Diarrhea Clinical Trial
Official title:
Randomized, Double Blind Placebo-controlled Studies to Evaluate the Effect of an Orally-fed Escherichia Coli (E. Coli) Phage in the Management of ETEC and EPEC Induced Diarrhea in Children
This study hopes to demonstrate the potentials of a new form of therapy for childhood diarrhea, a major cause of morbidity and deaths in Bangladesh and other developing countries, and thus a priority for improving child health.
This randomized double-blind, placebo controlled trial (RCT) aims to evaluate the effect of
oral administered E. coli phage in children aged 4-60 months of age with proven ETEC and
EPEC diarrhea. Children will be screened to exclude V. cholerae infections by dark field
microscopy, rotavirus by stool ELISA, and invasive diarrhoea clinically as well as by stool
microscopy, to identify children with possible ETEC and EPEC diarrhoea. Enrolled children
will be randomly assigned, in equal numbers, to receive either: (i) a new T4 phage cocktail
or (ii) Russian anti-E. coli phage cocktail (Microgen) at the dose recommended by the
manufacturer or (iii) only oral rehydration solution (placebo) for 5 days in addition to
management of dehydration and continued feeding in accordance with WHO guidelines. Duration
of diarrhea, daily and cumulative stool output, volume of oral rehydration solution intake,
stool frequency, time to recovery and weight gain will be the main outcome measures. As the
dose of phage we intend to use in this therapeutic trial is higher than the dose
administered to young children in earlier safety trial, we plan to initially conduct a
safety study with these three study products in 45 children with non cholera, non rotavirus
and non invasive diarrhea, to randomize equally in the three intervention groups, as for the
final study mentioned above. The outcome measures in this safety part will include
assessment of laboratory parameters including renal and liver function tests, haematological
indices, and microbiological efficacy of phage by measuring phage and E. coli titre in daily
stool samples. If the higher dose is found safe, tolerable, and not associated with any
significant adverse event, we will proceed to the clinical efficacy trial.
We believe if T4 coli phage is assessed to be effective in the overall diarrhea management,
this might lead to development of an affordable and sustainable adjunct to the currently
available case management of E. coli diarrhea, benefiting millions of children worldwide.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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