Browsing by Author "Tofail, Fahmida"

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A holistic approach to promoting early child development: A cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh
(BMJ Journals, 3/16/2021) Pitchik, Helen O; Tofail, Fahmida; Rahman, Mahbubur; Akter, Fahmida; Sultana, Jesmin; Shoab, Abul Kasham; Huda, Tarique Md. Nurul; Jahir, Tania; Amin, Md Ruhul; Hossain, Md Khobair; Das, Jyoti Bhushan; Chung, Esther O; Byrd, Kendra A; Yeasmin, Farzana; Kwong, Laura H; Forsyth, Jenna E; Mridha, Malay K; Winch, Peter J; Luby, Stephen P; Fernald, Lia CH
Introduction In low- and middle-income countries, children experience multiple risks for delayed development. We evaluated a multicomponent, group-based early child development intervention including behavioural recommendations on responsive stimulation, nutrition, water, sanitation, hygiene, mental health and lead exposure prevention. Methods We conducted a 9-month, parallel, multiarm, clusterrandomised controlled trial in 31 rural villages in Kishoreganj District, Bangladesh. Villages were randomly allocated to: group sessions (‘group’); alternating groups and home visits (‘combined’); or a passive control arm. Sessions were delivered fortnightly by trained community members. The primary outcome was child stimulation (Family Care Indicators); the secondary outcome was child development (Ages and Stages Questionnaire Inventory, ASQi). Other outcomes included dietary diversity, latrine status, use of a child potty, handwashing infrastructure, caregiver mental health and knowledge of lead. Analyses were intention to treat. Data collectors were independent from implementers. Results In July–August 2017, 621 pregnant women and primary caregivers of children<15 months were enrolled (group n=160, combined n=160, control n=301). At endline, immediately following intervention completion (July–August 2018), 574 participants were assessed (group n=144, combined n=149, control n=281). Primary caregivers in both intervention arms participated in more play activities than control caregivers (age-adjusted means: group 4.22, 95% CI 3.97 to 4.47; combined 4.77, 4.60 to 4.96; control 3.24, 3.05 to 3.39), and provided a larger variety of play materials (ageadjusted means: group 3.63, 3.31 to 3.96; combined 3.81, 3.62 to 3.99; control 2.48, 2.34 to 2.59). Compared with the control arm, children in the group arm had higher total ASQi scores (adjusted mean difference in standardised scores: 0.39, 0.15 to 0.64), while in the combined arm scores were not significantly different from the control (0.25, –0.07 to 0.54). Conclusion Our findings suggest that group-based, multicomponent interventions can be effective at improving child development outcomes in rural Bangladesh, and that they have the potential to be delivered at scale.
Cluster-randomised controlled trials of individual and combined water, sanitation, hygiene and nutritional interventions in rural Bangladesh and Kenya: the WASH benefits study design and rationale
(© 2013 BMJ Open, 2013) F. Arnold, Benjamin; Null, Clair; P. Luby, Stephen; Unicomb, Leanne; Ahmed, Tahmeed; Ashraf, Sania; Christensen, Garret; Clasen, Thomas; Dentz, Holly N.; Fernald, Lia C H; Haque, Rashidul; Hubbard, Alan E.; Kariger, Patricia; Leontsini, Elli; Lin, Audrie; Njenga, Sammy M.; Pickering, Amy J.; Ram, Pavani K.; Stewart, Christine P.; Dewey, Kathryn G.; Tofail, Fahmida; Winch, Peter J; Jr, John M Colford
Introduction: Enteric infections are common during the first years of life in low-income countries and contribute to growth faltering with long-term impairment of health and development. Water quality, sanitation, handwashing and nutritional interventions can independently reduce enteric infections and growth faltering. There is little evidence that directly compares the effects of these individual and combined interventions on diarrhoea and growth when delivered to infants and young children. The objective of the WASH Benefits study is to help fill this knowledge gap. Methods and analysis: WASH Benefits includes two cluster-randomised trials to assess improvements in water quality, sanitation, handwashing and child nutrition-alone and in combination-to rural households with pregnant women in Kenya and Bangladesh. Geographically matched clusters (groups of household compounds in Bangladesh and villages in Kenya) will be randomised to one of six intervention arms or control. Intervention arms include water quality, sanitation, handwashing, nutrition, combined water+sanitation+handwashing (WSH) and WSH +nutrition. The studies will enrol newborn children (N=5760 in Bangladesh and N=8000 in Kenya) and measure outcomes at 12 and 24 months after intervention delivery. Primary outcomes include child length-for-age Z-scores and caregiver-reported diarrhoea. Secondary outcomes include stunting prevalence, markers of environmental enteropathy and child development scores (verbal, motor and personal/social). We will estimate unadjusted and adjusted intention-to-treat effects using semiparametric estimators and permutation tests. Ethics and dissemination: Study protocols have been reviewed and approved by human subjects review boards at the University of California, Berkeley, Stanford University, the International Centre for Diarrheal Disease Research, Bangladesh, the Kenya Medical Research Institute, and Innovations for Poverty Action. Independent data safety monitoring boards in each country oversee the trials. This study is funded by a grant from the Bill & Melinda Gates Foundation to the University of California, Berkeley.
Cluster-randomised controlled trials of individual and combined water, sanitation, hygiene and nutritional interventions in rural Bangladesh and Kenya: the WASH benefits study design and rationale
(© 2013 BMJ Open, 2013) F. Arnold, Benjamin; Null, Clair; P. Luby, Stephen; Unicomb, Leanne; Ahmed, Tahmeed; Ashraf, Sania; Christensen, Garret; Clasen, Thomas; Dentz, Holly N.; Fernald, Lia C H; Haque, Rashidul; Hubbard, Alan E.; Kariger, Patricia; Leontsini, Elli; Lin, Audrie; Njenga, Sammy M.; Pickering, Amy J.; Ram, Pavani K.; Stewart, Christine P.; Dewey, Kathryn G.; Tofail, Fahmida; Winch, Peter J; Jr, John M Colford
Introduction: Enteric infections are common during the first years of life in low-income countries and contribute to growth faltering with long-term impairment of health and development. Water quality, sanitation, handwashing and nutritional interventions can independently reduce enteric infections and growth faltering. There is little evidence that directly compares the effects of these individual and combined interventions on diarrhoea and growth when delivered to infants and young children. The objective of the WASH Benefits study is to help fill this knowledge gap. Methods and analysis: WASH Benefits includes two cluster-randomised trials to assess improvements in water quality, sanitation, handwashing and child nutrition-alone and in combination-to rural households with pregnant women in Kenya and Bangladesh. Geographically matched clusters (groups of household compounds in Bangladesh and villages in Kenya) will be randomised to one of six intervention arms or control. Intervention arms include water quality, sanitation, handwashing, nutrition, combined water+sanitation+handwashing (WSH) and WSH +nutrition. The studies will enrol newborn children (N=5760 in Bangladesh and N=8000 in Kenya) and measure outcomes at 12 and 24 months after intervention delivery. Primary outcomes include child length-for-age Z-scores and caregiver-reported diarrhoea. Secondary outcomes include stunting prevalence, markers of environmental enteropathy and child development scores (verbal, motor and personal/social). We will estimate unadjusted and adjusted intention-to-treat effects using semiparametric estimators and permutation tests. Ethics and dissemination: Study protocols have been reviewed and approved by human subjects review boards at the University of California, Berkeley, Stanford University, the International Centre for Diarrheal Disease Research, Bangladesh, the Kenya Medical Research Institute, and Innovations for Poverty Action. Independent data safety monitoring boards in each country oversee the trials. This study is funded by a grant from the Bill & Melinda Gates Foundation to the University of California, Berkeley.
Exploration of attendance, active Participation, and behavior change in a group-based responsive stimulation, maternal and child health, and nutrition intervention
(ASTMH, 1/18/2021) Yeasmin, Farzana; Winch, Peter J.; Hwang, Sharon T.; Leontsini, Elli; Jahir, Tania; Das, Jyoti B.; Amin, Mohammad R.; Hossain, Md K.; Huda, Tarique Md. Nurul; Akter, Fahmida; Shoab, Abul Kashem; Tofail, Fahmida; Mridha, Malay K.; Sultana, Jesmin; Pitchik, Helen; Fernald, Lia C. H.; Luby, Stephen P.; Rahman, Mahbubur
Delivery of interventions through group sessions allows for in-depth discussions and creates opportunities for group members to work together to identify and solve common problems. However, low attendance may limit impact. We explored factors affecting attendance, active participation, and behavior change in an integrated group-based child development and maternal and child health intervention in Bangladesh. Community health workers (CHWs) facilitated two sessions a month including material on child stimulation; water, sanitation, and hygiene; nutrition, maternal depression, and lead exposure prevention. Sessions were conducted with 320 pregnant women and mothers with children younger than 24 months, in 16 villages in Kishoreganj district. After 4 and 9 months of intervention, we conducted focus group discussions and in-depth interviews with mothers (n = 55 and n = 48) to identify determinants of attendance and behavior change, and to examine potential for intervention scale-up. Recruiting family members to assist with childcare resulted in improved attention during sessions. Adopting a storytelling format for presentation of session materials resulted in more engaged participation during courtyard sessions. Session attendance and behavior change, especially purchasing decisions, were difficult for participants without the support of male heads of the household. Selecting a rotating leader from among the group members to remind group members to attend sessions and support CHWs in organizing the sessions was not successful. Facilitating self-appraisals and planning for water and sanitation allowed participants to identify areas for improvement and track their progress. Key determinants of a participant’s attendance were identified, and the resulting intervention shows promise for future implementation at scale.
Exploratory study on prevalence of infant shaking in urban Dhaka and rural Matlab in Bangladesh
(Dhaka: International Centre for Diarrhoeal Diseases Research, Bangladesh; 2009, 2009) Tofail, Fahmida
Home fortification during the first 1000 d improves child development in Bangladesh: a cluster-randomized effectiveness trial
(© 2017 American Journal of Clinical Nutrition, 3/8/2017) Matias, Susana L; Mridha, Malay K; Tofail, Fahmida; Arnold, Charles D; Khan, Md Showkat A; Siddiqui, Zakia; Ullah, Md Barkat; Dewey, Kathryn G
Background: Nutrition during the first 1000 d is critical for brain development.Objective: We evaluated the effects on child development of home fortification with lipid-based nutrient supplements (LNSs) for mothers and/or children or micronutrient powder (MNP) for children.Design: We conducted a cluster-randomized effectiveness trial with 4 arms: 1) LNSs during pregnancy and the first 6 mo postpartum and LNSs for the offspring from 6 to 24 mo (LNS-LNS), 2) iron and folic acid (IFA) during pregnancy and the first 3 mo postpartum and LNSs for the children from 6 to 24 mo (IFA-LNS), 3) IFA (as above) and MNP for the offspring from 6 to 24 mo (IFA-MNP), and 4) IFA (as above) and no child supplement (IFA-Control). Women were enrolled at ≤20 wk of gestation; children were assessed at 12 (n = 3331), 18 (n = 3364), and 24 (n = 3379) mo.Results: Compared with the IFA-Control group, motor development scores were higher in the LNS-LNS (P = 0.016) and IFA-LNS groups (P = 0.006) at 18 mo and in the IFA-MNP group (P = 0.048) at 24 mo. Receptive language scores were higher for the LNS-LNS group (P = 0.028) at 18 mo and for all 3 groups at 24 mo (P = 0.008 for LNS-LNS, P = 0.022 for IFA-LNS, and P = 0.009 for IFA-MNP compared with IFA-Control). Expressive language scores did not differ at 18 mo (P = 0.236) but were higher in the LNS-LNS (P = 0.035) and IFA-MNP (P = 0.002) groups than in the IFA-Control group at 24 mo. Groups did not differ in personal-social scores at 18 (P = 0.233) or 24 (P = 0.146) mo or in executive function score at 24 mo (P = 0.467).Conclusion: Prenatal LNSs, postnatal LNSs, or both, or postnatal MNP had a positive effect on motor and language development in Bangladeshi children. This trial was registered at clinicaltrials.gov as NCT01715038.
Implications of health care provision on acute lower respiratory infection mortality in Bangladeshi children
(2001-01) Ali, Mohammad; Emch, Michael; Tofail, Fahmida; Baqui, Abdullah H.
Long-term effects of prenatal Omega-3 fatty acid supplementation on child development in Bangladeshi children
(2006) Hamadani, Jena D.; Tofail, Fahmida
Short-term supplementation with zinc and vitamin A has no significant effect on the growth of undernourished Bangladeshi children
(2002) Rahman, Mohammad M.; Tofail, Fahmida; Wahed, Mohammad A.; Fuchs, George J.; Baqui, Abdullah H.; Alvarez, Jose O.
Supplementation of fish-oil and soy-oil during pregnancy and psychomotor development of infants
(2006-03) Tofail, Fahmida; Kabir, Iqbal; Hamadani, Jena D.; Chowdhury, Fahima; Yesmin, Sakila; Mehreen, Fardina; Huda, Syed N.
Supplementation of fish-oil and soy-oil during pregnancy and psychomotor development of infants
(2006-03) Tofail, Fahmida; Kabir, Iqbal; Hamadani, Jena D.; Chowdhury, Fahima; Yesmin, Sakila; Mehreen, Fardina; Huda, Syed N.
Use of family care indicators and their relationship with child development in Bangladesh
(2010-02) Hamadani, Jena D.; Tofail, Fahmida; Hilaly, Afroza; Huda, Syed N.; Engle, Patrice; Grantham-McGregor, Sally M.