64N Nutraceutical for the Prevention of Childhood Diarrhea and Pneumonia in Low Resource Settings
Primary Purpose
Diarrhea, Pneumonia
Status
Unknown status
Phase
Not Applicable
Locations
Guatemala
Study Type
Interventional
Intervention
64N Nutraceutical
No 64N Nutraceutical
Sponsored by
About this trial
This is an interventional prevention trial for Diarrhea focused on measuring Diarrhea, Pneumonia, Child, Preschool, Infant, Dietary Supplements, Colostrums, Developing Countries
Eligibility Criteria
Inclusion Criteria:
- Healthy neonates
Exclusion Criteria:
- Neonates with milk intolerance
- Neonates with lactose intolerance
- Premature neonates
- Neonates in poor health or who are being followed by a medical provider for illness
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Sham Comparator
Arm Label
64N Nutraceutical
No 64N Nutraceutical
Arm Description
Powdered 64N Nutraceutical 40 mg/kg/day mixed in 12 ounces of a culturally appropriate warm drink for 1 week (7 days).
Culturally appropriate 12 ounce warm drink daily for 1 week (7 days).
Outcomes
Primary Outcome Measures
Mortality from childhood diarrhea and pneumonia
Secondary Outcome Measures
Medical visits for childhood diarrhea and pneumonia
Full Information
NCT ID
NCT02231047
First Posted
August 28, 2014
Last Updated
November 15, 2014
Sponsor
H2O Health and Agriculture LLC
1. Study Identification
Unique Protocol Identification Number
NCT02231047
Brief Title
64N Nutraceutical for the Prevention of Childhood Diarrhea and Pneumonia in Low Resource Settings
Official Title
64N Nutraceutical for the Prevention of Childhood Diarrhea and Pneumonia in Low Resource Settings
Study Type
Interventional
2. Study Status
Record Verification Date
November 2014
Overall Recruitment Status
Unknown status
Study Start Date
January 2015 (undefined)
Primary Completion Date
August 2019 (Anticipated)
Study Completion Date
August 2019 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
H2O Health and Agriculture LLC
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to compare the occurrence of childhood diarrheal disease and pneumonia in subjects under the age of 5 years in low resource settings who have received prophylactic 64N nutraceutical (64N)as a neonate as compared with neonates who have not received prophylactic 64N.
Detailed Description
Diarrheal disease and pneumonia are two of the top four causes of mortality in children under the age of five . In 2010, 64 percent of deaths in this age group were due to infectious causes. A majority of these deaths occur in developing countries. Although vaccines have been proven to prevent pneumonia and diarrheal disease due to rotavirus, these vaccines may not be available to the most vulnerable children in developing countries. Barriers to vaccination in the poorest countries include lack of infrastructure, poor health systems, lack of finances, and lack of transportation. It has been estimated that an additional one billion US dollars will be needed to guarantee that the most vulnerable populations receive vaccinations.
Diarrheal disease is especially problematic since pathogens other than rotavirus cause diarrhea in children living in developing countries. Examples of pathogens causing diarrhea include Vibrio cholera, Salmonella enterica serovar Typhi, Escherichia coli [E. coli], Cryptosporidium, Entamoeba histolytica, and Shigella. Parasitic worms of the Schistosoma genus also cause diarrheal disease in poor countries. In developing countries, infants 0 to 11 months of age are at the highest risk of dying from diarrhea caused by typical E. coli and E. coli producing heat-stable toxin. Children 12 to 23 months of age are at the highest risk of dying from diarrhea caused by Cryptosporidium. It has been recommended that five pathogens (i.e., typical E. coli, E. coli producing heat-stable toxin, Cryptosporidium, Shigella, rotavirus) be targeted in order to decrease the burden of moderate-to-severe childhood diarrhea in developing countries.
In order to improve survival for children under the age of five in low resource settings, cost-effective, patient-directed, accessible, innovative, and alternative interventions that are culturally appropriate need to be explored. One such intervention that may confer passive immunity to protect young children in low resource settings against the multiple pathogenic causes of childhood diarrhea as well as childhood pneumonia is the utilization of 64N.
64N has been used by Ayurvedic physicians for medicinal purposes in humans in India and was also commonly used in Western medicine prior to the development of penicillin and other manufactured antibiotics. Both hyperimmune 64N and unadulterated 64N have been studied in children. Infants fed defatted hyperimmune 64N significantly decreased diarrhea due to rotavirus as compared with infants who received milk from the market. In children 3 to 15 months of age, 64N decreased rotavirus infection as compared with artificial infant formula.
Treatment studies have also shown a benefit of 64N for diarrhea. In children presenting with diarrhea due to E. coli, administration of 64N significantly decreased stool frequency as compared with placebo. 64N concentrates were found to be effective in the treatment of infants with hemorrhagic diarrhea and stopped the progression of the disease to hemolytic urea syndrome. 64N has also been studied in children (1 to 10 years of age) who had mild to moderate nonorganic failure to thrive. In this randomized controlled trial, the authors found that the Gomez index (a weight for age index) was significantly improved with 3 months of 64N supplementation as compared with no 64N supplementation.
There are few side effects of 64N. These are limited to lactose intolerance and sensitivity to milk proteins.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diarrhea, Pneumonia
Keywords
Diarrhea, Pneumonia, Child, Preschool, Infant, Dietary Supplements, Colostrums, Developing Countries
7. Study Design
Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare Provider
Allocation
Randomized
Enrollment
50 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
64N Nutraceutical
Arm Type
Experimental
Arm Description
Powdered 64N Nutraceutical 40 mg/kg/day mixed in 12 ounces of a culturally appropriate warm drink for 1 week (7 days).
Arm Title
No 64N Nutraceutical
Arm Type
Sham Comparator
Arm Description
Culturally appropriate 12 ounce warm drink daily for 1 week (7 days).
Intervention Type
Dietary Supplement
Intervention Name(s)
64N Nutraceutical
Other Intervention Name(s)
Bovine colostrum
Intervention Description
40 mg/kg/day of powdered 64N mixed in 12 ounces of a warm drink for 1 week (7 days)
Intervention Type
Other
Intervention Name(s)
No 64N Nutraceutical
Intervention Description
12 ounce warm drink daily for 1 week (7 days)
Primary Outcome Measure Information:
Title
Mortality from childhood diarrhea and pneumonia
Time Frame
Assessed every 3 months for 4.5 years
Secondary Outcome Measure Information:
Title
Medical visits for childhood diarrhea and pneumonia
Time Frame
Every 3 months for 4.5 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
6 Hours
Maximum Age & Unit of Time
1 Day
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Healthy neonates
Exclusion Criteria:
Neonates with milk intolerance
Neonates with lactose intolerance
Premature neonates
Neonates in poor health or who are being followed by a medical provider for illness
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Donna M Rohrs, DHSc, PA
Phone
517.281.0344
Email
h2ohealthag@gmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Donna M Rohrs, DHSc, PA
Organizational Affiliation
H2O Health and Agriculture LLC
Official's Role
Principal Investigator
Facility Information:
City
Santa Maria de Jesus
State/Province
Sacatepequez
ZIP/Postal Code
03011
Country
Guatemala
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Donna M Rohrs, DHSc, PA
Phone
517.281.0344
Email
h2ohealthag@gmail.com
First Name & Middle Initial & Last Name & Degree
Donna M Rohrs, DHSc, PA
12. IPD Sharing Statement
Citations:
PubMed Identifier
23178060
Citation
Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am. 2013 Feb;60(1):49-74. doi: 10.1016/j.pcl.2012.10.002.
Results Reference
background
PubMed Identifier
2570959
Citation
Davidson GP, Whyte PB, Daniels E, Franklin K, Nunan H, McCloud PI, Moore AG, Moore DJ. Passive immunisation of children with bovine colostrum containing antibodies to human rotavirus. Lancet. 1989 Sep 23;2(8665):709-12. doi: 10.1016/s0140-6736(89)90771-x.
Results Reference
background
PubMed Identifier
4069083
Citation
Ebina T, Sato A, Umezu K, Ishida N, Ohyama S, Oizumi A, Aikawa K, Katagiri S, Katsushima N, Imai A, et al. Prevention of rotavirus infection by oral administration of cow colostrum containing antihumanrotavirus antibody. Med Microbiol Immunol. 1985;174(4):177-85. doi: 10.1007/BF02123694.
Results Reference
background
Citation
Godhia, ML, Patel, N. Colostrum - its composition, benefits as a nutraceutical: A review. Current Research in Nutrition and Food Science, 1(1), 37-47, 2013.
Results Reference
background
PubMed Identifier
10512407
Citation
Huppertz HI, Rutkowski S, Busch DH, Eisebit R, Lissner R, Karch H. Bovine colostrum ameliorates diarrhea in infection with diarrheagenic Escherichia coli, shiga toxin-producing E. Coli, and E. coli expressing intimin and hemolysin. J Pediatr Gastroenterol Nutr. 1999 Oct;29(4):452-6. doi: 10.1097/00005176-199910000-00015.
Results Reference
background
PubMed Identifier
22254105
Citation
Hurley WL, Theil PK. Perspectives on immunoglobulins in colostrum and milk. Nutrients. 2011 Apr;3(4):442-74. doi: 10.3390/nu3040442. Epub 2011 Apr 14.
Results Reference
background
PubMed Identifier
23680352
Citation
Kotloff KL, Nataro JP, Blackwelder WC, Nasrin D, Farag TH, Panchalingam S, Wu Y, Sow SO, Sur D, Breiman RF, Faruque AS, Zaidi AK, Saha D, Alonso PL, Tamboura B, Sanogo D, Onwuchekwa U, Manna B, Ramamurthy T, Kanungo S, Ochieng JB, Omore R, Oundo JO, Hossain A, Das SK, Ahmed S, Qureshi S, Quadri F, Adegbola RA, Antonio M, Hossain MJ, Akinsola A, Mandomando I, Nhampossa T, Acacio S, Biswas K, O'Reilly CE, Mintz ED, Berkeley LY, Muhsen K, Sommerfelt H, Robins-Browne RM, Levine MM. Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. Lancet. 2013 Jul 20;382(9888):209-22. doi: 10.1016/S0140-6736(13)60844-2. Epub 2013 May 14.
Results Reference
background
PubMed Identifier
22579125
Citation
Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M, Mathers C, Black RE; Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012 Jun 9;379(9832):2151-61. doi: 10.1016/S0140-6736(12)60560-1. Epub 2012 May 11. Erratum In: Lancet. 2012 Oct 13;380(9850):1308.
Results Reference
background
PubMed Identifier
20639714
Citation
Panahi Y, Falahi G, Falahpour M, Moharamzad Y, Khorasgani MR, Beiraghdar F, Naghizadeh MM. Bovine colostrum in the management of nonorganic failure to thrive: a randomized clinical trial. J Pediatr Gastroenterol Nutr. 2010 May;50(5):551-4. doi: 10.1097/MPG.0b013e3181b91307.
Results Reference
background
PubMed Identifier
12142957
Citation
Solomons NW. Modulation of the immune system and the response against pathogens with bovine colostrum concentrates. Eur J Clin Nutr. 2002 Aug;56 Suppl 3:S24-8. doi: 10.1038/sj.ejcn.1601480.
Results Reference
background
PubMed Identifier
18952725
Citation
Stelwagen K, Carpenter E, Haigh B, Hodgkinson A, Wheeler TT. Immune components of bovine colostrum and milk. J Anim Sci. 2009 Apr;87(13 Suppl):3-9. doi: 10.2527/jas.2008-1377. Epub 2008 Oct 24.
Results Reference
background
PubMed Identifier
18538107
Citation
Struff WG, Sprotte G. Bovine colostrum as a biologic in clinical medicine: a review--Part II: clinical studies. Int J Clin Pharmacol Ther. 2008 May;46(5):211-25. doi: 10.5414/cpp46211.
Results Reference
background
Citation
World Health Organization. Causes of child mortality, by region, 2000-2011. In Global health observatory (GHO), (2014) Retrieved from http://www.who.int/gho/child_health/mortality/mortality_causes_region_text/en/
Results Reference
background
Citation
World Health Organization. Childhood vaccines at all-time high, but access not equitable, (2009). Retrieved from http://www.who.int/mediacentre/news/releases/2009/state_immunizaton_200910
Results Reference
background
Learn more about this trial
64N Nutraceutical for the Prevention of Childhood Diarrhea and Pneumonia in Low Resource Settings
We'll reach out to this number within 24 hrs