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Abstract：
Child growth impairments are rampant in sub-Saharan Africa. To combat this important health problem, long-term follow-up studies are needed to examine possible benefits and sustainability of various interventions designed to correct inadequate child growth. Our aim was to perform a follow-up study of children aged 60-72 months whose mothers participated in a two-armed cluster-randomized education intervention trial lasting 6 months in rural Uganda when their children were 6-8 months old with data collection at 20-24 and at 36 months. The education focused on nutrition, hygiene, and child stimulation.
We measured growth using anthropometry converted to z-scores according to WHO guidelines. We also included assessments of body composition using bioimpedance. We used multilevel mixed effect linear regression models with maximum likelihood method, unstructured variance-covariance structure, and the cluster as a random effect component to compare data from the intervention (receiving the education and routine health care) with the control group (receiving only routine health care).
Of the 511 children included in the original trial, data from 166/263 (63%) and 141/248 (57%) of the children in the intervention and control group, respectively, were available for the current follow-up study. We found no significant differences in any anthropometrical z-score between the two study groups at child age of 60-72 months, except that children in the intervention group had lower (P = 0.006) weight-for-height z-score than the controls. There were no significant differences in the trajectories of z-scores or height growth velocity (cm/year) from baseline (start of original trial) to child age of 60-72 months. Neither did we detect any significant difference between the intervention and control group regarding body composition (fat mass, fat free mass, and total body water) at child age 60-72 months. Separate gender analyses had no significant impact on any of the growth or body composition findings.
In this long-term study of children participating in a randomized maternal education trial, we found no significant impact of the intervention on anthropometrical z-scores, height growth velocity or body composition.
Clinical Trials (clinical trials.gov) ClinicalTrials.gov ID NCT02098031.
We measured growth using anthropometry converted to z-scores according to WHO guidelines. We also included assessments of body composition using bioimpedance. We used multilevel mixed effect linear regression models with maximum likelihood method, unstructured variance-covariance structure, and the cluster as a random effect component to compare data from the intervention (receiving the education and routine health care) with the control group (receiving only routine health care).
Of the 511 children included in the original trial, data from 166/263 (63%) and 141/248 (57%) of the children in the intervention and control group, respectively, were available for the current follow-up study. We found no significant differences in any anthropometrical z-score between the two study groups at child age of 60-72 months, except that children in the intervention group had lower (P = 0.006) weight-for-height z-score than the controls. There were no significant differences in the trajectories of z-scores or height growth velocity (cm/year) from baseline (start of original trial) to child age of 60-72 months. Neither did we detect any significant difference between the intervention and control group regarding body composition (fat mass, fat free mass, and total body water) at child age 60-72 months. Separate gender analyses had no significant impact on any of the growth or body composition findings.
In this long-term study of children participating in a randomized maternal education trial, we found no significant impact of the intervention on anthropometrical z-scores, height growth velocity or body composition.
Clinical Trials (clinical trials.gov) ClinicalTrials.gov ID NCT02098031.
摘要：
儿童生长障碍在撒哈拉以南非洲十分猖獗。为了解决这个重要的健康问题，需要进行长期随访研究,以检查旨在纠正儿童成长不足的各种干预措施的可能益处和可持续性.我们的目的是对60-72个月的儿童进行随访研究，这些儿童的母亲在乌干达农村地区参加了为期6个月的双臂集群随机教育干预试验，该试验的孩子年龄为6-8个月，并在20-24个月和36个月时收集数据。教育的重点是营养，卫生,孩子的刺激。
我们使用根据WHO指南转换为z分数的人体测量法测量生长。我们还包括使用生物阻抗评估身体组成。我们使用最大似然法的多级混合效应线性回归模型，非结构化方差-协方差结构，和集群作为随机效应成分，以比较干预（接受教育和常规医疗保健）与对照组（仅接受常规医疗保健）的数据。
在原始试验中包括的511名儿童中，干预组和对照组中166/263（63%）和141/248（57%）儿童的数据，分别,可用于当前的随访研究。我们发现，在60-72个月的儿童年龄时，两个研究组之间的人体测量z评分没有显着差异。干预组儿童身高体重z评分低于对照组(P=0.006).从基线（原始试验开始）到60-72个月的儿童年龄，z得分或身高生长速度（厘米/年）的轨迹没有显着差异。我们也没有检测到干预组和对照组在身体成分方面的任何显著差异(脂肪量，无脂肪质量，和全身水）在60-72个月的儿童。单独的性别分析对任何生长或身体成分的发现都没有显着影响。
在这项对参与随机母亲教育试验的儿童进行的长期研究中，我们发现干预对人体测量z得分没有显著影响，身高生长速度或身体成分。
临床试验（clinicaltrials.gov）ClinicalTrials.govIDNCT02098031。
我们使用根据WHO指南转换为z分数的人体测量法测量生长。我们还包括使用生物阻抗评估身体组成。我们使用最大似然法的多级混合效应线性回归模型，非结构化方差-协方差结构，和集群作为随机效应成分，以比较干预（接受教育和常规医疗保健）与对照组（仅接受常规医疗保健）的数据。
在原始试验中包括的511名儿童中，干预组和对照组中166/263（63%）和141/248（57%）儿童的数据，分别,可用于当前的随访研究。我们发现，在60-72个月的儿童年龄时，两个研究组之间的人体测量z评分没有显着差异。干预组儿童身高体重z评分低于对照组(P=0.006).从基线（原始试验开始）到60-72个月的儿童年龄，z得分或身高生长速度（厘米/年）的轨迹没有显着差异。我们也没有检测到干预组和对照组在身体成分方面的任何显著差异(脂肪量，无脂肪质量，和全身水）在60-72个月的儿童。单独的性别分析对任何生长或身体成分的发现都没有显着影响。
在这项对参与随机母亲教育试验的儿童进行的长期研究中，我们发现干预对人体测量z得分没有显著影响，身高生长速度或身体成分。
临床试验（clinicaltrials.gov）ClinicalTrials.govIDNCT02098031。
