Bahir Dar Child Development Cross-Sectional Study, Ethiopia: study protocol

Sarah K G Jensen; Kalkidan Yibeltal; Krysten North; Firehiwot Workneh; Atsede Teklehaimanot; Betelhem Haimanot Abate; Nebiyou Fasil; Tizita Lemma Melka; Theresa I Chin; Lian V Folger; Unmesha Roy Paladhi; Fred Van Dyk; Moriah E Thomason; Patricia Ellen Grant; Terrie Inder; Alemayehu Worku; Yemane Berhane; Anne Cc Lee

doi:10.1136/bmjpo-2024-003173

Bahir Dar Child Development Cross-Sectional Study, Ethiopia: study protocol

BMJ Paediatr Open. 2025 Apr 2;9(1):e003173. doi: 10.1136/bmjpo-2024-003173.

Authors

Sarah K G Jensen^{1

2}, Kalkidan Yibeltal³, Krysten North^{2

4}, Firehiwot Workneh⁵, Atsede Teklehaimanot⁶, Betelhem Haimanot Abate⁷, Nebiyou Fasil⁸, Tizita Lemma Melka⁹, Theresa I Chin^{2

10}, Lian V Folger¹¹, Unmesha Roy Paladhi^{2

10}, Fred Van Dyk¹², Moriah E Thomason¹³, Patricia Ellen Grant^{2

14}, Terrie Inder¹⁵, Alemayehu Worku⁵, Yemane Berhane⁵, Anne Cc Lee^{2

4

10}

Affiliations

¹ Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts, USA sarah.jensen@childrens.harvard.edu.
² Harvard Medical School, Boston, Massachusetts, USA.
³ Department of Reproductive Health and Population, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
⁴ Department of Pediatric Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
⁵ Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
⁶ Pediatrics and Child Health, College of Health Science Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia.
⁷ Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
⁸ Global Health and Health Policy, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
⁹ Department of Psychology, Bahir Dar University, Bahir Dar, Ethiopia.
¹⁰ Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
¹¹ Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
¹² Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
¹³ Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, New York, USA.
¹⁴ Boston Children's Hospital, Boston, Massachusetts, USA.
¹⁵ Children's Hospital of Orange County, Orange, California, USA.

Abstract

Introduction: Foundational preacademic skills are crucial for academic success and serve as predictors of socioeconomic status, income and access to healthcare. However, there is a gap in our understanding of neurodevelopmental patterns underlying preacademic skills in children across low-income and middle-income countries (LMICs). It is essential to identify primary global and regional factors that drive children's neurodevelopment in LMICs. This study aims to characterise the typical development of healthy children and factors that influence child development in Bahir Dar, Ethiopia.

Methods and analysis: The Bahir Dar Child Development Study is a cross-sectional study implemented in two health centres, Shimbit and Abaymado and in Felege Hiwot Comprehensive Specialized Hospital (FHCSH) in Bahir Dar, Amhara, Ethiopia. Healthy children between 6 and 60 months of age will be recruited from the health centres during vaccination visits or via community outreach. Young children aged 6-36 months will complete the Global Scale for Early Development. A battery of paper and tablet-based assessments of neurocognitive outcomes including visual and verbal reasoning, executive functions and school readiness will be completed for children aged 48-60 months. Caregivers will respond to surveys covering sociodemographic information, the child's medical history and nutrition, and psychosocial experiences including parental stress and mental health. During a second visit, participants will undergo a low-field MRI scan using the ultra-low-field point-of-care Hyperfine MRI machine at FHCSH. Analyses will examine relationships between risk and protective factors, brain volumes and neurocognitive/developmental outcomes.

Ethics and dissemination: The study is approved by the Institutional Review Boards of Addis Continental Institute of Public Health (ACIPH/lRERC/004/2023/Al/05-2024), Mass General Brigham Hospital (2022P002539) and Brown University (STUDY00000474). Findings will be disseminated via local dissemination events, international conferences and publications.

Trial registeration number: NCT06648863.

Keywords: Low and Middle Income Countries; Neurodevelopment.

Publication types

Clinical Trial Protocol

MeSH terms

Child Development* / physiology
Child, Preschool
Cross-Sectional Studies
Ethiopia
Female
Humans
Infant
Magnetic Resonance Imaging
Male

Associated data

ClinicalTrials.gov/NCT06648863