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Trial registered on ANZCTR
Registration number
ACTRN12611001244998
Ethics application status
Approved
Date submitted
30/11/2011
Date registered
6/12/2011
Date last updated
5/03/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Efficacy and safety of artesunate+sulfadoxine/pyrimethamine for the treatment of uncomplicated Plasmodium falciparum malaria in four sites of Pakistan
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Scientific title
Efficacy and safety of artesunate+sulfadoxine/pyrimethamine for the treatment of uncomplicated Plasmodium falciparum malaria in four sites of Pakistan
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Secondary ID [1]
273506
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Nil
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Universal Trial Number (UTN)
Nil
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Trial acronym
Nil
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Malaria
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Condition category
Condition code
Infection
279498
279498
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0
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Studies of infection and infectious agents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
One arm propective evaluation with artesunate+sulfadoxine+ pyrimethamine for the treatment of uncomplicated Plasmodium falciparum malaria. Eligible subjects will be treated with artesunate+sulfadoxine+pyrimethamine. All patients will be followed up for 28 days.
Dose regimen:
artesunate+sulfadoxine/pyrimethamine tablets: artesunate 4 mg/kg body weight per day for 3 days plus a single dose of sulfadoxine 25/1.25 pyrimethamine mg/kg body weight.
All treatment will be orally taken tablets.
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Intervention code [1]
283822
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Treatment: Drugs
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Comparator / control treatment
"N/A - This is a one-arm prospective evaluation of clinical and parasitological responses to directly observed treatment for uncomplicated falciparum malaria".
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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% of artesunate+sulfadoxine+pyrimethamine treatment failures (early treatment failure+late clinical failure+late parasitological failure)
Enrolled patients will be assessed for parasitological (using microscopy), clinical responses during the 28 days follow-up and treatment outcomes will be classified according to the latest WHO protocol (http://www.who.int/malaria/publications/atoz/9789241597531/en/index.html).
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Assessment method [1]
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Timepoint [1]
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At 28 day following treatment
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Secondary outcome [1]
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% of adverse events (e.g. abdominal pain, nausea, vomiting, headache and dizziness) in the artesunate+sulfadoxine/ pyrimethamine treated patients. All patients will be asked routinely about previous symptoms and about symptoms that have emerged since the previous follow-up visit. All adverse events will be recorded on the case report form.
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Assessment method [1]
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Timepoint [1]
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At 28 day following treatment
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Eligibility
Key inclusion criteria
*age between 6 months and 60 years with the exception of 12-17 years old female minors and unmarried females aged 18 years and above;
*mono-infection with P. falciparum detected by microscopy;
*parasitaemia of 1000 – 250000 / micro liter asexual forms for sites in Sindh, Baluchistan and FATA and parasitaemia of 250 – 250000 / microliterl asexual forms for the site in Punjab;
*presence of axillary temperature greater or equal to 37.5 degrees centigrade or history of fever during the past 24 h;
*ability to swallow oral medication;
*ability and willingness to comply with the study protocol for the duration of the study and to comply with the study visit schedule; and
*informed consent from the patient or from a parent or guardian in the case of children.
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Minimum age
6
Months
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Maximum age
60
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
*presence of general danger signs in children aged under 5 years or signs of severe falciparum malaria according to the definitions of World Health Organization (WHO);
*mixed or mono-infection with another Plasmodium species detected by microscopy;
*presence of severe malnutrition (defined as a child whose growth standard is below –3 z-score, has symmetrical oedema involving at least the feet or has a mid-upper arm circumference < 110 mm);
*presence of febrile conditions due to diseases other than malaria (e.g. measles, acute lower respiratory tract infection, severe diarrhoea with dehydration) or other known underlying chronic or severe diseases (e.g. cardiac, renal and hepatic diseases, Human Immuno Deficiency Virus /Auto Immune Deficiency Syndrome (HIV/AIDS);
*regular medication, which may interfere with antimalarial pharmacokinetics;
*history of hypersensitivity reactions or contraindications to any of the medicine(s) being tested or used as alternative treatment(s); and
*a positive pregnancy test or breastfeeding;
*Unable to or unwilling to take a pregnancy test or contraceptives.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Potential patients will be screened for inclusion/exclusion criteria. Once the patient meets all the enrolment criteria and a parent/guardian consented to participate in the study, the patient will be recruited in to the study. All antimalarial treatment doses will be given by a study team member under supervision. Thereafter, patients are required to undergo regular clinical reassessment. Blood films for parasite counts will be made on days 2, 3 and 7 and then weekly for the remainder of the follow-up period, i.e. on days 14, 21, and 28.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
N/A. This is a one arm prospective study in which all eligible patients are given test drug.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/01/2012
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Actual
12/01/2011
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Date of last participant enrolment
Anticipated
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Actual
20/12/2012
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Date of last data collection
Anticipated
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Actual
19/01/2013
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Sample size
Target
340
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Accrual to date
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Final
314
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Recruitment outside Australia
Country [1]
3987
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Pakistan
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State/province [1]
3987
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Liaqat University of Medicine and Health Sciences
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Address [1]
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Jamshoro, Sindh - Pakistan.
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Country [1]
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Pakistan
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Primary sponsor type
University
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Name
Liaqat University of Medicine and Health Sciences
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Address
Jamshoro, Sindh - Pakistan.
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Country
Pakistan
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
283245
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Country [1]
283245
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Health Services Academy, Ministry of Inter Provincial Coordination
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Ethics committee address [1]
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Park Road, Chak Shahzad, Islamabad, Pakistan
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Ethics committee country [1]
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Pakistan
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Date submitted for ethics approval [1]
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01/07/2011
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Approval date [1]
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12/09/2011
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Ethics approval number [1]
286257
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Letter of approval. No number
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Summary
Brief summary
Title: Efficacy and safety of artesunate+sulfadoxine/pyrimethamine for the treatment of uncomplicated Plasmodium falciparum malaria in four sites of Pakistan. Background: Therapeutic efficacy studies will be done in Somalia to assess the efficacy and safety of artesunate+ sulfadoxine/pyrimethamine for the treatment of uncomplicated falciparum malaria. The participants will be febrile people aged between 6 months and 60 years except female minors aged 12-17 and umarreied women aged 18 years and above. Patients will be treated with tesunate+sulfadoxine/pyrimethamine once a day over 3 consecutive days. Clinical and parasitological parameters will be monitored over a 28-day follow-up period to evaluate drug efficacy. The results of this study will be used to assist the Ministry of Health of Pakistan in assessing the current national treatment guidelines for uncomplicated P. falciparum.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Mr Munir Ahmad Khan
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Address
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Provincial Reference Laboratory ,
Institute of Public Health,
Quetta Balochistan
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Country
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Pakistan
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Phone
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+92 3337807644
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Salma Shaikh
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Address
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Liaqat University of Medical and Health Sciences,
Jamshoro, Sindh, Pakistan
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Country
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Pakistan
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Phone
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+92-22-2785115
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Fax
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+92-22-2784012
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Marian Warsame
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Address
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Global malaria Programme
World Health Organization
20 Av. Appia,
1211 Geneva 27 Switzerland
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Country
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Switzerland
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Phone
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+41 22 791 5076
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Fax
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+41 22 791 48 24
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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