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The SUMMIT 10 Year


This study is a continuation of the Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT), which was implemented by the Summit Institute of Development 10 years ago. The SUMMIT 10 year follow-up study will assess the impact of maternal multiple micronutrient (MMN) supplementation on child cognition, socio-emotional and physical capability, at 9-12 years of age in children whose mothers had consumed MMN supplements, as compared to Iron and Folic Acid (IFA), during pregnancy and 3 months postpartum in Lombok, Indonesia. Evidence of long-term benefits of MMN on child development would inform policy change, and current investments in community-based maternal and infant health programs that would provide for deployment of maternal MMN supplementation in low-resource settings.

The design of our follow-up study is based on two lines of evidence from the SUMMIT and existing literature. First, micronutrients in addition to IFA are important for brain development during pregnancy and lactation, which are crucial periods for the brain development of the infant. Second, the benefit of MMN is greater for certain groups of women. In the SUMMIT, we found benefits of MMN over IFA on motor and cognitive ability at age 3.5 years in children of undernourished (low arm circumference) and anemic mothers.

The study is being conducted from June 2012 to October 2014. In Phase 1, we are tracking all the women who had been enrolled in SUMMIT between 2001-2004 and re-enrolling them. In Phase 2, we are selecting a cohort of 3,115 children and collecting data on cognition, socio-emotional,physical activity, motoric function, child health, hemoglobin and nutritional status.Tests are audio-recorded and reviewed by two independent trained reviewers. We have currently tested over 2000 children. In Phase 3, we are gathering information from the children schools including teacher qualification, facilities and school performance.

The scientists are Husni Muadz (University of Mataram), Anuraj Shankar (Harvard University), Elizabeth Prado (UC Davis), Susy Sebayang, Mandri Apriatni and Ben Harefa (Summit Institute of Development), Michael Ullman (Georgetown University) and Katie Alcock (Lancaster University). Summit Institute of Development (SID) has experience in large scale community-based research methodology including design, recruitment, training, standardization and quality control, and high throughput data base management systems (DBMS). We have recruited more than 300 staff through systematic recruitment tests and rigorous training and evaluation. Grand Challenges Canada has provided the grant to carry out this study.

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