Small quantity lipid-based nutritional supplementation and measles vaccination coverage in children aged 6−23 months: a pragmatic cluster-randomized trial

IF 52.5 1区医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY

Nature Medicine Pub Date : 2026-10-02 DOI:10.1038/s41591-026-04675-1

Cécile Cazes, Baba Waru Goni, Delphine Gabillard, Olumuyiwa Owolabi, Brice Yapi, Juliet Nabunje, Irine Atanga, Ariong’o M. Akinyi, Serge Danho, Eric Balestre, Anani Badje, Fatima Idriss, Mohammed Kasim, Muhammad M. Audu Bukarti, Chikezie Ugonna Emeka, Michelle Chouinard, Jean-Paul Mushenvula, Soma Bahonan, Mélanie Plazy, Ousmane Abdoulaye, Umar Chiroma, Hadiza Maina Adam, Camille Montfort, Nuru Suleiman Muhammad, Renaud Becquet, Kevin P. Q. Phelan

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Abstract

Undernutrition and infectious diseases pose a double threat to child survival, especially in areas with a high malnutrition burden and low vaccination coverage. In this study, we evaluated whether distributing preventive small-quantity lipid-based nutrient supplements (SQ-LNS) alongside routine immunization services may increase vaccine uptake in a pediatric, pragmatic, cluster-randomized controlled trial in northern Nigeria. Twenty geographically defined clusters across two Local Government Areas were randomized 1:1 to the NutriVax strategy (intervention) or standard National Program of Immunization (NPI) services (control). NutriVax provided a monthly ration of SQ-LNS to children aged 6−23 months after routine NPI delivery at primary healthcare centers. The primary outcome was coverage of the first dose of measles-containing vaccine (MCV1) verified by vaccination card among children aged 12−23 months, assessed in an endline population-based household cross-sectional survey 12 months after conducting a similar baseline survey. The endline survey included 1,604 children (801 control, 803 NutriVax); 48% of children surveyed in intervention clusters had ever received SQ-LNS. The odds of receiving card-verified MCV1 were two times higher in the NutriVax arm than in the control arm (odds ratio = 2.08, 95% confidence interval (CI): 1.30−3.35, P = 0.004). The difference-in-differences, cluster conditional analysis indicated a 20.1 percentage-point (pp) increase in MCV1 coverage from baseline (95% CI: 13.7−26.5 pp, P < 0.0001) relative to the control arm. Co-delivering SQ-LNS with routine immunization substantially improved card-verified MCV1 uptake, supporting a scalable strategy to make progress toward targets set by the World Health Organizationʼs Immunization Agenda 2030 in similar settings. ClinicalTrials.gov identifier: NCT06387511 . A pragmatic, superiority, cluster-randomized trial done in Yobe State, northern Nigeria, found that distributing small-quantity lipid-based nutrient supplements alongside routine immunization services substantially increased measles vaccination uptake in children aged 12−23 months.

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6 - 23月龄儿童的少量脂质营养补充和麻疹疫苗接种覆盖率：一项实用的集群随机试验

营养不足和传染病对儿童生存构成双重威胁，特别是在营养不良负担沉重和疫苗接种覆盖率低的地区。在这项研究中，我们评估了在尼日利亚北部的一项儿科、实用的、集群随机对照试验中，在常规免疫服务的同时分发预防性小剂量脂质营养补充剂（SQ-LNS）是否可以增加疫苗的吸收率。将两个地方政府区的20个地理上确定的集群按1:1的比例随机分配到NutriVax战略（干预）或标准国家免疫规划（NPI）服务（对照）。NutriVax为在初级卫生保健中心进行常规NPI分娩后6 - 23个月的儿童每月提供定量SQ-LNS。主要结果是在进行类似基线调查12个月后，在以人口为基础的终末家庭横断面调查中评估12 - 23个月儿童接种疫苗卡验证的第一剂含麻疹疫苗（MCV1）的覆盖率。终线调查包括1604名儿童（801名对照组，803名NutriVax）；干预组中有48%的儿童曾接受过SQ-LNS治疗。NutriVax组接受卡验证MCV1的几率比对照组高2倍（优势比= 2.08,95%可信区间（CI）： 1.30−3.35,P = 0.004）。差异中的差异，聚类条件分析显示，相对于对照组，MCV1覆盖率较基线增加了20.1个百分点（95% CI: 13.7 - 26.5 pp, P < 0.0001）。将SQ-LNS与常规免疫联合提供，可大大提高卡验证MCV1的吸收，支持可扩展战略，在类似环境中朝着世界卫生组织2030年免疫议程设定的目标取得进展。ClinicalTrials.gov识别码：NCT06387511。

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来源期刊

Nature Medicine 医学-生化与分子生物学

CiteScore

100.90

自引率

0.70%

发文量

525

审稿时长

1 months

期刊介绍： Nature Medicine is a monthly journal publishing original peer-reviewed research in all areas of medicine. The publication focuses on originality, timeliness, interdisciplinary interest, and the impact on improving human health. In addition to research articles, Nature Medicine also publishes commissioned content such as News, Reviews, and Perspectives. This content aims to provide context for the latest advances in translational and clinical research, reaching a wide audience of M.D. and Ph.D. readers. All editorial decisions for the journal are made by a team of full-time professional editors. Nature Medicine consider all types of clinical research, including: -Case-reports and small case series -Clinical trials, whether phase 1, 2, 3 or 4 -Observational studies -Meta-analyses -Biomarker studies -Public and global health studies Nature Medicine is also committed to facilitating communication between translational and clinical researchers. As such, we consider “hybrid” studies with preclinical and translational findings reported alongside data from clinical studies.