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Assessment of Zinc Intake From Enriched Water and Other Dietary Sources in Kisumu, Kenya

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02162238
Recruitment Status : Completed
First Posted : June 12, 2014
Last Update Posted : September 3, 2014
ETH Zurich
Maseno University
Information provided by (Responsible Party):
Wageningen University

Brief Summary:

Introduction: The prevalence of low serum zinc in children under 5 in East Seme, Kisumu is 73.5% and this is likely due at least in part to low bioavailable zinc from the local cereal-based diet. Interventions that will increase zinc intake could prove useful in the effort to control zinc deficiency. A potential strategy is to increase zinc intake through enriched or fortified water. The Life Straw Family filter (LSF, Verstergaard Frandsen S.A, Switzerland) is capable of purifying water and at the same time enriching it with zinc at a variable concentration with mean delivery of approximately 1-4mg/L.

Aims of the study: The primary aim of this study will be to quantify in under 5 year old children the contribution of the household LSF device to zinc intake and dietary zinc bioavailability in participating households. Secondary objectives are; 1) to assess change in serum zinc levels, growth, morbidity in the intervention group compared to control; 2) to characterize composition of the intestinal flora of children in the intervention group compared to control.

Study Design and Methods:

Consenting households from East Seme, Kisumu, Kenya will be randomly allocated to 2 treatment arms in an effectiveness study (90 under-five's per treatment arm). Group one will receive the LSF device with the zinc delivery system; group 2 will receive a LSF without the zinc delivery system.

Zinc intake will be assessed in a subsample of the under 5 year old children enrolled in the effectiveness trial (n=100). This will be estimated by 24 hr recalls administered on 2 non-consecutive days in the dry and wet season. Selected food samples will be collected for direct analysis of zinc and phytic acid content, to supplement data from food composition tables (FCT's). The dietary assessment data will be used to estimate the distribution of zinc intakes in this age group and the EAR cut-off method will be used to estimate the proportion at risk of inadequate intakes.

Data on water intake from the LSF device will be obtained by personal diaries and tally counters. The Zn concentration of the filtered water will be measured weekly. Using these data and the data from the dietary assessment, the contribution of the LSF zinc delivery to the overall dietary zinc intake will be estimated.

The effectiveness study will be conducted as a 6-month double blind randomised trial with 3 assessment time points (baseline, midpoint and endpoint). Three ml (3ml) whole blood will be collected from under 5 year old children enrolled in the households for determination of serum zinc (SZn), C-reactive protein (CRP), Alpha-1- acid glycoprotein (AGP) and hemoglobin (Hb). Stool samples will be collected from a subsample at baseline, midpoint and endpoint in the intervention and control group to assess the composition of the gut microflora and gut inflammation. Anthropometrics (weight and height) will be measured at baseline, midpoint and endpoint of the study. Weekly active surveillance for incidence and severity of malaria, diarrhea and other infectious diseases will be done by questionnaire.

Condition or disease Intervention/treatment Phase
Zinc Deficiency Device: LSF-filtering device Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 186 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Prevention
Official Title: Assessment of Zinc Intake From Enriched Water and Other Dietary Sources in Kisumu, Kenya
Study Start Date : February 2014
Actual Primary Completion Date : August 2014
Actual Study Completion Date : August 2014

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Drinking Water

Arm Intervention/treatment
Placebo Comparator: purified water
Filtered water Pump water purified by the LSF-filtering device Intervention: Device: LSF-filtering device
Experimental: zinc enriched purified water
Zinc water water purified and zinc-enriched by the LSF-filtering device Intervention: Device: LSF-filtering device
Device: LSF-filtering device
Device: LSF-filtering device LifeStraw Family is a water purification device that by means of hollow fibres removes solid particles (<0.5 Nephelometric Turbidity units turbidity reduction), bacteria (>Log 6 reduction), viruses (>Log 4 reduction) and cysts (>Log 3 reduction). Zinc enrichment is provided by a chamber housing a zinc releasing glass-plate that is placed annexed to the hollow fibre column. It is estimated that the LSF can provide about 5 mg of zinc/l of filtered water. By consuming daily a portion of 0.6 litres of enriched water, >100% of the age-specific estimated physiologic requirement would be covered, assuming a fractional absorption of 40%.
Other Name: LifeStraw Family by Vestergaard Frandsen SA

Primary Outcome Measures :
  1. number of participants with adequate zinc intake above the EAR (estimated average requirement) [ Time Frame: 6 months ]

Secondary Outcome Measures :
  1. number of participants with increased serum zinc level from baseline [ Time Frame: at 3 months into intervention and at 6 months ]
  2. morbidity incidence [ Time Frame: every week up to 24 weeks ]

Information from the National Library of Medicine

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Ages Eligible for Study:   2 Years to 5 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Children (under 5 year olds) in consenting households will participate in the study

Exclusion Criteria:

  • Subjects with severe anemia (Hb<7g/dl)
  • Subjects receiving zinc supplementation
  • Subject with chronic diseases affecting zinc metabolism, such as kidney diseases or chronic gastrointestinal disease.
  • Subjects participating in any other clinical trials in the study site

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02162238

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Maseno University
Kisumu, Nyanza, Kenya
Sponsors and Collaborators
Wageningen University
ETH Zurich
Maseno University
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Principal Investigator: Diego Moretti, PhD ETH Zurich
Study Director: Inge D Brouwer, PhD Wageningen University
Study Chair: Michael B Zimmerman, PhD ETH Zurich and Wageningen University
Study Director: Pauline Andango, PhD Maseno University
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Wageningen University Identifier: NCT02162238    
Other Study ID Numbers: Kisumu dietary Zn Study
First Posted: June 12, 2014    Key Record Dates
Last Update Posted: September 3, 2014
Last Verified: September 2014
Keywords provided by Wageningen University: