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Trial registered on ANZCTR
Registration number
ACTRN12618000960257
Ethics application status
Approved
Date submitted
22/05/2018
Date registered
7/06/2018
Date last updated
7/06/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Iron Supplementation and Nutritional Education in Palestinian Adolescents
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Scientific title
Effects of Iron Supplementation and Nutritional Education Among Iron Deficinecy Anemia and Iron Deficient Female Adolescents in The Gaza Strip Palestine
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Secondary ID [1]
294965
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NONE
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
iron deficiency
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iron deficient anemia
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Condition category
Condition code
Diet and Nutrition
306998
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0
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Other diet and nutrition disorders
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Blood
307177
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0
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Anaemia
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Weekly iron supplementation (Ferrous Fumarate 200 mg) will be administered
for 3 months while the nutritional education will be 3 months as well. The percentage of
iron in ferrous fumarate 200 mg is 33%, which mean contain 66 mg elemental iron per
tablet. The guidelines used by WHO of iron supplements to treat IDA recommended 60
mg iron daily. The same guidelines reported that the efficacy of once or twice/weekly
supplementation in adolescents group appears promising, and the operational efficiency
of intermittent dosing regimens is being evaluated. Group A received iron tablets and Group B received nutrition education.
Strategies to monitor adherence include unused tablet return and to calculate total number of iron pills intake by particular participants). Compliance will be measured via :
Compliance % (Group A) = Total no. of iron pills intake by participants X 100% Total no. of supposed no. of pills.
Whereby, for Group B, it is based on attendance records. This sheet will be used for the subjects in the nutritional educational group B to indicate the number of session attended by a particular students.
Compliance % (Group B) = Total no. of sessions attendant by participants X 100% Total no. of sessions delivered
All participants will also need to report their health status by doing weekly health recall. This is to monitor the changes observed during the intervention, as well as side effects, such as constipation, diarrhea, nausea or vomiting, abdominal or stomach pain cramping (continuing) or soreness.
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Intervention code [1]
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Prevention
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Comparator / control treatment
Nutrition Education Group
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Control group
Active
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Outcomes
Primary outcome [1]
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Anemia status will be assessed by measuring hemoglobin (Hb) concentration using a Sysmex XE-2100 hematology analyzer; Calibration of the device will checked daily using control solutions provided by the manufacturer. The result will be recorded as hemoglobin in grams per deciliter, each sample will be analysed in duplicate. Anemia will be defined according to WHO guidelines as Hb < 12.0 g/dl, mild anemia as Hb 9.0-< 12.0 g/dl, moderate anemia as Hb <90 g/dL, and severe anemia as Hb < 70 g/dl.
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Assessment method [1]
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Timepoint [1]
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Baseline and 3 months
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Secondary outcome [1]
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Iron status :
Iron status will be assessed by measuring serum ferritin and determined by enzyme linked immunosorbent assay (ELISA) by (Human Ferritin ELISA Kit-Sigma-Aldrich-Germany) in duplicate and the average results will be recorded
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Assessment method [1]
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Timepoint [1]
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baseline and 3 months
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Secondary outcome [2]
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Malonyledialdehyde (MDA) will be measured by thiobarbituric acid (TBA) method seems to be most suitable method because of its high sensitivity (Kei 1978).
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Assessment method [2]
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Timepoint [2]
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Baseline and 3 months
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Secondary outcome [3]
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C-reactive protein (CRP) is a sensitive marker of systemic inflammation that synthesized by the liver. CRP is a nonspecific acute-phase reactant that has traditionally used to detect acute injury infection and inflammation (Backes et al. 2004). C-reactive protein (CRP) will be measured from the serum of participants as an indicator of infection or inflammation, which can affect hemoglobin and serum ferritin concentrations, by latex-enhanced immunonephelometry on a BN II Analyzer (Dade Behring, Newark, DE). A cutoff value of > 6 mg/L will be used (Schneider 1973).
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Assessment method [3]
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Timepoint [3]
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Baseline and 3 months
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Secondary outcome [4]
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The knowledge questionnaire will be used to evaluate the knowledge in management of iron deficiency anaemia among adolescent female (Sichert-Hellert et al. 2011). A planned teaching programme will be prepared on anemia, iron deficiency anaemia, and risk factors that causes its.
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Assessment method [4]
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Timepoint [4]
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Baseline and 3 months
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Eligibility
Key inclusion criteria
1. Students who diagnosed iron deficient and iron deficient anemic.
2. Students who iron deficient non-anemic, mild anemic or moderate iron
deficient anemic.
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Minimum age
13
Years
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Maximum age
18
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1.Student who diagnosed anemic but have normal ferritin level.
2. Students who iron deficient severe anemic (Hb. < 7.0 g/dl).
3. White blood cells (WBC) above normal range.
4. Students who are diagnose underweight.
5. Students who have anemia either than iron deficiency anemia.
6. Students who are under medication
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
Statistical package for social science (IBM-SPSS) version 22 will be used for analysis
of data, which will be conducted as follow:
1. Review of the filled questionnaire, Coding the questions, Data entry, Data
cleaning, and coding variable.
2. Descriptive statistics including frequencies, percentages, mean, median,
confidence interval (CI), interquartile range (IQR) and standard deviation.
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3. Chi-square distribution to determine the association between categorical
variable like: parents education, parent employment, family size …etc.
4. Univariate analysis, after assumption of normality, parametric test like t-tests,
one way ANOVA, and non-parametric tests like; Mann-Whitney test, Kruskal
Wallis test to compare continuous variables like hemoglobin, ferritin, and IQ.
5. Bivariate analysis after assumption of normality to identify the relationships
between continuous variable like; Spearman, Pearson and simple linear
regression.
6. Multivariate analysis; Odd ratio OR CI determine by conditional logistic
regression of association of risk factors associated with anemia and IDA.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/01/2016
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Date of last participant enrolment
Anticipated
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Actual
1/10/2016
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Date of last data collection
Anticipated
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Actual
31/12/2016
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Sample size
Target
126
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Accrual to date
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Final
126
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Recruitment outside Australia
Country [1]
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Palestinian Territory, Occupied
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State/province [1]
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Gaza
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Razinah Sharif
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Address [1]
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Program of Nutritional Sciences, Universiti Kebangsaan Malaysia,
Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
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Country [1]
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Malaysia
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Primary sponsor type
Individual
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Name
Razinah Sharif
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Address
Program of Nutritional Sciences, Universiti Kebangsaan Malaysia,
Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
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Country
Malaysia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Marwan O Jalambo
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Address [1]
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Palestine Technical College, Deir-al Balah, Gaza Palestine
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Country [1]
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Palestinian Territory, Occupied
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Secondary sponsor category [2]
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Individual
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Name [2]
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Ihab Naser
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Address [2]
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Al-Azhar University-Gaza
Jamal Abdl Naser St.
Gaza, Gaza Strip
Palestine
Gaza P.O Box 1277
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Country [2]
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Palestinian Territory, Occupied
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Research & Ethics Commitee Universiti Kebangsaan Malaysia & Palestinian Health Board (Helsinki Committee)
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Ethics committee address [1]
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Hospital Canselor Tuanku Muhriz Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) Jalan Yaacob Latif Bandar Tun Razak 56000 Cheras, Kuala Lumpur Malaysia.
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Ethics committee country [1]
300451
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Malaysia
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Date submitted for ethics approval [1]
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21/02/2015
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Approval date [1]
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01/06/2015
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Ethics approval number [1]
300451
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Ethics committee name [2]
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Helsinki Commitee
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Ethics committee address [2]
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Palestinian health Research Council
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Ethics committee country [2]
300452
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Palestinian Territory, Occupied
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Date submitted for ethics approval [2]
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01/12/2014
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Approval date [2]
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02/02/2015
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Ethics approval number [2]
300452
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PHRC/HC/3/14
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Summary
Brief summary
Iron deficiency (ID) is the most common form of malnutrition worldwide, affecting more than 2000 million people globally. Iron deficiency anemia (IDA) is highly widespread in developing countries. Adolescent female constitute about fifth of total female population in the world. Adolescent is one of the most challenging period in human development. The sudden changes create nutritional needs. As a period of growth and development, is considered the best time to intervene, to assist in physical and mental development, and to prevent later maternal anemia. The prevalence estimates of IDA among adolescents is 30–55% worldwide. Adolescence is an opportune time for interventions to address anaemia. Not only is there a need (growth, preparation for pregnancy), but large numbers of both male and female adolescents can be reached easily if school attendance or participation in other group activities is high. Also, adolescents are open to new information and new practices since they are often striving for physical or academic excellence. The present study designed to determine the prevalence of anemia, ID and IDA and to study the efficacy of iron-supplementation and nutritional education on hemoglobin and ferritin levels among female adolescents aged 15-19 years living in the Gaza strip-Palestine. The study has two phases: the first phase will be a cross sectional descriptive study, which will enroll randomly 374 female students aged 15-19 years in the Gaza strip-Palestine. The study population in the study is female students enrolled in the secondary schools. Five female secondary schools will be selected randomly from five governorates in the Gaza strip. In each school, one to two classes of each grade will be selected randomly as well. According to the list of the student’s names, the subjects will be selected upon odd number in the school records. The second phase is randomized controlled trial (intervention phase) that will be divided into three groups; the first group for iron supplementation, the second for nutritional education intervention and the last as control group. Data will be collected by questionnaires, anthropometric measurements, complete blood counts (CBC) and serum ferritin will be analysed. All ID and iron deficient anemic female adolescents will be monitored to evaluate the effectiveness of iron supplement and nutritional education. Statistical package for social science (IBM-SPSS) version 22 will be used for analysis of data.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
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/AnzctrAttachments/375162-Marwan Jalambo Proposal.pdf
(Protocol)
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Attachments [2]
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/AnzctrAttachments/375162(v22-05-2018-15-23-35)-Marwan Jalambo Proposal.pdf
(Ethics approval)
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Attachments [3]
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/AnzctrAttachments/375162-WhatsApp Image 2018-05-22 at 1.51.25 PM.pdf
(Ethics approval)
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Contacts
Principal investigator
Name
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Dr Razinah Sharif
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Address
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Program of Nutritional Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur
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Country
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Malaysia
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Phone
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+60392897459
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Razinah Sharif
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Address
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Program of Nutritional Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur
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Country
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Malaysia
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Phone
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+60392897459
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Razinah Sharif
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Address
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Program of Nutritional Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur
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Country
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Malaysia
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Phone
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+60392897459
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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