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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01319448
Other study ID # 5856
Secondary ID
Status Completed
Phase Phase 1/Phase 2
First received March 16, 2011
Last updated March 20, 2014
Start date September 2011
Est. completion date April 2013

Study information

Verified date March 2014
Source London School of Hygiene and Tropical Medicine
Contact n/a
Is FDA regulated No
Health authority Nigeria: The National Agency for Food and Drug Administration and Control
Study type Interventional

Clinical Trial Summary

Malaria prophylaxis is recommended for sickle cell disease patients. In Nigeria, daily proguanil or weekly pyrimethamine are the most commonly prescribed regimens, but the current policy is not effective due to poor compliance and drug resistance. Intermittent treatment with a long acting drug regimen administered under supervision at clinic visits may be more effective. The aim of this trial is to compare the tolerability and acceptability of supervised bimonthly treatment with either sulfadoxine-pyrimethamine plus amodiaquine (SP+AQ) or mefloquine plus artesunate (MQ+AS), with the daily proguanil. Two hundred and seventy patients with sickle cell disease attending the paediatric sickle cell disease clinic in Ilorin hospital who meet the eligibility criteria and have parental consent, will be randomized to one of three prophylactic regimens: daily proguanil, bimonthly sulfadoxine-pyrimethamine plus amodiaquine, or bimonthly mefloquine plus artesunate. Patients will be asked to return to clinic every two months and whenever they are sick. At enrollment, the study paediatrician will conduct a physical examination of the child, and collect a venous blood sample for a complete blood cell count and biochemical screen, determination of G6PD genotype, preparation of blood smears for malaria microscopy and a blood spot for determination of molecular markers of resistance. Four days after each clinic visit, patients will be interviewed (by phone and, for a subset, at home or in the clinic) to ask about compliance and adverse events. Participants will be followed for one year. The parents or carer will be encouraged to bring their child to the Outpatient Department clinic if the child becomes unwell. The primary outcome of the trial is tolerability, secondary outcomes are adherence to the regimen, and incidence of malaria and the number of hospitalizations over 12 months. If the bimonthly regimens are well tolerated and the preliminary data from this study are promising, a larger multicentre trial will be required to determine efficacy.


Recruitment information / eligibility

Status Completed
Enrollment 270
Est. completion date April 2013
Est. primary completion date April 2013
Accepts healthy volunteers Accepts Healthy Volunteers
Gender Both
Age group 6 Months to 45 Years
Eligibility Inclusion Criteria:

- Age 6months or older and >=5kg

- Sickle cell clinic attendant

- Both males and females

- Agree to abide by the study protocol

- Give informed consent and assent

- Not acutely sick at the time of recruitment

- Not having additional chronic disease

- Hb genotype of SS and SC confirmed by electrophoresis

Exclusion Criteria:

- known allergy to any of the antimalarial drugs use in the trial,

- severe illnesses requiring urgent admission,

- treatment with sulfadoxine-pyrimethamine or mefloquine in the previous 2wks

- patients on cotrimoxazole prophylaxis

Study Design

Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention


Related Conditions & MeSH terms


Intervention

Drug:
Proguanil
Proguanil tablets, 1.5mg/kg/day
mefloquine plus artesunate
This treatment is given once a day for 3 days. Patients weighing 5-8 kg receive one paediatric tablet per day, those weighing 9-17 kg two paediatric tablets, those weighing 18-29 kg one adult tablet and those weighing 30 kg and two adult tablets.
Sulfadoxine-pyrimethamine plus amodiaquine
amodiaquine plus sulfadoxine-pyrimethamine supervised at each bimonthly clinic visit (amodiaquine 10mg/kg per day for three days and sulfadoxine-pyrimethamine (25/1.25 mg/kg) on the first day).

Locations

Country Name City State
Nigeria Department of Paediatrics and Child Health, University of Ilorin Teaching Hospital Ilorin Kwara

Sponsors (4)

Lead Sponsor Collaborator
London School of Hygiene and Tropical Medicine Medical Research Council Unit, The Gambia, University of Ilorin Teaching Hospital, Wellcome Trust

Country where clinical trial is conducted

Nigeria, 

Outcome

Type Measure Description Time frame Safety issue
Primary Incidence of adverse events 12 months Yes
Primary Adherence to the recommended regimen 12 months No
Secondary Efficacy against malaria 12 months No
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