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Trial registered on ANZCTR
Registration number
ACTRN12612000183886
Ethics application status
Approved
Date submitted
6/02/2012
Date registered
10/02/2012
Date last updated
10/02/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Efficacy and safety of dihydroartemisinin-piperaquine (DP) in Pailin, Preah Vihear and Rattanakiri, and artesunate-mefloquine (ASMQ) in Preah Vihear for uncomplicated P. falciparum malaria and chloroquine (CQ) for P.vivax malaria in the above 3 sites, Cambodia, 2009
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Scientific title
Efficacy and safety of dihydroartemisinin-piperaquine (DP) in Pailin, Preah Vihear and Rattanakiri, and artesunate-mefloquine (ASMQ) in Preah Vihear for uncomplicated P. falciparum malaria and chloroquine (CQ) for P.vivax malaria in the above 3 sites, Cambodia, 2009
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Secondary ID [1]
279892
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Nil
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Universal Trial Number (UTN)
U1111-1128-0194
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Trial acronym
TESCAM09
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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
285971
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0
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Other infectious diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Study Drugs were dihydroartemisinin-piperaquine (DP), artesunate-mefloquine (ASMQ) and Chloroquine (CQ). One group was treated with DP daily over 3 days, and another group was treated with ASMQ daily over 3 days for uncomplicated Plasmodium falciparum malaria. In a separate group of patients with P. vivax malaria, CQ alone was used for treatment.
DP (oral tablet) with a dose of 4mg/kg for D and 20mg/kg for P daily for 3 days based on the weight group
ASMQ (oral tablet) with AS at a dose of 11-14 mg/kg and with MQ at a dose of 22-28 mg/kg daily based on the weight group
CQ (oral tablet) at 10mg/kg on Day1, 10mg/kg on Day2 and 5 mg/kg on Day3 based on the weight group
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Intervention code [1]
284215
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Treatment: Drugs
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Comparator / control treatment
No control and comparator group. This was a single group trial. In falciparum infected patients in Preah Vihear, DP was tested first and when it was finished ASMQ was tested for another group of patients, in Pailin and Rattanakiri only DP was tested. In a separate group of vivax infected patients, CQ was tested in the three sites.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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42-day cure rate or ACPR (adequate clinical and parasitological response for falciparum cases and 28-day for vivax.
42-day PCR-corrected ACPR (PCR: polymerase chain reaction, a molecular tool/test to differentiate if the failure is a true resistance or reinfection) for falciparum cases only
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Assessment method [1]
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Timepoint [1]
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at the end of 42-day follow up for falciparum cases and end of 28 days for vivax cases
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Secondary outcome [1]
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Reported signs and symptoms of adverse effects during the time of drug administration were collected in the case record form. The patients may experience the following adverse effect.
1 Dizziness 2 Headache 3 Vestige
4 Nausea
5 Vomiting
6 Diarrhea
7 Abdomen pain
8 Dark Urine
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Assessment method [1]
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Timepoint [1]
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first 3 days after drug administration
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Eligibility
Key inclusion criteria
-Above 1 year old;
-Mono Infection with P. falciparum or P. vivax;
-Parasitaemia, 1000–200 000 asexual forms per microlitre for P.f and above 250 asexual forms per microlitre for P.v ;
-Axillary temperature greater than 37.5 degree C
-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;
-Informed consent from the patient or from a parent or guardian in case of children.
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Minimum age
1
Years
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Maximum age
No limit
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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 among children <5 years old or other signs of severe and complicated falciparum malaria according to current WHO definitions;
-Mixed species;
-Presence of febrile conditions due to diseases other than malaria (measles, acute lower tract respiratory infection, severe diarrhea with dehydration, etc.),
-Known hypersensitivity or allergy to artesunate or mefloquine
-Known psychiatric disorders, e.g. depression or epilepsy
-Anti arrhythmic or others drugs which are known to influence cardiac function
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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)
This is a modified single group study where participants received the same drug per site per specie infection. Patients were enrolled in a sequential manner as they come for consultation at the study site and satisfy the inclusion criteria.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Nil
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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
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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
1/09/2009
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
420
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Cambodia
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State/province [1]
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Pailin
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Country [2]
4112
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Cambodia
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State/province [2]
4112
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Preah Vihear
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Country [3]
4113
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Cambodia
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State/province [3]
4113
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Rattanakiri
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Funding & Sponsors
Funding source category [1]
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Other
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Name [1]
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WHO
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Address [1]
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World Health Organization Regional Office for the Western Pacific, UN Avenue, Manila 1000 Philippines
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Country [1]
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Philippines
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Funding source category [2]
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Other
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Name [2]
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Global Fund For Malaria
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Address [2]
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# 372 Monivong Blvd, Phnom Penh, Cambodia
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Country [2]
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Cambodia
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Primary sponsor type
Other
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Name
Institude Paster du Cambodge
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Address
Monivong Blvd, Phnom Penh Cambodia
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Country
Cambodia
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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]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Summary
Brief summary
This study was a one-arm prospective evaluation of the clinical and parasitological responses to directly observed treatment for uncomplicated falciparum and vivax malaria. The objective was to assess the efficacy and safety of dihydroartemisinin-piperaquine (DP) and artesunate-mefloquine (ASMQ) for the treatment of uncomplicated Plasmodium falciparum malaria in Preah Vihear and only DP in Pailin and Rattanakiri provinces, and Chloroquine (CQ) in these three sites in Cambodia. The WHO 28-day and 42-day in vivo protocol was used. Patients with uncomplicated P.f or P.v malaria who met the study inclusion criteria were enrolled and treated on site with DP or ASMQ or CQ and monitored weekly for 28 days for P.v cases and 42 days for P.f cases. The follow-up consists of a fixed schedule of check-up visits and corresponding clinical and laboratory examinations. On the basis of the results of these assessments, the patients were classified as having therapeutic failure (early or late) or an adequate response. The proportion of patients experiencing therapeutic failure during the follow-up period were used to estimate the efficacy of the study drug. PCR analysis were used to distinguish between a true recrudescence or reinfection. The results of this study are being used to assist the Ministry of Health of Cambodia in assessing the current national treatment guidelines for uncomplicated P. f and P.v malaria.
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Trial website
Nil
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Trial related presentations / publications
Presentations in Cambodia during the annual report workshop organized by the National Centre for Parasitology, Entomology and Malaria Control in 2009
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr. Char Meng Chuor
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Address
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National Centre for Parasitology, Entomology and Malaria Control
#372 Monivong Blvd, Phnom Penh
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Country
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Cambodia
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Phone
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855 12 841168
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Fax
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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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Steven Bijorge
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Address
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World Health Organization Office to representative of Cambodia
#177-179 Corner Streets Pasteur (51) and 254, Sangkat Chak Tomouk, Khan Daun Penh, Phnom Penh, Cambodia
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Country
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Cambodia
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Phone
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(855) 23 216610, 216942, 212228
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Fax
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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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