7/30/2019 Clinical Dan Community Trials

1/2

Kangaroo Mother Care in very low

birth weight infants.

Ramanathan K,Paul VK, Deorari AK,Taneja U,George G.

Source

Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

Abstract

OBJECTIVE:

This study was conducted (i) to study through a randomized control trial the effect ofKangaroo Mother Care (KMC) on breast feeding rates, weight gain and length of

hospitalization of very low birth neonates and (ii) to assess the acceptability of

Kangaroo Mother Care by nurses and mothers.

METHODS:

Babies whose birth weight was less than 1500 Grams were included in the study once

they were stable. The effect of Kangaroo Mother Care on breast feeding rates, weight

gain and length of hospitalization of very low birth weight neonates was studied

through a randomized control trial in 28 neonates. The Kangaroo group (n = 14) was

subjected to Kangaroo Mother Care of at least 4 hours per day in not more than 3sittings. The babies received Kangaroo Care after shifting out from NICU and at

home. The control group (n = 14) received only standard care (incubator or open care

system). Attitude of mothers and nurses towards KMC was assessed on Day 3 +/- 1

and on day 7 +/- 1 after starting Kangaroo Care in a questionnaire using Likert's scale.

RESULTS:

The results of the clinical trial reveal that the neonates in the KMC group

demonstrated better weight gain after the first week of life (15.9 +/- 4.5 gm/day vs.

10.6 +/- 4.5 gm/day in the KMC group and control group respectively p < 0.05) and

earlier hospital discharge (27.2 +/- 7 vs. 34.6 +/- 7 days in KMC and control grouprespectively, p < 0.05). The number of mothers exclusively breastfeeding their babies

at 6 week follow-up was double in the KMC group than in the control group (12/14

vs. 6/14) (p < 0.05).

CONCLUSION:

KMC managed babies had better weight gain, earlier hospital discharge and, more

impressively, higher exclusive breast-feeding rates. KMC is an excellent adjunct to

the routine preterm care in a nursery.

http://www.ncbi.nlm.nih.gov/pubmed?term=Ramanathan%20K%5BAuthor%5D&cauthor=true&cauthor_uid=11770234http://www.ncbi.nlm.nih.gov/pubmed?term=Paul%20VK%5BAuthor%5D&cauthor=true&cauthor_uid=11770234http://www.ncbi.nlm.nih.gov/pubmed?term=Paul%20VK%5BAuthor%5D&cauthor=true&cauthor_uid=11770234http://www.ncbi.nlm.nih.gov/pubmed?term=Deorari%20AK%5BAuthor%5D&cauthor=true&cauthor_uid=11770234http://www.ncbi.nlm.nih.gov/pubmed?term=Deorari%20AK%5BAuthor%5D&cauthor=true&cauthor_uid=11770234http://www.ncbi.nlm.nih.gov/pubmed?term=Taneja%20U%5BAuthor%5D&cauthor=true&cauthor_uid=11770234http://www.ncbi.nlm.nih.gov/pubmed?term=George%20G%5BAuthor%5D&cauthor=true&cauthor_uid=11770234http://www.ncbi.nlm.nih.gov/pubmed?term=George%20G%5BAuthor%5D&cauthor=true&cauthor_uid=11770234http://www.ncbi.nlm.nih.gov/pubmed?term=Paul%20VK%5BAuthor%5D&cauthor=true&cauthor_uid=11770234http://www.ncbi.nlm.nih.gov/pubmed?term=Deorari%20AK%5BAuthor%5D&cauthor=true&cauthor_uid=11770234http://www.ncbi.nlm.nih.gov/pubmed?term=Taneja%20U%5BAuthor%5D&cauthor=true&cauthor_uid=11770234http://www.ncbi.nlm.nih.gov/pubmed?term=George%20G%5BAuthor%5D&cauthor=true&cauthor_uid=11770234http://www.ncbi.nlm.nih.gov/pubmed?term=Ramanathan%20K%5BAuthor%5D&cauthor=true&cauthor_uid=11770234

7/30/2019 Clinical Dan Community Trials

2/2

Impact of improved treatment of sexuallytransmitted diseases on HIV infection in ruralTanzania: randomised controlled trial

H. Grosskurth MD a, J. Todd PhD a, E. Mwijarubia, P. Mayaud MD a, A. NicollFRCP a, G. ka-

GinaMDa,J. Newell PhD a,H. Grosskurthb, J. Toddb, P. Mayaudb, A. Nicollb, J. Newellb,

D. Mabey FRCP b, R. Hayes MSc *b,F. Mosha MD c,K. Senkoro MSc c, J. Changalucha MSc c,

A. Klokke PhD d,E. Mwijarubie,G. ka-Ginaf, K. Mugeye MD f

Abstract

Summary

A randomised trial was done to evaluate the impact of improved sexually

transmitted disease (STD) case management at primary health care level on

the incidence of HIV infection in the rural Mwanza region of Tanzania. HIV

incidence was compared in six intervention communities and six pair-

matched comparison communities. A random cohort of about 1000 adults

aged 15-54 years from each community was surveyed at baseline and at

follow-up 2 years later. Intervention consisted of establishment of an STD

reference clinic, staff training, regular supply of drugs, regular supervisory

visits to health facilities, and health education about STDs.12 537 individuals were recruited. Baseline HIV prevalences were 38% and

44% in the intervention and comparison communities, respectively. At

follow-up, 8845 (71%) of the cohort were seen. Of those initially

seronegative, the proportions seroconverting over 2 years were 48 of 4149

(12%) in the intervention communities and 82 of 4400 (19%) in the

comparison communities. HIV incidence was consistently lower in the

intervention communities in all six matched pairs. Allowing for the

community-randomised design and the effects of confounding factors, theestimated risk ratio was 058 (95% Cl 042-079, p=0007). No change in

reported sexual behaviour was observed in either group.

We conclude that improved STD treatment reduced HIV incidence by about

40% in this rural population. This is the first randomised trial to demonstrate

an impact of a preventive intervention on HIV incidence in a general

population.

http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=H.+Grosskurthhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=J.+Toddhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=E.+Mwijarubihttp://www.thelancet.com/search/results?fieldName=Authors&searchTerm=E.+Mwijarubihttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=P.+Mayaudhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=A.+Nicollhttp://www.thelancet.com/search/results?fieldName=Authors&searchTerm=A.+Nicollhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=G.+ka-Ginahttp://www.thelancet.com/search/results?fieldName=Authors&searchTerm=G.+ka-Ginahttp://www.thelancet.com/search/results?fieldName=Authors&searchTerm=G.+ka-Ginahttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=J.+Newellhttp://www.thelancet.com/search/results?fieldName=Authors&searchTerm=J.+Newellhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=H.+Grosskurthhttp://www.thelancet.com/search/results?fieldName=Authors&searchTerm=H.+Grosskurthhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=J.+Toddhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=P.+Mayaudhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=A.+Nicollhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=J.+Newellhttp://www.thelancet.com/search/results?fieldName=Authors&searchTerm=J.+Newellhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=D.+Mabeyhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=R.+Hayeshttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=F.+Moshahttp://www.thelancet.com/search/results?fieldName=Authors&searchTerm=F.+Moshahttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF3%23ART8-AFF3http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=K.+Senkorohttp://www.thelancet.com/search/results?fieldName=Authors&searchTerm=K.+Senkorohttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF3%23ART8-AFF3http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=J.+Changaluchahttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF3%23ART8-AFF3http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=A.+Klokkehttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF4%23ART8-AFF4http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=E.+Mwijarubihttp://www.thelancet.com/search/results?fieldName=Authors&searchTerm=E.+Mwijarubihttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF5%23ART8-AFF5http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF5%23ART8-AFF5http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=G.+ka-Ginahttp://www.thelancet.com/search/results?fieldName=Authors&searchTerm=G.+ka-Ginahttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF6%23ART8-AFF6http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF6%23ART8-AFF6http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=K.+Mugeyehttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF6%23ART8-AFF6http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=H.+Grosskurthhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=J.+Toddhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=E.+Mwijarubihttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=P.+Mayaudhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=A.+Nicollhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=G.+ka-Ginahttp://www.thelancet.com/search/results?fieldName=Authors&searchTerm=G.+ka-Ginahttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=J.+Newellhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF1%23ART8-AFF1http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=H.+Grosskurthhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=J.+Toddhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=P.+Mayaudhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=A.+Nicollhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=J.+Newellhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=D.+Mabeyhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=R.+Hayeshttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF2%23ART8-AFF2http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=F.+Moshahttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF3%23ART8-AFF3http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=K.+Senkorohttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF3%23ART8-AFF3http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=J.+Changaluchahttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF3%23ART8-AFF3http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=A.+Klokkehttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF4%23ART8-AFF4http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=E.+Mwijarubihttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF5%23ART8-AFF5http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=G.+ka-Ginahttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF6%23ART8-AFF6http://www.thelancet.com/search/results?fieldName=Authors&searchTerm=K.+Mugeyehttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(95)91380-7/abstract#ART8-AFF6%23ART8-AFF6