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Iron Babies Pilot Supplementation Trial

Phase 3
Completed
Conditions
Iron-deficiency
Anaemia in Early Infancy
Interventions
Dietary Supplement: Iron drops/Ferrous sulphate
Dietary Supplement: Placebo drops
Registration Number
NCT04751994
Lead Sponsor
London School of Hygiene and Tropical Medicine
Brief Summary

2-arm, double blind, placebo controlled, randomised trial, with 50 6-week-old infants per arm randomized to 98 days of daily iron (1.5mg/kg/day as ferrous sulphate) or placebo drops

Detailed Description

Healthy infants will be randomised to receive daily supplementation from 6-20wks of either a) iron drops or b) placebo drops. Infants with significant illness or any clinical syndromes that would affect interpretation will be excluded. Low birthweight infants and infants born prematurely will not be excluded. Venous blood samples will be collected at enrollment (age 6 weeks) and after 14 weeks (98 days) of iron/placebo supplementation.

Participants will be visited daily in their villages by Fieldworkers (FW) to administer the iron/placebo dose and will interview mothers to complete a short health questionnaire. The iron will be dosed at 75% of WHO guideline dose (ie 1.5mg/kg/day). Weekly, a more detailed morbidity and breastfeeding questionnaires will be administered. Infants will be weighed and measured monthly, along with a faecal sample being taken.

During the daily visits, the FWs will record any adverse events (AEs) and ensure the safety of participants. If a child is found unwell or if the mother/guardian reports that the child is unwell, the study nurse will check on the child and decide on treatment/referral to the nearest health centre

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Infants (male or female) from 6 weeks to 10 weeks of age.
  • Breast fed infants (with plans to continue breastfeeding through 6 months of age).
  • Parent/guardian with participant reside in study site area and are able and willing to adhere to all protocol visits and procedures (willingness to stay in the study area for the 14 weeks of supplementation).
  • Healthy with no current illness and no chronic health problems.
  • Signed or fingerprinted informed consent obtained from participants parent/guardian
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Exclusion Criteria
  • Low birthweight babies (ie less than 2.5kg at birth) or babies born prematurely (ie less than 37 weeks) will NOT be excluded.
  • Formula fed infants or those planning to terminate exclusive breast feeding before 6months of age.
  • Acute illness (once acute illness is resolved, if appropriate, as per investigator assessment, participant may be re-revaluated for eligibility)
  • Fever (for eligibility purpose defined as a body temperature greater than 37.5°C or mother report of fever) within 3 days prior to study initiation (once fever/acute illness is resolved, if appropriate, as per investigator assessment, participant may be re-revaluated for eligibility).
  • Administration of any investigational drug within 30 days prior to study initiation or planned administration during the study period.
  • Unwilling to avoid (their child to avoid) the ingestion of supplements or herbal/other traditional medications during the study period.
  • Any history of or evidence for chronic clinically significant (as per investigator assessment) disorder or disease (including, but not limited to, immunodeficiency, autoimmunity, congenital abnormality, bleeding disorder, and pulmonary, cardiovascular, metabolic, neurologic, renal, or hepatic disease).
  • Any history of human immunodeficiency virus, chronic hepatitis B or chronic hepatitis C infections.
  • History of meningitis, seizures, Guillain-Barré syndrome, or other neurological disorders.
  • Any condition that in the opinion of the investigator might compromise the safety or well- being of the participant or compromise adherence to protocol procedures
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Iron supplement/ ferrous sulphate syrupIron drops/Ferrous sulphateadministration of daily iron drops, 7.5mg/day iron as ferrous sulphate
supplement with placeboPlacebo dropsadministration of daily placebo drops
Primary Outcome Measures
NameTimeMethod
serum iron levelat day 0 and at day 99

Serum iron concentration at days 0 and 99

Secondary Outcome Measures
NameTimeMethod
maternal reported illnessesdaily up to day 99

Proportion of maternal-reported illnesses assessed daily up to study day 99.

Serious adverse events (SAE) assessmentdaily up to day 99

Proportion of serious adverse events assessed daily, up to study day 99

Erythroferrone at days 0 and 99day 0 and 99

Erythroferrone at days 0 and 99

adverse events assessmentdaily up to day 99

Proportion of adverse events assessed daily, up to study day 99

iron deficiency anemia (Hb < 11 g/dL & sTfR/logFerritin ratio < 2.0 and ferritin < 12 ug/L or < 30 ug/L in the presence of inflammationat day 0 and day 99

Proportion of children that are iron deficiency anaemia (Hb \< 11 g/dL \& sTfR/logFerritin ratio \< 2.0 and ferritin \< 12 ug/L or \< 30 ug/L in the presence of inflammation)

Iron regulationday 0 and day 99

Hepcidin levels at day 0 and day 99

Percentage of infants with anaemiaat day 99

Percentage of infants with anaemia (defined as: Hb\< 110g/L, )

raised inflammatory markers assessmentafter 98 days of supplementation

Proportion of raised inflammatory markers (CRP/AGP)

Fecal iron after supplementationday 0 and day 99

Fecal iron assessed at day 0 and day 99

breast feedingweekly up to week 14

Duration of breast feeding assessed weekly, up to study day 98.

Reticulocytes at day 0 and day 99day 0 and day 99

Reticulocytes at day 0 and day 99

Haemoglobin concentrationat day 0 and at day 99

Haemoglobin concentration at days 0 and 99

Erythropoietin at days 0 and 99day 0 and 99

Erythropoietin at days 0 and 99

Trial Locations

Locations (1)

Keneba Field Station

🇬🇲

Keneba, Gambia

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