Exclusive breastfeeding promotion by peer counsellors in sub-Saharan Africa (PROMISE-EBF): a cluster-randomised trial

Simple item page
dc.contributor.authorTylleskar, Thorkild
dc.contributor.authorJackson, Debra
dc.contributor.authorMeda, Nicolas
dc.contributor.authorIngrebetsen, Ingunn Marie S
dc.contributor.authorChopra, Mickey
dc.contributor.authorDiallo, Abdoulaye Hama
dc.contributor.authorDoherty, Tanya
dc.contributor.authorEkström, Eva-Charlotte
dc.contributor.authorFadnes, Lars Thore
dc.contributor.authorGoga, Ameena
dc.contributor.authorKankasa, Chipepo
dc.contributor.authorKlungsøyr, Jørn I
dc.contributor.authorLombard, Carl
dc.contributor.authorNankabirwa, Victoria
dc.contributor.authorNankunda, Jolly K
dc.contributor.authorVan de Perre, Philippe
dc.contributor.authorSanders, David
dc.contributor.authorShanmugam, Rebecca
dc.contributor.authorSommerfelt, Halvor
dc.contributor.authorWamani, Henry
dc.contributor.authorTumwine, James K
dc.contributor.authorPROMISE-EBF Study Group
dc.date.accessioned2013-01-28T06:50:53Z
dc.date.available2013-01-28T06:50:53Z
dc.date.issued2011
dc.description.abstractBackground: Exclusive breastfeeding (EBF) is reported to be a life-saving intervention in low-income settings. The effect of breastfeeding counselling by peer counsellors was assessed in Africa. Methods:24 communities in Burkina Faso, 24 in Uganda, and 34 in South Africa were assigned in a 1:1 ratio, by use of a computer-generated randomisation sequence, to the control or intervention clusters. In the intervention group, we scheduled one antenatal breastfeeding peer counselling visit and four post-delivery visits by trained peers. The data gathering team were masked to the intervention allocation. The primary outcomes were prevalance of EBF and diarrhoea reported by mothers for infants aged 12 weeks and 24 weeks. Country-specific prevalence ratios were adjusted for cluster effects and sites. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00397150. Findings 2579 mother–infant pairs were assigned to the intervention or control clusters in Burkina Faso (n=392 and n=402, respectively), Uganda (n=396 and n=369, respectively), and South Africa (n=535 and 485, respectively). The EBF prevalences based on 24-h recall at 12 weeks in the intervention and control clusters were 310 (79%) of 392 and 139 (35%) of 402, respectively, in Burkina Faso (prevalence ratio 2·29, 95% CI 1·33–3·92); 323 (82%) of 396 and 161 (44%) of 369, respectively, in Uganda (1·89, 1·70–2·11); and 56 (10%) of 535 and 30 (6%) of 485, respectively, in South Africa (1·72, 1·12–2·63). The EBF prevalences based on 7-day recall in the intervention and control clusters were 300 (77%) and 94 (23%), respectively, in Burkina Faso (3·27, 2·13–5·03); 305 (77%) and 125 (34%), respectively, in Uganda (2·30, 2·00–2·65); and 41 (8%) and 19 (4%), respectively, in South Africa (1·98, 1·30–3·02). At 24 weeks, the prevalences based on 24-h recall were 286 (73%) in the intervention cluster and 88 (22%) in the control cluster in Burkina Faso (3·33, 1·74–6·38); 232 (59%) and 57 (15%), respectively, in Uganda (3·83, 2·97–4·95); and 12 (2%) and two (<1%), respectively, in South Africa (5·70, 1·33–24·26). The prevalences based on 7-day recall were 279 (71%) in the intervention cluster and 38 (9%) in the control cluster in Burkina Faso (7·53, 4·42–12·82); 203 (51%) and 41 (11%), respectively, in Uganda (4·66, 3·35–6·49); and ten (2%) and one (<1%), respectively, in South Africa (9·83, 1·40–69·14). Diarrhoea prevalence at age 12 weeks in the intervention and control clusters was 20 (5%) and 36 (9%), respectively, in Burkina Faso (0·57, 0·27–1·22); 39 (10%) and 32 (9%), respectively, in Uganda (1·13, 0·81–1·59); and 45 (8%) and 33 (7%), respectively, in South Africa (1·16, 0·78–1·75). The prevalence at age 24 weeks in the intervention and control clusters was 26 (7%) and 32 (8%), respectively, in Burkina Faso (0·83, 0·45–1·54); 52 (13%) and 59 (16%), respectively, in Uganda (0·82, 0·58–1·15); and 54 (10%) and 33 (7%), respectively, in South Africa (1·31, 0·89–1·93). Interpretation: Low-intensity individual breastfeeding peer counselling is achievable and, although it does not affect the diarrhoea prevalence, can be used to effectively increase EBF prevalence in many sub-Saharan African settings.en_US
dc.description.accreditationWeb of Scienceen_US
dc.description.sponsorshipEuropean Union, Sixth Framework International Cooperation–Developing Countries, Research Council of Norway, Swedish International Development Cooperation Agency, Norwegian Programme for Development, Research and Education, South African National Research Foundation, and Rockefeller Brothers Foundation.en_US
dc.identifier.citationTylleskar, T, et.al. (2011). Exclusive breastfeeding promotion by peer counsellors in sub-Saharan Africa (PROMISE-EBF): a cluster-randomised trial. Lancet, 378: 420–27en_US
dc.identifier.issn0099-5355
dc.identifier.urihttp://hdl.handle.net/10566/516
dc.language.isoenen_US
dc.privacy.showsubmitterfalse
dc.publisherElsevieren_US
dc.rightsThis is the authors postprint version of an article published by Elsevier. The file may be freely used, provided that acknowledgement of the source is given.
dc.source.urihttp://dx.doi.org/10.1016/S0140-6736(11)60738-1
dc.status.ispeerreviewedtrue
dc.subjectExclusive Breast Feedingen_US
dc.subjectPeer Supporten_US
dc.subjectCluster Randomised Controlled Trialen_US
dc.subjectDiarrhoeaen_US
dc.subjectSouth Africaen_US
dc.subjectBurkina Fasoen_US
dc.subjectUgandaen_US
dc.subjectSub-Saharan Africaen_US
dc.titleExclusive breastfeeding promotion by peer counsellors in sub-Saharan Africa (PROMISE-EBF): a cluster-randomised trialen_US
dc.typeArticleen_US

Files

Original bundle
Now showing 1 - 2 of 2
Thumbnail Image
Name:
TylleskarExclusiveBreastfeeding2011.pdf
Size:
1006.3 KB
Format:
Adobe Portable Document Format
Description:
Author final version
Download
No Thumbnail Available
Name:
TylleskarExclusiveBreastfeedingWebappendix2011.pdf
Size:
2 MB
Format:
Adobe Portable Document Format
Description:
Web appendix
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.55 KB
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

Research Articles (School of Public Health)