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Prebiotics and Microbiota Composition and Functionality in Rural Burkinabe Infants

Not Applicable
Completed
Conditions
Infant Morbidity
Growth Retardation
Interventions
Dietary Supplement: lipid based nutrient supplement
Dietary Supplement: Fortified lipid based nutrient supplement
Registration Number
NCT02716935
Lead Sponsor
University Ghent
Brief Summary

The purpose of this study is to assess the effect of a mixture of prebiotics included in a food supplement on microbiota diversity and functionality, and to explore its subsequent effects on linear growth velocity and morbidity.

Detailed Description

The central role of gut microbiota in immunity and nutritional homeostasis is now acknowledged, albeit not fully understood. Gut microbiota composition imbalances have been found in malnourished children, which were not restored by nutritional interventions as currently conducted. Therefore, the necessity to design more complete nutritional interventions that include gut health has been advised by expert committees.

Prebiotics are compound that selectively enhance the growth of beneficial gut bacteria. They have been recommended and used in infant formula and weaning cereals resulting in gut microbiota resembling that of breastfed infants in formula fed infants in developed countries. A healthy gut microbiota was shown to be associated with enhanced growth patterns and decreased morbidity in children in developed countries. Evidence of such outcome is lacking in developing countries, yet such results would be particularly valuable for children from these settings, living in rather poor sanitary conditions in an environment characterized with high infectious disease load, conditions that mostly explain the high prevalence of chronic malnutrition. This study aims to assess the effect of a 6 months' supplementation with a lipid based nutrient supplement fortified with fructo-oligosaccharides and inulin on microbiota diversity and functionality in rural Burkinabe infants, and to explore its subsequent effects on linear growth velocity and morbidity.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
153
Inclusion Criteria
  • 6-6.5 month old infants
  • Weight for height and height for age z-score above -2
  • Permanent resident of the area and not intending to move for the next 6 months for more than a week
  • No chronic antibiotic treatment
  • Exempt of any current serious illness
  • Still breastfed.
Exclusion Criteria
  • Moderate or severe malnutrition (weight for height or height for age z-score below -2)
  • non-permanent residence in the study area,
  • the presence of any congenital anomalies in the child or mental/physical disease of the mother that can interfere with child feeding
  • a chronic antibiotic treatment i.e. more than 6 weeks treatment at the time of enrolment
  • a history of allergy to a constituent of the supplement
  • a serious current illness

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
lipid based nutrient supplementlipid based nutrient supplementlipid based nutrient supplement (Nutributter)
Fortified lipid based nutrient supplementFortified lipid based nutrient supplementlipid based nutrient supplement (Nutributter) fortified with fructo-oligosaccharides and inulin
Primary Outcome Measures
NameTimeMethod
Fecal microbiota range-weighted richness6 months

Composition of fecal microbiota will be determined by Illumina sequencing from which range-weighted richness will be calculated

Mean concentration of short-chain fatty acids in stool6 months

Concentration of short-chain fatty acids (acetate, butyrate and propionate) will be measured by Gas Chromatography

Secondary Outcome Measures
NameTimeMethod
Calprotectin concentration in stoolat inclusion, 3 months and 6months after inclusion

Concentration of calprotectin will be measured by ELISA

Mean stool pHonce every week during the first month of supplementation

Stool pH will be measured once a week with pH sticks by a study nurse

Residual fecal microbiota range-weighted richness3 months and 6 months

Composition of fecal microbiota will be determined by Illumina sequencing, from which range-weighted richness will be calculated

Infant linear growth velocityonce a month during 6 months

Linear growth velocity will be determined using the difference between 2 length measures over the follow up time in months and expressed in millimeters/ month

Stool consistencyOnce every week during the first month of supplementation

Stool consistency will be recalled

Frequency of digestive intolerance symptoms (flatulence, abdominal pain, regurgitation, vomiting, or diarrhea)once every week during the first month of supplementation

Digestive intolerance symptoms will be recalled.

Stool frequency per day6 months

Stool frequency per day will be recalled.

Cumulative morbidityStarting from inclusion, weekly during a follow-up of 6 months

Cumulative morbidity of (malaria, gastro-intestinal tract infection, acute respiratory tract infection, acute otitis) will be assessed one a week by a study nurse

Infant ponderal growth velocityonce a month during 6 months

Ponderal growth velocity will be determined using the difference between 2 weight measures over the follow up time in month and expressed in grams/ month. Infant's weight will be measured at inclusion and once a month during 6 months

Infant's intestinal permeabilityat inclusion, 3 months and 6 months after inclusion

Intestinal permeability will be assessed using a mannitol-lactulose test

Residual concentration of short-chain fatty acids in stool3 months and 6 months

Concentration of short chain fatty acids (acetate, butyrate and propionate) will be measured by Gas Chromatography

Trial Locations

Locations (1)

IRSS/DRO

🇧🇫

Bobo-Dioulasso, Houet, Burkina Faso

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