AzTrials
AzTrials

Glucose-Galactose MalabsorptionSBT4EENCT04109352

Labelled Carbon Sucrose Breath Test (13C-SBT) as a Marker of Environmental Enteropathy

An observational study of Glucose-Galactose Malabsorption and Enteropathy, run by University of Virginia at 9 sites in 8 countries.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

Linear growth failure, a manifestation of chronic undernutrition in early childhood, is a recalcitrant problem in resource constrained settings. The underlying causes of growth failure are multifactorial, but persistent and recurrent infection and inflammation of the gastrointestinal tract and immune activation, a… Read more about this study

Who is it for?
Ages 12 to 15 months
How many people
600 participants
Where
9 sitesin 8 countries
Study dates
1 Sep 2019to Dec 2022
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 12 to 15 months
  • All sexes
  • Child

Study population: Because of exigent test requirements enrollment will be restricted to convenience samples from populations near centers of excellence in nutritional studies in Dhaka, Bangladesh (the International Centre for Diarrhoeal Disease Research); Bangalore, India (St. John's Research Institute, St. John's National Academy of Health Sciences); Kingston, Jamaica (The Tropical Metabolism Research Unit of the Caribbean Institute for Health Research, University of West Indies); Kakamega, Kenya (Masinde Muliro University of Science and Technology); Iquitos, Peru44 (Asociación Benefica PRISMA and the University of Virginia); and Ndola, Zambia (Tropical Disease Research Centre). These sites represent a range of epidemiologic contexts which will enhance the cross-context applicability of study results.

Who may be able to join

  • All children will be recruited and enrolled through convenience sampling, either at the community level (if the study site has previously censused the community) or through child clinic visits.

Who cannot join

  • Severe acute malnutrition
  • HIV positive
  • Weight for height Z >+2
  • Known medical illness contributing to growth failure

Trial locations and contacts

9 sites in 8 countries.

Margaret N Kosek, MD contact

434-243-9552

mkosek@virginia.edu

Victor Owino, PhD contact

V.Owino@iaea.org

9 sites in 8 countries

Zambia2 sites, 2 recruiting
  • Tropical Gastroenterology & Nutrition Ltd

    Lusaka

    Paul Kelly, MD, m.p.kelly@qmul.ac.uk

    Not yet recruiting
  • Tropical Diseases Research Centre

    Ndola

    Justin Chileshe, MSc, chilesej@tdrc.org.zm

    Not yet recruiting

Other trials in Zambia

Australia1 site, 1 recruiting
  • Flinders University

    Adelaide

    Roger Yazbek, PhD, roger.yazbek@flinders.edu.au

    Recruiting

Other trials in Australia

Bangladesh1 site, 1 recruiting
  • Nutrition and Clincial Services Division, icddr, b

    Dhaka

    Sayeeda Huq, PhD, sayeeda@icddrb.org

    Recruiting

Other trials in Bangladesh

India1 site, 1 recruiting
  • CBCI Society for Medical Education, St John's Research Institute

    Bengaluru

    Nirupama Shivakumar, MBBS, DCH, nirupama.s@sjri.res.in

    Recruiting

Other trials in India

Jamaica1 site, 1 recruiting
  • Tropical Metabolism Research Unit, University of West Indies

    Kingston

    Sherine White, MSc, sherine.whyte@uwimona.edu.jm

    Not yet recruiting

Other trials in Jamaica

Kenya1 site, 1 recruiting
  • Masinde Muliro University of Science and Technology

    Kakamega

    Silvenus Konyole, PhD, konyole2000@yahoo.com

    Recruiting

Other trials in Kenya

Peru1 site
  • Investigaciones Biomedicas, Asociacion Benefica PRISMA

    Iquitos

    Completed

Other trials in Peru

United Kingdom1 site, 1 recruiting
  • Scottish Universities Environmental Research Centre

    East Kilbride

    Douglas Morrison, PhD, douglas.morrison@glasgow.ac.uk

    Recruiting

Other trials in United Kingdom

About this study

Official title: Validation and Field-applicability of a 13C-Sucrose Breath Test to Assess Carbohydrate Uptake and Utilization in Environmental Enteropathy Among Children in Resource Poor Settings: A Multi-site Prospective Study

Linear growth failure, a manifestation of chronic undernutrition in early childhood, is a recalcitrant problem in resource constrained settings. The underlying causes of growth failure are multifactorial, but persistent and recurrent infection and inflammation of the gastrointestinal tract and immune activation, a condition commonly referred to as environmental enteropathy, is an important contributor. A highly enriched 13C-Sucrose Breath Test, a measure of sucrase-isomaltase activity, will be evaluated as a non-invasive biomarker of environmental enteropathy, and more specifically of intestinal brush border enzyme activity in 6 resource poor countries (Bangladesh, India, Jamaica, Kenya, Peru and Zambia) in 100 volunteers aged 12-15 months (total n=600) and evaluated relative to the lactose rhamnose test and linear and ponderal growth over a 3-6 month period following biomarker assessment. Field usability will also be assessed.

Read the detailed description

Environmental enteropathy is associated with linear and ponderal growth shortfalls in young children in resource constrained settings. However, the physiological alterations of intestinal function that accompany both the demonstrable evidence of inflammation and architectural changes seen in biopsies from effected children have yet to be elucidated, and this knowledge gap limits the development of effective strategies to optimally manage the condition. Furthermore, a limited number of non-invasive assays exist with which to assess the presence of environmental enteropathy in low resource settings. This study aims 1) to determine if sucrose-isomaltase enzyme is altered in children with environmental enteropathy by using a 13C-Sucrose breath test 2) to determine if the test is able to be employed in resource limited settings.

Medical subject headings
Glucose-Galactose Malabsorption, Intestinal Diseases, Child Nutrition Disorders, Failure to Thrive

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Comparison of SBT to Lactulose rhamnose (LR) test-% dose 90 min

    The 13C-SBT (cumulative percent of dose recovered at 90 minutes post administration) will be compared to LR ratio (the ratio of the percent recovery of administered lactulose and mannitol)

    Measured: 6 months after enrollment is completed

  2. Comparison of SBT to Lactulose rhamnose (LR) test- time to 50% recovery

    The 13C-SBT (time to 50% area under the curve of 13C tracer, expressed in minutes ) will be compared to LR ratio (the ratio of the percent recovery of administered lactulose and mannitol)

    Measured: 6 months after enrollment is completed

  3. Correlation of SBT (% recovery at 90 minutes) to Lactulose rhamnose (LR) test-Lactulose recovery

    The 13C-SBT (cumulative percent of dose recovered at 90 minutes post administration) will be compared to the percent lactulose recovery at 90 minutes post administration

    Measured: 6 months after enrollment is completed

  4. Correlation of SBT (time to 50% recovery) to Lactulose rhamnose (LR) test-Lactulose recovery

    The 13C-SBT (time to 50% area under the curve 13C tracer, expressed in minutes) will be compared to the percent lactulose recovery at 90 minutes post administration

    Measured: 6 months after enrollment is completed

  5. Correlation of SBT (% dose recovered at 09 minutes) to Lactulose rhamnose (LR) test-Mannitol recovery

    The 13C-SBT (cumulative percent of dose of 13C recovered at 90 minutes post administration) will be compared to percent mannitol recovery

    Measured: 6 months after enrollment is completed

  6. Correlation of SBT (time to recovery of 50% of dose) to Lactulose rhamnose (LR) test-Mannitol recovery

    The 13C-SBT (time to 50% area under the curve 13C tracer, expressed in minutes) will be compared to percent mannitol recovery

    Measured: 6 months after enrollment is completed

  7. Characterize the relationship between SBT (% of dose recovered at 90 min) and baseline childhood anthropometrics (attained length)

    We will compare results of the SBT test expressed as cumulative percent of dose recovered at 90 minutes post administration and LAZ (length for age Z-score as defined by 2006 World Health Organization norms, cross-sectional)

    Measured: 6 months after enrollment is completed

  8. Characterize the relationship between SBT (time to recovery of 50% of dose) and baseline childhood anthropometrics (attained length)

    We will compare results of the SBT test expressed as time to 50% area under the curve 13C tracer, expressed in minutes and LAZ (length for age Z-score as defined by 2006 World Health Organization norms, cross-sectional)

    Measured: 6 months after enrollment is completed

  9. Characterize the relationship between SBT and childhood anthropometrics (attained weight)

    We will compare results of the SBT test expressed as the cumulative percent of dose recovered at 90 minutes post administration and WAZ (weight for age Z-score as defined by 2006 World Health Organization norms, cross-sectional)

    Measured: 6 months after enrollment is completed

  10. Characterize the relationship between SBT and childhood anthropometrics (attained weight for height)

    We will compare results of the SBT test expressed as time to 50% area under the curve 13C tracer, expressed in minutes and WAZ (weight for age Z-score as defined by 2006 World Health Organization norms, cross-sectional)

    Measured: 6 months after enrollment is completed

  11. Characterize the relationship between SBT (time to 50% recovery of 13C) and childhood linear growth, 3 months

    We will compare values for the 13C-SBT expressed as time to 50% area under the curve 13C tracer, expressed in minutes and change in length for age Z score (WHO 2006 reference standards) over the subsequent 3 months

    Measured: 6 months after enrollment is completed

  12. Characterize the relationship between SBT and childhood linear growth, 6 months

    We will compare values for the 13C-SBT expressed as time to 50% area under the curve 13C tracer, expressed in minutes and change in length for age Z score (WHO 2006 reference standards) over the subsequent 6 months

    Measured: 6 months after enrollment is completed

  13. Characterize the relationship between SBT (% dose recovered at 90 min)and childhood linear growth, 3 months

    We will compare the 13C-SBT tests results (cumulative percent of dose recovered at 90 minutes post administration) and change in LAZ over the subsequent 3 months

    Measured: 6 months after enrollment is completed

  14. Characterize the relationship between SBT and childhood linear growth

    We will compare the 13C-SBT tests results (cumulative percent of dose recovered at 90 minutes post administration) and change in LAZ over the subsequent 6 months

    Measured: 6 months after enrollment is completed

Secondary outcomes (8)
  1. Assess the relationship between the 13C-SBT (% recovery 90min) and fecal myeloperoxidase

    Compare fecal myeloperoxidase concentration (ng/mL) with 13SBT (% of cumulative dose recovered at 90 minutes, expressed as %)

    Measured: Six months from the enrollment of the last subject

  2. Assess the relationship between SBT ( time to recovery of 50% of the 13C-tracer) and fecal myeloperoxidase

    Compare fecal myeloperoxidase concentration (ng/mL) with 13SBT (time to recovery of 50% of the administered 13C tracer, measured in minutes)

    Measured: Six months from the enrollment of the last subject

  3. Assess the relationship between the 13C-SBT (% recovery 90 min) and serum fatty acid binding protein

    Compare serum fatty acid binding protein concentration (ng/mL), with 13SBT as assessed by % of administered dose recovered at 90 minutes

    Measured: Six months from the enrollment of the last subject

  4. Assess the relationship between the 13C-SBT (time to 50% recovery) and serum fatty acid binding protein concentration

    Compare serum fatty acid binding protein concentration (ng/mL) with 13SBT as measured by the time (in minutes) to the recovery of 50% of the administered dose of 13C.

    Measured: Six months from the enrollment of the last subject

  5. Assess the relationship between the 13C-SBT (time to 50% recovery) and kynurenine tryptophan ratio

    Compare time to recovery of 50% of 13C probe of SBT with kynurenine tryptophan ratio (molar ratio of KT multiplied by 1000)

    Measured: Six months from the enrollment of the last subject

  6. Assess the relationship between the 13C-SBT (% recovery at 90 minutes) and kynurenine tryptophan ratio,

    Compare 13C SBT as measured by % recovery of 13C probe at 90 minutes with kynurenine tryptophan ratio

    Measured: Six months from the enrollment of the last subject

  7. Assess the relationship between the 13C-SBT as assessed by percent of 13C tracer recovered in at 90 minutes and fecal alpha-antitrypsin concentration

    Compare 13CSBT as measured by the percent of tracer recovered at 90 minutes with fecal anti-trypsin concentration (mg/g)

    Measured: Six months from the enrollment of the last subject

  8. Assess the relationship between the 13C-SBT as measured by the time to 50% recovery of 13C and fecal alpha-antitrypsin

    Compare 13C SBT as measured by the time to 50% recovery of 13C with fecal anti-trypsin concentration (mg/g)

    Measured: Six months from the enrollment of the last subject

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Sep 2019
  2. Study start1 Sep 2019
  3. Primary completion1 Jul 2022 (estimated)
  4. Study completionDec 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
600 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04109352
Sponsor's protocol ID
CE0783.19
Acronym
SBT4EE
Status last verified
Oct 2021
First submitted
20 Jul 2019
Last updated
6 Oct 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Shivakumar N, Huq S, Paredes-Olortegui M, Konyole SO, Devi S, Yazbeck R, Owino VO, Brouwer AF, Kosek MN, Kelly P, Morrison DJ, Lee GO. A cross-sectional study of associations between the 13C-sucrose breath test, the lactulose rhamnose assay, and growth in children at high risk of environmental enteropathy. Am J Clin Nutr. 2024 Dec;120(6):1354-1363. doi: 10.1016/j.ajcnut.2024.10.001. Epub 2024 Oct 9.

    PubMed 39384142
  • Lee GO, Schillinger R, Shivakumar N, Whyte S, Huq S, Ochieng Konyole S, Chileshe J, Paredes-Olortegui M, Owino V, Yazbeck R, Kosek MN, Kelly P, Morrison D. Optimisation, validation and field applicability of a 13C-sucrose breath test to assess intestinal function in environmental enteropathy among children in resource poor settings: study protocol for a prospective study in Bangladesh, India, Kenya, Jamaica, Peru and Zambia. BMJ Open. 2020 Nov 17;10(11):e035841. doi: 10.1136/bmjopen-2019-035841.

    PubMed 33203623

Questions about this trial

What is this clinical trial studying?

An observational study of Glucose-Galactose Malabsorption and Enteropathy, run by University of Virginia at 9 sites in 8 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 6 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in Zambia, Australia, Bangladesh, India, Jamaica and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Margaret N Kosek, MD (434-243-9552, mkosek@virginia.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Comparison of SBT to Lactulose rhamnose (LR) test-% dose 90 min (time frame: 6 months after enrollment is completed). The study lists 14 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04109352, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Oct 2021.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in