Small quantity lipid-based nutritional supplementation and measles vaccination coverage in children aged 6-23 months: a pragmatic cluster-randomized trial
In brief
Adding monthly nutrition supplements raised measles vaccine coverage by 20 points
In a cluster-randomized trial in northern Nigeria, offering small-quantity lipid-based supplements alongside routine immunization increased card-verified first-dose measles vaccination coverage by 20 percentage points relative to standard services. Only 48% of children in intervention areas had received supplements, and whether the approach works in other settings remains unknown.
- Journal
- Nature medicine (Q1)
- Published
- 2 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Cécile Cazes, Baba Waru Goni, Delphine Gabillard, Olumuyiwa Owolabi, Brice Yapi, Juliet Nabunje, et al.
- PMID
- 42827131
- DOI
- 10.1038/s41591-026-04675-1
Why clinicians should know about it
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- Picked for Pediatrics and Child Health (top studies of the week, 4 October 2026): SQ‑LNS improves measles vaccine uptake in Nigeria
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 Organization's Immunization Agenda 2030 in similar settings. ClinicalTrials.gov identifier: NCT06387511 .
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.