Co-trimoxazole or multivitamin multimineral supplement for post-discharge outcomes after severe anaemia in African children: a randomised controlled trial

Publication date: October 2019Source: The Lancet Global Health, Volume 7, Issue 10Author(s): Kathryn Maitland, Peter Olupot-Olupot, Sarah Kiguli, George Chagaluka, Florence Alaroker, Robert O Opoka, Ayub Mpoya, Kevin Walsh, Charles Engoru, Julius Nteziyaremye, Machpherson Mallewa, Neil Kennedy, Margaret Nakuya, Cate Namayanja, Julianne Kayaga, Eva Nabawanuka, Tonny Sennyondo, Denis Aromut, Felistas Kumwenda, Cynthia Williams MusikaSummaryBackgroundSevere anaemia is a leading cause of paediatric admission to hospital in Africa; post-discharge outcomes remain poor, with high 6-month mortality (8%) and re-admission (17%). We aimed to investigate post-discharge interventions that might improve outcomes.MethodsWithin the two-stratum, open-label, multicentre, factorial randomised TRACT trial, children aged 2 months to 12 years with severe anaemia, defined as haemoglobin of less than 6 g/dL, at admission to hospital (three in Uganda, one in Malawi) were randomly assigned, using sequentially numbered envelopes linked to a second non-sequentially numbered set of allocations stratified by centre and severity, to enhanced nutritional supplementation with iron and folate-containing multivitamin multimineral supplements versus iron and folate alone at treatment doses (usual care), and to co-trimoxazole versus no co-trimoxazole. All interventions were administered orally and were given for 3 months after discharge from hospital. Separately reported randomisations investigated transfusion m...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research