AnemiaNCT05185661
Impact of eHealth Education to Reduce Anemia Among School-going Adolescent Girls in Rural Bangladesh
A study testing eHealth education in people with Anemia, run by Hiroshima University at 1 site in Bangladesh.
Trial summary
Adolescent girls are the highly vulnerable group to develop anemia due to reproductive immaturities, poor personal hygiene, lack of nutritional intake, and lack of health education in the rural area of Bangladesh. Read more about this study
- Who is it for?
- Ages 10 to 19 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Anemia
- What is being tested?
- eHealth education
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 138 participants
- Where
- 1 siteBangladesh
- Study dates
- 22 May 2022to 30 Jan 2024
- Phase
- Interventional
- 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 10 to 19 years
- Women only
- Healthy volunteers accepted
- Child, Adult
Who may be able to join
- Who is diagnosed with mild and moderate anemia in the baseline screening of the study.
- Who gives written consent to participate in the study through the legal guardian/participants.
- Who is living and studying Chandpur district with assigned school for the study.
Who cannot join
- Participants whose guardians/participants do not have a mobile phone will be excluded from the study.
- Who is pregnant will be excluded from our study.
- Who are physically and mentally sick will be excluded from our study.
- 3. Disagree to participate in this study
Trial locations and contacts
1 site in 1 country.
Bangladesh1 site
Baburhat high school and Zubaida girl school
Chāndpur, 3603
About this study
Official title: Anemia Prevalence, Associated Factors, and Impact of eHealth Education Among School-going Adolescent Girls in Rural Bangladesh
Adolescent girls are the highly vulnerable group to develop anemia due to reproductive immaturities, poor personal hygiene, lack of nutritional intake, and lack of health education in the rural area of Bangladesh. Rapid advantage of technology, eHealth is the promising tool to overcome the barriers and provide appropriate health guidelines in distant rural communities by developing knowledge, attitude, and practice to reduce anemia and mitigate risk among the school-going adolescent girls. This research aims (1) To evaluate eHealth education's impact on reducing anemia among adolescent girls in rural Bangladesh. (2) To assess the effect of eHealth education to change the knowledge, attitude, and practice among adolescent girls regarding anemia. A Randomized Control Trial study will be conducted from May 22, 2022, to January 21, 2023, in the two schools at the Chandpur district, Bangladesh. During the 8th months' intervention, will be provided eHealth education by the trained community health worker. The participant will be allocated who will be diagnosed as anemic through the blood hemoglobin screening. The sample size was calculated, and the total sample is 138. In this study, one school will be considered an intervention group and another school control group through the simple coin toss randomization technique. Then random sampling technique will be used to select study participants.
Read the detailed description
Globally 1.62 billion people affect anemia, a significant public health threat, especially in low and middle-income countries (LMICs). The prevalence of anemia among non-pregnant and school-going is 30% and 25%, respectively, and 35% of this anemia in the LMICs. Anemia is a medical condition that can develop at any life stage, but at the reproductive age of women, adolescent girls (10-19 years), and growing children are susceptible. Adolescent age is a critical period of developmental transmission and reproductive maturation, requiring increased nutritional intake and proper health education; otherwise, it leads adolescents more vulnerable to future development. The primary reasons for developing anemia are the lack of iron-containing food intake, contaminated water, and poor sanitation. Also, the infection with soil-transmitted helminth is one of the leading blood losses causes of anemia.
Bangladesh is a middle-income, highly populated developing country. As per World Health Organization (WHO) 2019 data, Bangladesh has a 36.7% anemia prevalence among women of reproductive age. According to the WHO, if anemia prevalence is more than 40%, it is an alarming and severe public health problem. The whole-population anemia prevalence satisfies the criteria apparently; however, focusing on sub-population, it does not. For example, among the non-pregnant women's anemia, 73% live in rural Bangladesh. A scientific article reported that 51.6% of adolescent girls were suffering from anemia; 46%, 5.4%, and 0.2% were mild, moderate, severe anemia, respectively. Due to the high prevalence of rural women and adolescent girls' anemia in Bangladesh, adolescents are the highly venerable and more focused group. The lack of education, shortage of iron intake, poor economic status, poor personal hygiene, unhygienic toilets, parasitic infection are the main risk factors of anemia in Bangladesh. Proper interventions, including health education, should be provided to those vulnerable populations. i.e., adolescent girls in rural areas.
Lifestyle and behavioral change depend on knowledge, and nutritional knowledge is essential for good dietary habits. Health education is an effective way to increase knowledge. A school-based nutritional education reported that it is a feasible tool improving the hemoglobin level, knowledge, attitudes, and practices among adolescents. Health education is a useful approach to creating awareness among adolescent girls to reduce preventable diseases like anemia and build a future healthy mother.
In Bangladesh, mobile phone (85%) and network (99%) coverage are high among the rural communities, which is effective in delivering health education through eHealth technology. eHealth is the cost-effective and secure use of information and communications technologies supporting health and health-related fields, including health-care services, health surveillance, health literature, and health education, knowledge, and research (WHO E-Health Resolution 2005). mHealth is an important part of eHealth, which is the use of mobile and wireless technologies to support the achievement of health objectives and is viewed as having the potential to transform the face of health service delivery.
To investigators' knowledge, specific research is lacking about the effect of eHealth education among adolescent girls to create awareness and knowledge about the preventive, control, and risk reduction strategies of anemia in the school-going adolescent girls of rural Bangladesh. Moreover, knowledge gaps still exist regarding food habits and dietary practice, hygiene maintenance, lifestyle and behavior, medication adherence, etc., which are important factors developing anemia.
Knowledge gap:
To investigators' knowledge, specific research is lacking about the effect of eHealth education among adolescent girls to create awareness and knowledge about the preventive, control, and risk reduction strategies of anemia in the school-going adolescent girls of rural Bangladesh. Moreover, knowledge gaps still exist regarding food habits and dietary practice, hygiene maintenance, lifestyle and behavior, medication adherence, etc., which are important factors developing anemia.
- Conditions
- Anemia
- Being tested
- eHealth education
- Keywords
- eHealth education, Anemia, Adolescents girl, Bangladesh
- Medical subject headings
- Anemia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
eHealth educationBehavioural
eHealth education intervention regarding the dietary plan, healthy-lifestyle, and hygiene:
- Group-wise eHealth education through online PowerPoint presentation session among study participants with their guardian: Two times (Before starting the intervention and mid-line; end of 4th-month intervention)
- eHealth education through phone calls \& SMS
- 1st to 4th month: 4 times in a month
- 5th to 6th month: 3 times in a month
- 6th to 8th month: 2 times in a month
- Control group will not get care and education
| Study group | Role | What they receive |
|---|---|---|
| Intervention Group | Experimental | 1. Two surveys: Demographic, lifestyle, hygiene-related (1) \& knowledge, attitude, and practice (2) regarding anemia at baseline and end line of study.
2. Investigations and physical examination will perform for CBC blood test except ESR, urine R/E, stool R/E, Height, weight for BMI, waist circumference, hip circumference, hip - waist ratio, and mid-upper arm circumference (MUAC) at baseline, mid-line, and end-line of study. Receives: Behavioral: eHealth education |
| Control Group | No intervention | 1. Two surveys: Demographic, lifestyle, hygiene-related (1) \& knowledge, attitude, and practice (2) regarding anemia at baseline and end line of study. 2. Investigations and physical examination will perform for CBC blood test except ESR, urine R/E, stool R/E, Height, weight for BMI, waist circumference, hip circumference, hip - waist ratio, and mid-upper arm circumference (MUAC) at baseline, mid-line, and end-line of study. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Impact of eHealth education to change the anemia level among school-going adolescent girls in rural areas of Bangladesh
Individuals school-going adolescent girls will be measured anemia level (No anemic, mild, moderate, and severe anemia) through the blood hemoglobin screening by the auto-hematology analyzer. According to WHO, 10-11 years adolescent girls Hb <11.5g/dl will be considered anemic, and <10-11.4, 7.0-9.9 g/dl, <7.0 g/dl will be considered mild, moderate, and severe anemia, respectively. Non-pregnant adolescent girls (12-19 years) Hb level < 12 g/dl will be considered suffering any form of anemia, and 10.0-11.9 g/dl, 7.0-9.9 g/dl, and <7.0 g/dl will be considered mild, moderate, and severe anemia, respectively. After eHealth education intervention, changes will be assessed (e.g., anemic to non-anemic, severe to mild/ moderate/non-anemic, moderate to mild/non-anemic, mild to non-anemic) from the baseline of anemia level among the school-going adolescent girls.
Measured: 8 months after intervention
Secondary outcomes (1)
Changes of knowledge, attitude, and practice regarding anemia among the school-going adolescent girls in rural areas of Bangladesh
The impact of eHealth education in changing knowledge, attitude, and practice regarding anemia will be assessed among school-going adolescent girls. Knowledge, attitude, and practice (KAP) will be measured through an adapted KAP model questionnaire of the Food and Agriculture Organization (FAO) at baseline and end of eight months of study. The questionnaire consisted of the multiple-choice options 'Yes', 'No,' and 'I don't know'. Correct responses will be given a score of 1, and incorrect responses will be given a score of 0. The option 'I don't know' will be considered as lack of knowledge and given a score of 0. KAP scores will be calculated by adding the number of correct answers divided by the total number of questions and multiplying by 100 to obtain a percentage score.
Measured: 8 months after intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Jan 2022
- Study start22 May 2022
- Primary completion1 Feb 2023
- Study completion30 Jan 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for AnemiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Randomized control trial (RCT) study.
- Masking
- None (open label)
- Enrolment
- 138 participants (actual)
Sponsor and investigators
- Lead sponsor
- Hiroshima University
- Sponsor type
- University, hospital or other
- Collaborators
- North South University, Bangladesh
- Responsible party
- Principal investigator, Md Jiaur Rahman, Hiroshima University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05185661
- Sponsor's protocol ID
- 2021/OR-NSU/IRB/1102
- Status last verified
- Feb 2024
- First submitted
- 4 Dec 2021
- Last updated
- 28 Feb 2024
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Jalambo M, Karim N, Naser I, Sharif R. Effects of iron supplementation and nutrition education on haemoglobin, ferritin and oxidative stress in iron-deficient female adolescents in Palestine: randomized control trial. East Mediterr Health J. 2018 Jul 29;24(6):560-568. doi: 10.26719/2018.24.6.560.
PubMed 30079951Sunuwar DR, Sangroula RK, Shakya NS, Yadav R, Chaudhary NK, Pradhan PMS. Effect of nutrition education on hemoglobin level in pregnant women: A quasi-experimental study. PLoS One. 2019 Mar 21;14(3):e0213982. doi: 10.1371/journal.pone.0213982. eCollection 2019.
PubMed 30897129Rahman MJ, Rahman MM, Sarker MHR, Matsuyama R, Kakehashi M, Tsunematsu M, Ali M, Ahmed A, Hawlader MDH, Kawasaki H, Shimpuku Y. Impact of mobile health-based nutritional education on hemoglobin levels in anemic adolescent girls in rural Bangladesh: a randomized controlled trial. BMC Public Health. 2025 Jul 28;25(1):2567. doi: 10.1186/s12889-025-23687-z.
PubMed 40722070
Study at a glance
From the registry record, last updated by the sponsor on 28 Feb 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Anemia Prevalence, Associated Factors, and Impact of eHealth Education Among School-going Adolescent Girls in Rural Bangladesh
- ClinicalTrials.gov ID
- NCT05185661
- Acronym / sponsor ID
- 2021/OR-NSU/IRB/1102
- Conditions
- Anemia
- Keywords
- eHealth education, Anemia, Adolescents girl, Bangladesh
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 138 participants (actual)
- Lead sponsor
- Hiroshima UniversityUniversity, hospital or other
- Collaborators
- North South University, Bangladesh
- Study start
- 22 May 2022 (actual)
- Primary completion
- 1 Feb 2023 (actual)
- Study completion
- 30 Jan 2024 (actual)
- First posted
- 11 Jan 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Adolescent girls are the highly vulnerable group to develop anemia due to reproductive immaturities, poor personal hygiene, lack of nutritional intake, and lack of health education in the rural area of Bangladesh. Rapid advantage of technology, eHealth is the promising tool to overcome the barriers and provide appropriate health guidelines in distant rural communities by developing knowledge, attitude, and practice to reduce anemia and mitigate risk among the school-going adolescent girls. This research aims (1) To evaluate eHealth education's impact on reducing anemia among adolescent girls in rural Bangladesh. (2) To assess the effect of eHealth education to change the knowledge, attitude, and practice among adolescent girls regarding anemia. A Randomized Control Trial study will be conducted from May 22, 2022, to January 21, 2023, in the two schools at the Chandpur district, Bangladesh. During the 8th months' intervention, will be provided eHealth education by the trained community health worker. The participant will be allocated who will be diagnosed as anemic through the blood hemoglobin screening. The sample size was calculated, and the total sample is 138. In this study, one school will be considered an intervention group and another school control group through the simple coin toss randomization technique. Then random sampling technique will be used to select study participants.
Detailed description
Globally 1.62 billion people affect anemia, a significant public health threat, especially in low and middle-income countries (LMICs). The prevalence of anemia among non-pregnant and school-going is 30% and 25%, respectively, and 35% of this anemia in the LMICs. Anemia is a medical condition that can develop at any life stage, but at the reproductive age of women, adolescent girls (10-19 years), and growing children are susceptible. Adolescent age is a critical period of developmental transmission and reproductive maturation, requiring increased nutritional intake and proper health education; otherwise, it leads adolescents more vulnerable to future development. The primary reasons for developing anemia are the lack of iron-containing food intake, contaminated water, and poor sanitation. Also, the infection with soil-transmitted helminth is one of the leading blood losses causes of anemia.
Bangladesh is a middle-income, highly populated developing country. As per World Health Organization (WHO) 2019 data, Bangladesh has a 36.7% anemia prevalence among women of reproductive age. According to the WHO, if anemia prevalence is more than 40%, it is an alarming and severe public health problem. The whole-population anemia prevalence satisfies the criteria apparently; however, focusing on sub-population, it does not. For example, among the non-pregnant women's anemia, 73% live in rural Bangladesh. A scientific article reported that 51.6% of adolescent girls were suffering from anemia; 46%, 5.4%, and 0.2% were mild, moderate, severe anemia, respectively. Due to the high prevalence of rural women and adolescent girls' anemia in Bangladesh, adolescents are the highly venerable and more focused group. The lack of education, shortage of iron intake, poor economic status, poor personal hygiene, unhygienic toilets, parasitic infection are the main risk factors of anemia in Bangladesh. Proper interventions, including health education, should be provided to those vulnerable populations. i.e., adolescent girls in rural areas.
Lifestyle and behavioral change depend on knowledge, and nutritional knowledge is essential for good dietary habits. Health education is an effective way to increase knowledge. A school-based nutritional education reported that it is a feasible tool improving the hemoglobin level, knowledge, attitudes, and practices among adolescents. Health education is a useful approach to creating awareness among adolescent girls to reduce preventable diseases like anemia and build a future healthy mother.
In Bangladesh, mobile phone (85%) and network (99%) coverage are high among the rural communities, which is effective in delivering health education through eHealth technology. eHealth is the cost-effective and secure use of information and communications technologies supporting health and health-related fields, including health-care services, health surveillance, health literature, and health education, knowledge, and research (WHO E-Health Resolution 2005). mHealth is an important part of eHealth, which is the use of mobile and wireless technologies to support the achievement of health objectives and is viewed as having the potential to transform the face of health service delivery.
To investigators' knowledge, specific research is lacking about the effect of eHealth education among adolescent girls to create awareness and knowledge about the preventive, control, and risk reduction strategies of anemia in the school-going adolescent girls of rural Bangladesh. Moreover, knowledge gaps still exist regarding food habits and dietary practice, hygiene maintenance, lifestyle and behavior, medication adherence, etc., which are important factors developing anemia.
Knowledge gap:
To investigators' knowledge, specific research is lacking about the effect of eHealth education among adolescent girls to create awareness and knowledge about the preventive, control, and risk reduction strategies of anemia in the school-going adolescent girls of rural Bangladesh. Moreover, knowledge gaps still exist regarding food habits and dietary practice, hygiene maintenance, lifestyle and behavior, medication adherence, etc., which are important factors developing anemia.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Randomized control trial (RCT) study.
| Arm | Type | Receives |
|---|---|---|
| Intervention Group | Experimental | Behavioral: eHealth education1. Two surveys: Demographic, lifestyle, hygiene-related (1) \& knowledge, attitude, and practice (2) regarding anemia at baseline and end line of study. 2. Investigations and physical examination will perform for CBC blood test except ESR, urine R/E, stool R/E, Height, weight for BMI, waist circumference, hip circumference, hip - waist ratio, and mid-upper arm circumference (MUAC) at baseline, mid-line, and end-line of study. |
| Control Group | No intervention | –1. Two surveys: Demographic, lifestyle, hygiene-related (1) \& knowledge, attitude, and practice (2) regarding anemia at baseline and end line of study. 2. Investigations and physical examination will perform for CBC blood test except ESR, urine R/E, stool R/E, Height, weight for BMI, waist circumference, hip circumference, hip - waist ratio, and mid-upper arm circumference (MUAC) at baseline, mid-line, and end-line of study. |
Who may qualify
- Ages
- 10 to 19 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult
Key inclusion criteria (3 listed)
- Who is diagnosed with mild and moderate anemia in the baseline screening of the study.
- Who gives written consent to participate in the study through the legal guardian/participants.
- Who is living and studying Chandpur district with assigned school for the study.
Key exclusion criteria (4 listed)
- Participants whose guardians/participants do not have a mobile phone will be excluded from the study.
- Who is pregnant will be excluded from our study.
- Who are physically and mentally sick will be excluded from our study.
- 3. Disagree to participate in this study
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| eHealth educationeHealth education intervention regarding the dietary plan, healthy-lifestyle, and hygiene: 1. Group-wise eHealth education through online PowerPoint presentation session among study participants with their guardian: Two times (Before starting the intervention and mid-line; end of 4th-month intervention) 2. eHealth education through phone calls \& SMS * 1st to 4th month: 4 times in a month * 5th to 6th month: 3 times in a month * 6th to 8th month: 2 times in a month 3. Control group will not get care and education | Behavioural | Intervention Group |
Primary outcome
Impact of eHealth education to change the anemia level among school-going adolescent girls in rural areas of Bangladesh
Time frame: 8 months after intervention
Individuals school-going adolescent girls will be measured anemia level (No anemic, mild, moderate, and severe anemia) through the blood hemoglobin screening by the auto-hematology analyzer. According to WHO, 10-11 years adolescent girls Hb <11.5g/dl will be considered anemic, and <10-11.4, 7.0-9.9 g/dl, <7.0 g/dl will be considered mild, moderate, and severe anemia, respectively. Non-pregnant adolescent girls (12-19 years) Hb level < 12 g/dl will be considered suffering any form of anemia, and 10.0-11.9 g/dl, 7.0-9.9 g/dl, and <7.0 g/dl will be considered mild, moderate, and severe anemia, respectively. After eHealth education intervention, changes will be assessed (e.g., anemic to non-anemic, severe to mild/ moderate/non-anemic, moderate to mild/non-anemic, mild to non-anemic) from the baseline of anemia level among the school-going adolescent girls.
1 secondary outcome
Changes of knowledge, attitude, and practice regarding anemia among the school-going adolescent girls in rural areas of Bangladesh
Time frame: 8 months after intervention
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Feb 2024.
- Background: PubMed 30079951Jalambo M, Karim N, Naser I, Sharif R. Effects of iron supplementation and nutrition education on haemoglobin, ferritin and oxidative stress in iron-deficient female adolescents in Palestine: randomized control trial. East Mediterr Health J. 2018 Jul 29;24(6):560-568. doi: 10.26719/2018.24.6.560.
- Background: PubMed 30897129Sunuwar DR, Sangroula RK, Shakya NS, Yadav R, Chaudhary NK, Pradhan PMS. Effect of nutrition education on hemoglobin level in pregnant women: A quasi-experimental study. PLoS One. 2019 Mar 21;14(3):e0213982. doi: 10.1371/journal.pone.0213982. eCollection 2019.
- Derived from this study: PubMed 40722070Rahman MJ, Rahman MM, Sarker MHR, Matsuyama R, Kakehashi M, Tsunematsu M, Ali M, Ahmed A, Hawlader MDH, Kawasaki H, Shimpuku Y. Impact of mobile health-based nutritional education on hemoglobin levels in anemic adolescent girls in rural Bangladesh: a randomized controlled trial. BMC Public Health. 2025 Jul 28;25(1):2567. doi: 10.1186/s12889-025-23687-z.
- Regional strategy for strengthening ehealth in the South-East Asia Region, WHO (2014-2020)Link provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing eHealth education in people with Anemia, run by Hiroshima University at 1 site in Bangladesh.
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 3 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: finished, as of the sponsor's last update on 28 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Bangladesh. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Impact of eHealth education to change the anemia level among school-going adolescent girls in rural areas of Bangladesh (time frame: 8 months after intervention). 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 NCT05185661, which also lists 3 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 28 Feb 2024.