Cluster-Randomized trial of the Implementation of the Responses to Illness Severity Quantification System (RISQ) in children with acute Malnutrition Six to Fifty-nine months of age in Ngouri, Chad (CRIMSON)
Project overview
A cluster randomised control trial comparing implementation of the RISQ System with usual care in an ALIMA-run nutrition treatment program.
Countries
Chad
Organisations
Alliance for International Medical Action (ALIMA)
Partners
Alerte Santé, The Department of Nutrition and Food Technology (DNTA) of the Ministry of Health Chad, The Hospital for Sick Children (SickKids)
Area of funding
Humanitarian Research
Grant amount
400,000
Start date
01
March
2023
End date
01
September
2024
Project length (in months)
18
Funding calls
R2HC Annual Funding Call
R2HC Call for research to strengthen health systems in humanitarian settings
Focus areas
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Topics
Nutrition
Status
Live
Project solution
This project offers [specific solution or intervention] to tackle [challenge]. By implementing [strategies, tools, or innovations], the project aims to achieve [desired outcomes]. The approach is designed to [specific actions or methods] to bring about meaningful change in [community, region, or issue area].
Expected outcomes
This project aims to achieve [specific outcomes], such as [measurable results, improvements, or changes]. The expected impact includes [benefits to the target community, advancements in research or innovation, or long-term effects]. By the end of the project, we anticipate [specific changes or milestones] that will contribute to [broader goals or objectives].
Dr Youssouf Djidita Hagre
University of N'djamena
In sub-Saharan Africa, malnutrition is a major factor in child mortality. The evaluation of children in a malnutrition situation is not always obvious, which means that many children die at home despite having been in a health facility. It is essential to have reliable tools to detect children in severe situations. The RISQ score will contribute to a better detection of these children.
Principal Investigators: Dr. Christopher Parshuram and Dr Youssouf Djitida Hagre
Purpose
This research project addresses child mortality associated with acute malnutrition. Globally 16.6 million children under 5 years of age suffer from severe acute malnutrition (UNICEF 2021). The prevailing community-based management of acute malnutrition (CMAM) model consists of regular use of therapeutic food and outpatient visits and inpatient care for children with acute complications (WHO 2007). Referral to hospital is guided by the World Health Organization’s (WHO) ‘danger-signs’ and inpatient care through established guidelines (WHO 2005, WHO 2013). With this approach, hospital mortality remains high with many children dying shortly after admission (Houssin 2017). A 4-part RISQ System has been developed, which includes a 7-item severity of illness score (Dale 2022), and score-matched care recommendations and an implementation program for the System. Application of the RISQ System to complement current practice may improve outcomes.
Expected Outcomes
Implementation of the RISQ system will facilitate recognition of sick versus less-sick children and should provide a decision tool to render triage less subjective. Triage is essential in humanitarian contexts where large numbers of children presenting for nutritional screening must be evaluated in short time periods due to security constraints The results of our research will contribute to improving the function of a health system by addressing the following WHO health system building blocks:
- ‘Health service delivery’ is improved on both an individual and system level
- ‘Health workforce’ is strengthened through improved clinical assessment skills.
- ‘Information’ is improved by the clinical presentation of the RISQ system documentation as a standardized tool
- ‘Medical products, vaccines, technologies’ is improved through the introduction of pulse oximeters into both inpatient and outpatient care settings
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Project delivery & updates
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