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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Growth effects of exclusive breastfeeding promotion by peer counsellors in sub-Saharan Africa: The cluster-randomised PROMISE EBF trial
BMC Public Health, Volume 14, No. 1, Article 633, Year 2014
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Description
Background: In this multi-country cluster-randomized behavioural intervention trial promoting exclusive breastfeeding (EBF) in Africa, we compared growth of infants up to 6 months of age living in communities where peer counsellors promoted EBF with growth in those infants living in control communities. Methods. A total of 82 clusters in Burkina Faso, Uganda and South Africa were randomised to either the intervention or the control arm. Feeding data and anthropometric measurements were collected at visits scheduled 3, 6, 12 and 24 weeks post-partum. We calculated weight-for-length (WLZ), length-for-age (LAZ) and weight-for-age (WAZ) z-scores. Country specific adjusted Least Squares Means with 95% confidence intervals (CI) based on a longitudinal analysis are reported. Prevalence ratios (PR) for the association between peer counselling for EBF and wasting (WLZ < -2), stunting (LAZ < -2) and underweight (WAZ < -2) were calculated at each data collection point. Results: The study included a total of 2,579 children. Adjusting for socio-economic status, the mean WLZ at 24 weeks were in Burkina Faso -0.20 (95% CI -0.39 to -0.01) and in Uganda -0.23 (95% CI -0.43 to -0.03) lower in the intervention than in the control arm. In South Africa the mean WLZ at 24 weeks was 0.23 (95% CI 0.03 to 0.43) greater in the intervention than in the control arm. Differences in LAZ between the study arms were small and not statistically significant. In Uganda, infants in the intervention arm were more likely to be wasted compared to those in the control arm at 24 weeks (PR 2.36; 95% CI 1.11 to 5.00). Differences in wasting in South Africa and Burkina Faso and stunting and underweight in all three countries were small and not significantly different. Conclusions: There were small differences in mean anthropometric indicators between the intervention and control arms in the study, but in Uganda and Burkina Faso, a tendency to slightly lower ponderal growth (weight-for-length z-scores) was found in the intervention arms. Trial registration number. ClinicalTrials.gov: NCT00397150. © 2014 Engebretsen et al.; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC4082276/bin/1471-2458-14-633-S1.doc
Authors & Co-Authors
Engebretsen, Ingunn Marie Stadskleiv
Norway, Bergen
Universitetet I Bergen
Jackson, Debra J.
South Africa, Bellville
University of the Western Cape
Fadnes, Lars Thore
Norway, Bergen
Universitetet I Bergen
Nankabirwa, Victoria
United States, New York
Mailman School of Public Health
Uganda, Kampala
Makerere University
Diallo, Abdoulaye Hama
Burkina Faso, Ouagadougou
Centre Muraz
Doherty, Tanya M.
South Africa, Bellville
University of the Western Cape
South Africa, Tygerberg
South African Medical Research Council
Lombard, Carl J.
South Africa, Tygerberg
South African Medical Research Council
Swanevelder, Sonja A.
South Africa, Tygerberg
South African Medical Research Council
Nankunda, Jolly K.
Uganda, Kampala
Makerere University
Ramokolo, Vundli
Norway, Bergen
Universitetet I Bergen
South Africa, Tygerberg
South African Medical Research Council
Sanders, David M.
South Africa, Bellville
University of the Western Cape
Wamani, Henry
Uganda, Kampala
Makerere University
Méda, Nicolas Yelbomkan
Burkina Faso, Ouagadougou
Centre Muraz
Tumwine, James Kashugyera
Uganda, Kampala
Makerere University
Ekström, Eva Charlotte M.
Sweden, Uppsala
Uppsala Universitet
van de Perre, Philippe
France, Montpellier
Pathogenèse et Contrôle Des Infections Chroniques
France, Montpellier
Université de Montpellier
France, Montpellier
Centre Hospitalier Universitaire de Montpellier
Kankasa, Chipepo
Zambia, Lusaka
University of Zambia School of Medicine
Sommerfelt, Halvor
Norway, Bergen
Universitetet I Bergen
Norway, Oslo
Folkehelseinstituttet
Tylleskär, Thorkild
Norway, Bergen
Universitetet I Bergen
Statistics
Citations: 47
Authors: 19
Affiliations: 12
Identifiers
Doi:
10.1186/1471-2458-14-633
e-ISSN:
14712458
Research Areas
Food Security
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Grounded Theory
Study Locations
Burkina Faso
South Africa
Uganda