Falciparum Malaria Clinical Trial
Official title:
Efficacy and Safety of Artesunate+Sulfadoxine-Pyrimethamine for the Treatment of Uncomplicated Plasmodium Falciparum Malaria in Malaria Control Centers in Nangarhar, Kunar, Thakhar and Faryab Provinces of Afghanistan
In Afghanistan, studies over the past 15 years have shown a high degree of Plasmodium falciparum resistance to chloroquine (80%) and more recently an increasing degree of resistance to sulfadoxine-pyrimethamine monotherapy (12%). In 2003 the high failure rate of chloroquine against falciparum malaria led the national malaria treatment programme to switch its recommended first line drug treatment for uncomplicated Plasmodium falciparum malaria to artemisinin-based combination therapy (ACT) in the form of Artesunate/Sulfadoxine-Pyrimethamine (AS+SP). Second line drug treatment is oral quinine (7 days). The aim of this study is to conduct ongoing monitoring of the efficacy of the new combination against P. falciparum in a group of sentinel sites in Afghanistan.
The objective of the study is to assess the efficacy and safety of
Artesunate/Sulfadoxine-Pyrimethamine (AS+SP) for the treatment of uncomplicated P.
falciparum infections in Nangarhar, Kunar, Thakhar, Faryab malaria control centers in
Afghanistan.
This is an observational study. Patients will receive the recommended treatment for P.
falciparum malaria in Afghanistan (Nangarhar, Kunar, Thakhar, Faryab malaria control
centers). The participants will be febrile children above six months of age and non-pregnant
adults with confirmed uncomplicated P. falciparum infection. Patients will be treated with
AS+SP according to standard dosing regimens. Clinical and parasitological parameters will be
monitored over a 42-day follow-up period to evaluate drug efficacy. The study will be
conducted during the transmission season of falciparum malaria, i.e. October 2009 to January
2010 and September-December, 2010. Patients will be assessed clinically and via laboratory
tests, particularly focussing on whether recurrences are recrudescences of the original
infection or reinfections. All bio-medical findings will be recorded in specific patient
case record forms and the electronic form of analyzed data as well as a final report will be
sent to WHO-Afghanistan and National malaria control program offices for further actions.
The patients will receive reasonable transportation costs for follow-up visits as well as
one insecticide treated bed-net at the end of enrolment. The results of this study will be
used to assist the Ministry of Health of Afghanistan in assessing the current national
treatment guidelines for uncomplicated P. falciparum malaria.
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Observational Model: Case-Only, Time Perspective: Prospective
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