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Trial registered on ANZCTR
Registration number
ACTRN12616000640404
Ethics application status
Approved
Date submitted
10/05/2016
Date registered
17/05/2016
Date last updated
4/06/2019
Date data sharing statement initially provided
18/03/2019
Date results provided
18/03/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
The 3-Day Malarone Schedule: Acceptability and Tolerability for Malaria Prophylaxis in Adults Travelling to Malaria Endemic Areas.
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Scientific title
The 3-Day Malarone Schedule: Acceptability and Tolerability for Malaria Prophylaxis in Adults Travelling to Malaria Endemic Areas
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Secondary ID [1]
289169
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Malaria
298697
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Condition category
Condition code
Infection
298753
298753
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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
The trial will assess the use of a 3-day schedule of Atovaquone-Proguanil (250/100mg per tablet) for malaria prophylaxis. The modified schedule involves taking 4 tablets per day for 3 consecutive days to provide protection for one month. The 3-day schedule will be completed at least 2-5 days prior to leaving Australia, depending on duration of travel, itinerary, and convenience. A travel medicine nurse will contact the traveller by phone prior to departure from Australia to monitor adherence to the recommended schedule. If a traveller is unable to tolerate the 3-day schedule, alternative malaria chemoprophylaxis will be arranged prior to departure.
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Intervention code [1]
294692
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Prevention
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Intervention code [2]
294729
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Treatment: Drugs
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
298234
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Tolerability of the 3-day schedule of Atovaquone-Proguanil for malaria prophylaxis. Tolerability will be assessed using a memory aid and symptom diary (4-point Likert Scale) to record the frequency and severity of adverse events.
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Assessment method [1]
298234
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Timepoint [1]
298234
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One week after travellers return from overseas travel to malaria-endemic area.
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Primary outcome [2]
298270
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Acceptability of the 3-day schedule of Atovaquone-Proguanil for malaria prophylaxis. Acceptability will be assessed during post-travel telephone interviews to be conducted by travel health nurses. Travellers will be asked if they would choose to take the 3-day Malarone schedule again if travelling to another malaria endemic area in the future, and the reasons for their decision including considerations related to convenience and cost.
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Assessment method [2]
298270
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Timepoint [2]
298270
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One week after travellers return from overseas travel to malaria-endemic area.
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Primary outcome [3]
298271
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Compliance with the 3-day schedule of Atovaquone-Proguanil for malaria prophylaxis. Compliance will be assessed during pre-travel telephone interviews to be conducted by travel health nurses. Nurses will call each traveller prior to departure to ask whether the 3-day schedule of tablets had been taken properly. If not, the reasons for non-compliance will be ascertained. If travellers were unable to complete the 3-day schedule because of adverse events, alternative chemoprophylaxis will be arranged prior to travel.
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Assessment method [3]
298271
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Timepoint [3]
298271
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One week after travellers return from overseas travel to malaria-endemic area.
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Secondary outcome [1]
323621
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Prevalence of adverse events from 3-day schedule of Malarone. The most common adverse events include nausea, vomiting, abdominal pain, diarrhoea, headache, and mouth ulcers. Adverse events will be assessed using a 4-point Likert Scale in a symptom diary.
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Assessment method [1]
323621
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Timepoint [1]
323621
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One week after travellers return from overseas travel to malaria-endemic area.
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Eligibility
Key inclusion criteria
1. Over 18 years of age
2. Travelling to a malaria-endemic area in Asia, Pacific Islands, and South/Central
America for 4 weeks or less
3. Able to give written Informed Consent and sign consent after all aspects of the
protocol explained
4. Subject must agree to participate in all planned follow-up telephone reviews, and to
return their Memory Aid and Diary to their travel clinic.
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Minimum age
18
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?
Yes
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Key exclusion criteria
1. Previous adverse reactions to Malarone
2. Taking other medications that adversely interact with Malarone (metoclopramide,
rifampicin and tetracyclines may decrease the efficacy of Atovaquone; fluvoxamine may
decrease the efficacy of Proguanil).
3. Pregnancy or planning pregnancy.
4. Significant medical conditions including diabetes, heart problems, asthma, epilepsy,
depression, renal impairment, gastrointestinal disorders, and those taking long-term
antibiotics.
5. Travelling to highly endemic countries with a high risk of malaria, e.g Sub-Saharan
Africa.
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Study design
Purpose of the study
Prevention
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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 3 / Phase 4
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Type of endpoint/s
Safety
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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
1/07/2016
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Actual
25/10/2016
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Date of last participant enrolment
Anticipated
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Actual
1/03/2018
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Date of last data collection
Anticipated
31/05/2018
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Actual
31/05/2018
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Sample size
Target
222
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Accrual to date
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Final
232
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Recruitment in Australia
Recruitment state(s)
QLD,SA,WA
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Funding & Sponsors
Funding source category [1]
293556
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Self funded/Unfunded
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Name [1]
293556
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Unfunded
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Address [1]
293556
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N/A
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Country [1]
293556
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Primary sponsor type
Individual
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Name
Colleen Lau
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Address
Department of Global Health
Research School of Population Health
Australian National University,
Building 62, Mills Road
Canberra, ACT 0200
Postal address:
Dr Colleen Lau
P O Box 2726,
New Farm, QLD 4005
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Country
Australia
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Secondary sponsor category [1]
292371
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Individual
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Name [1]
292371
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Dr Deborah Mills
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Address [1]
292371
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Dr Deb The Travel Doctor
5th Floor, 247 Adelaide St,
Brisbane, QLD 4000
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Country [1]
292371
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Australia
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Other collaborator category [1]
278995
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Individual
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Name [1]
278995
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Ms Lani Ramsay
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Address [1]
278995
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Travel-Bug Vaccination Clinic
182 Ward St
Adelaide, SA 5006
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Country [1]
278995
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Australia
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Other collaborator category [2]
278996
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Individual
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Name [2]
278996
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Dr Andrew Ebringer
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Address [2]
278996
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Senior Medical Director
International SOS
Level 27, 288 Edward St
Brisbane, QLD 4000
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Country [2]
278996
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Australia
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Other collaborator category [3]
280055
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Other
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Name [3]
280055
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Travel Medicine Centre Perth
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Address [3]
280055
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Ground Floor, 5 Mill St,
Perth WA 6000
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Country [3]
280055
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294993
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Human Research Ethics Committee, Australian National University
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Ethics committee address [1]
294993
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Research Integrity & Compliance, Research Services, Ground Floor, Chancelry 10B Ellery Crescent, The Australian National University ACTON ACT 2601
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Ethics committee country [1]
294993
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Australia
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Date submitted for ethics approval [1]
294993
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09/05/2016
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Approval date [1]
294993
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25/08/2016
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Ethics approval number [1]
294993
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2016087
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Summary
Brief summary
Malaria is one of the most common causes of fever in Australian travellers, with approximately 400 cases reported each year in Australia. In addition, some travellers develop malaria and seek treatment while overseas, and are not included in these reported numbers. Most travellers who develop malaria did not take anti-malarial medications, or did not take the medications properly (e.g. forgot to take tablets). Malaria is a serious illness, and could potentially be life-threatening if not treated promptly. Antimalarial medications reduce the risk of malaria by about 90%, and the most commonly used options in Australia are Malarone, Doxycycline, and Mefloquine (Lariam). This research project aims to reduce the risk of malaria in travellers by improving compliance with anti-malarial medications. We propose to test the acceptability and tolerability of a 3-day schedule of a malaria medication called Malarone. Currently, travellers are required to take Malarone daily, starting 2 days before travel to a malaria risk area and continuing until 7 days after leaving the area. With the 3-day schedule, travellers will only need to take medications for 3 days and be protected for 4 weeks. The schedule will likely improve compliance and therefore reduce the risk of malaria. For trips that are of 4 weeks duration or less, travellers will be able to complete their antimalarial medications before leaving home, and not worry about carrying or taking tablets during their trip.
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Trial website
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Trial related presentations / publications
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Public notes
The Malarone tablets will be paid for by each individual traveller (or their employer for work-related trips), just as travellers would normally pay for any malaria chemoprophylaxis. This study has not received funding for medications from the clinics, doctors, researchers, pharmaceutical companies, or any other third parties.
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Attachments [1]
875
875
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/AnzctrAttachments/370664-2016087_Lau_Study Protocol_3MT.pdf
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Contacts
Principal investigator
Name
65714
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Dr Colleen Lau
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Address
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Department of Global Health
Research School of Population Health
Australian National University
Building 62, Mills Road
Canberra, ACT 0200
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Country
65714
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Australia
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Phone
65714
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+61 402134878
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Fax
65714
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Email
65714
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[email protected]
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Contact person for public queries
Name
65715
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Colleen Lau
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Address
65715
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Department of Global Health
Research School of Population Health
Australian National University
Building 62, Mills Road
Canberra, ACT 0200
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Country
65715
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Australia
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Phone
65715
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+61 402134878
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Fax
65715
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Email
65715
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[email protected]
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Contact person for scientific queries
Name
65716
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Colleen Lau
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Address
65716
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Department of Global Health
Research School of Population Health
Australian National University
Building 62, Mills Road
Canberra, ACT 0200
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Country
65716
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Australia
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Phone
65716
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+61 402134878
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Fax
65716
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Email
65716
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Confidentiality
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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
Source
Title
Year of Publication
DOI
Embase
Drug-free holidays: Compliance, tolerability, and acceptability of a 3-day atovaquone/proguanil schedule for pretravel malaria chemoprophylaxis in australian travelers.
2019
https://dx.doi.org/10.1093/cid/ciy854
N.B. These documents automatically identified may not have been verified by the study sponsor.
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