Cognitive Outcomes at 18 Months: Findings from the Early Life Interventions for Childhood Growth and Development in Tanzania (ELICIT) Trial

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  • 1 University of Virginia Division of Infectious Diseases and International Health, Charlottesville, Virginia;
  • | 2 Haukeland University Hospital, Bergen, Norway;
  • | 3 Haydom Global Health Research Centre, Haydom Lutheran Hospital, Haydom, Tanzania;
  • | 4 Department of Pediatrics, University of Virginia, Charlottesville, Virginia

Micronutrient deficiencies and enteric infections negatively impact child growth and development. We enrolled children shortly after birth in a randomized, placebo-controlled, 2 × 2 factorial interventional trial in Haydom, Tanzania, to assess nicotinamide and/or antimicrobials (azithromycin and nitazoxanide) effect on length at 18 months of age. Cognitive score at 18 months using the Malawi Developmental Assessment Tool (MDAT), which includes gross motor, fine motor, language, and social assessments, was a secondary outcome. Here, we present the MDAT results of 1,032 children. There was no effect of nicotinamide (change in development-for-age Z score [DAZ] −0.08; 95% CI: −0.16, 0) or antimicrobials (change in DAZ 0.04; 95% CI: −0.06, 0.13) on overall MDAT score. The interventions had no effect on cognitive outcomes in subgroups defined by gender, socioeconomic status, birthweight, and birth season or on MDAT subscores. Further analyses are needed to identify targetable risk factors for impaired cognitive development in these settings.

Author Notes

Address correspondence to Tarina Parpia, University of Virginia Division of Infectious Diseases and International Health, Charlottesville, VA 22903-1738. E-mail: tcp7df@virginia.edu

Authors’ addresses: Tarina Parpia, Sarah Elwood, Anne Wanjuhi, Eric Houpt, Elizabeth Rogawski McQuade, and James Platts-Mills, University of Virginia Division of Division of Infectious Diseases and International Health, Charlottesville, VA, E-mails: tcp7df@virginia.edu, see4v@hscmail.mcc.virginia.edu, aww3y@hscmail.mcc.virginia.edu, erh6k@virginia.edu, etr5m@virginia.edu, and jp5t@virginia.edu. Erling Svensen, Haukeland University Hospital, Bergen, Norway, E-mail: erling.svensen@helse-bergen.no. Ladislaus Blacy, Eliwaza Bayo, and Estomih Mduma, Haydom Global Health Research Centre, Haydom Lutheran Hospital, Haydom, Tanzania, E-mails: ladisblacy@yahoo.com, elb.bayo@gmail.com, and esto@haydom.co.tz. Mark DeBoer and Rebecca Scharf, Department of Pediatrics, University of Virginia, Charlottesville, VA, E-mails: mdd5z@hscmail.mcc.virginia.edu and rs3yk@hscmail.mcc.virginia.edu.

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