAN toolbox will be used to conduct annual assessments within the SHINE cohort from ages 8–12 years. Ethics and dissemination: Approval was obtained from Medical Research Council of Zimbabwe (08/02/21) and registered with Pan-African Clinical Trials Registry (PACTR202201828512110, 24/01/22). Primary caregivers provided written informed consent and children written assent. Findings will be disseminated through community sensitisation, peer-reviewed journals and stakeholders including the Zimbabwean Ministry of Health and Child Care.

Original languageEnglish
Article number306
JournalWellcome Open Research
Volume8
DOIs
StatePublished - 2023

Keywords

  • body composition
  • Child
  • cognition
  • fitness
  • HIV
  • IYCF
  • nutrition
  • WASH

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