Randomised controlled pilot feasibility trial of an early intervention programme for young infants with neurodevelopmental impairment in Uganda: a study protocol.

Journal: BMJ open

Volume: 9

Issue: 10

Year of Publication: 2020

Affiliated Institutions:  Social Aspects of Health Programme, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda. MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom. Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom. Adara Development, Washington, United Kingdom. Neonatal Medicine, Mulago National Referral Hospital, Kampala, Uganda. Kiwoko Hospital, Nakaseke, Uganda. Department of Paediatrics, Imperial College London, London, United Kingdom. Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom. Cerebral Palsy Alliance Research Institute, Sydney, New South Wales, Australia. Social Aspects of Health Programme, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda Cally.Tann@lshtm.ac.uk.

Abstract summary 

Early intervention programmes (EIPs) for infants with neurodevelopmental impairment have been poorly studied especially in low-income settings. We aim to evaluate the feasibility and acceptability of a group participatory EIP, the 'ABAaNA EIP', for young children with neurodevelopmental impairment in Uganda.We will conduct a pilot feasibility, single-blinded, randomised controlled trial comparing the EIP with standard care across two study sites (one urban, one rural) in central Uganda. Eligible infants (n=126, age 6-11 completed months) with neurodevelopmental impairment (defined as a developmental quotient <70 on Griffiths Scales of Mental Development, and, or Hammersmith Infant Neurological Examination score <60) will be recruited and randomised to the intervention or standard care arm. Intervention arm families will receive the 10-modular, peer-facilitated, participatory, community-based programme over 6 months. Recruited families will be followed up at 6 and 12 months after recruitment, and assessors will be blinded to the trial allocation. The primary hypothesis is that the ABAaNA EIP is feasible and acceptable when compared with standard care. Primary outcomes of interest are feasibility (number recruited and randomised at baseline) and acceptability (protocol violation of arm allocation and number of sessions attended) and family and child quality of life. Guided by the study aim, the qualitative data analysis will use a data-led thematic framework approach. The findings will inform scalability and sustainability of the programme.The trial protocol has been approved by the relevant Ugandan and UK ethics committees. Recruited families will give written informed consent and we will follow international codes for ethics and good clinical practice. Dissemination will be through peer-reviewed publications, conference presentations and public engagement.ISRCTN44380971; protocol version 3.0, 19th February 2018.

Authors & Co-authors:  Nampijja Margaret M Webb Emily E Nanyunja Carol C Sadoo Samantha S Nalugya Ruth R Nyonyintono James J Muhumuza Anita A Ssekidde Moses M Katumba Kenneth K Magnusson Brooke B Kabugo Daniel D Cowan Frances M FM Martinez-Biarge Miriam M Zuurmond Maria M Morgan Cathy C Lester Deborah D Seeley Janet J Tann Cally J CJ

Study Outcome 

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Statistics
Citations :  WHO U Survive and thrive: transforming care for every small and sick newborn. key findings, 2018. Available: https://www.unicef.org/every-child-alive/Survive-and-Thrive_KEY_FINDINGS_FINAL.pdf
Authors :  18
Identifiers
Doi : e032705
SSN : 2044-6055
Study Population
Male,Female
Mesh Terms
Early Medical Intervention
Other Terms
Uganda;cohort study;impairment;neonatal encephalopathy;neurodevelopment;outcomes
Study Design
Cross Sectional Study
Study Approach
Qualitative
Country of Study
Uganda
Publication Country
England