Malaria,Falciparum Clinical Trial
— MATAMALOfficial title:
Adjunctive Ivermectin Mass Drug Administration for Malaria Control on the Bijagos Archipelago of Guinea Bissau: A Cluster-randomized Placebo-controlled Trial
NCT number | NCT04844905 |
Other study ID # | 19156 |
Secondary ID | |
Status | Recruiting |
Phase | Phase 3 |
First received | |
Last updated | |
Start date | May 3, 2021 |
Est. completion date | August 2023 |
This is a cluster-randomized placebo-controlled clinical trial to evaluate the additive benefit of Ivermectin (IVM) (or Placebo) mass drug administration (MDA) to dihydroartemisinin-piperaquine (DP) MDA for malaria control in a moderate to low malaria-endemic setting as an adjunctive strategy to existing programmatic malaria control measures. The regime of DP and IVM will target both human reservoirs of Plasmodium falciparum and the Anopheles gambiae vector respectively, with the aim of interrupting transmission. The trial will be conducted on the Bijagos Archipelago, where islands (clusters) will be randomised to receive seasonal DP and IVM or DP and Placebo MDA. The primary outcome will be the prevalence of infection with Plasmodium falciparum in all age groups detected by nucleic acid amplification testing during the peak malaria transmission season after two years of intervention.
Status | Recruiting |
Enrollment | 24000 |
Est. completion date | August 2023 |
Est. primary completion date | March 2023 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 6 Months and older |
Eligibility | Inclusion Criteria: 1. Age over six months to receive dihydroartemisinin-piperaquine 2. Height over 90cm or weight over 15kg to receive ivermectin or placebo 3. Willingness to adhere to trial procedures 4. Individual written, informed consent from the participant or parent/guardian in the case of participants below the age of 18 years (and assent in young people between the ages of 12 and 17 years of age) Exclusion Criteria: 1. Known severe chronic illness (AIDS, Tuberculosis, chronic malnutrition) 2. Known hypersensitivity to either dihydroartemisinin-piperaquine or ivermectin 3. Pregnancy (any trimester) and breastfeeding (for ivermectin (or placebo)) and pregnancy (first trimester only) (for dihydroartemisinin-piperaquine) 4. Travel to a Loa loa endemic country (eg Central African Republic) (for ivermectin (or placebo)) 5. Concomitant drugs that influence cardiac function or affect the corrected QT interval (for dihydroartemisinin-piperaquine) |
Country | Name | City | State |
---|---|---|---|
Guinea-Bissau | Bijagos Archipelago (islands) | Bissau |
Lead Sponsor | Collaborator |
---|---|
London School of Hygiene and Tropical Medicine | Bandim Health Project, Instituto Nacional de Estudos e Pesquisas, Guinee-Bissau, Medical Research Council Unit, The Gambia, Ministerio de Saude Publica, Guinee-Bissau |
Guinea-Bissau,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Prevalence of infection with Plasmodium falciparum | Prevalence of infection with Plasmodium falciparum in all age groups estimated using a cross-sectional survey sample conducted during peak transmission season after 2 years of intervention | 2 years | |
Secondary | Vector parous rate | Vector parous rate will be determined by assessment of mosquitoes trapped 7-14 days following MDA. Vector parity will be used to determine Anopheles gambiae age structure to estimate vector survival between arms. | 7-14 days post-MDA | |
Secondary | Prevalence of infection with Plasmodium falciparum | Prevalence of infection with Plasmodium falciparum in all age groups estimated using a cross-sectional survey sample conducted after the first year of intervention | 1 year | |
Secondary | Incidence of clinical malaria (Passive Case Detection) | Incidence of clinical malaria diagnosed at health facilities confirmed by malaria Rapid Diagnostic Test | For six months during the malaria transmission season | |
Secondary | Incidence of clinical malaria (Active Case Detection) | Incidence of clinical malaria confirmed by malaria Rapid Diagnostic Test in a cohort of 50 children per cluster aged 5-14 years | For six months during the malaria transmission season | |
Secondary | Age-adjusted prevalence of recent exposure to Plasmodium falciparum | Mean Median Fluorescence Intensity of serological markers associated with recent exposure to Plasmodium falciparum in all age groups estimated using a cross-sectional survey sample during peak transmission season after each year of intervention | Peak transmission season at 1 year and 2 years | |
Secondary | Vector density | Total number of trapped mosquitoes per cluster | For six months during the malaria transmission season | |
Secondary | Vector species composition | Species characterisation using nucleic acid amplification tests as a proportion of total mosquitoes caught in traps | For six months during the malaria transmission season | |
Secondary | Prevalence of exposure to Anopheles exposure | Mean Median Fluorescence Intensity of serological markers associated with exposure to Anopheles salivary antigen in all age groups estimated using a cross-sectional survey sample | Peak transmission season at 1 year and 2 years | |
Secondary | Vector sporozoite rates | Proportion of Plasmodium falciparum circumsporozoite antibody (CSP) positive mosquitoes caught in traps | For six months during the malaria transmission season | |
Secondary | Prevalence of Ivermectin-susceptible Neglected Tropical Diseases (NTDs) | Prevalence of IVM-susceptible NTDs (scabies, strongyloides, other soil-transmitted helminths and lymphatic filariasis) and head lice using clinical and serological parameters estimated using a cross-sectional survey sample during the dry season after two years of intervention. | 2 years | |
Secondary | MDA coverage estimates | Cluster level coverage estimates calculated from MDA distribution and denominator census | During MDA in year 1 and year 2 | |
Secondary | Prevalence of resistance to artemisinin and partner drugs in humans | Prevalence of resistance to artemisinin and partner drugs in humans using molecular markers of resistance in all age groups estimated using a cross-sectional survey sample | Peak transmission season at 1 year and at 2 years |
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