Malaria Clinical Trial
— MULTIPLYOfficial title:
MULTIple Doses of IPTi Proposal: a Lifesaving High Yield Intervention
As efforts to control malaria are stalling, and the disease is particularly severe in children under the age of two, it is imperative for countries in sub-Saharan Africa, with areas of moderate-to-high transmissions, to implement Perennial Malaria Chemoprevention (PMC) delivered through the Expanded Program on Immunization (EPI), which is the only feasible, sustainable and cost-effective strategy to reach this high-risk group. PMC is a full therapeutic course of antimalarial medicine (with sulfadoxine-pyrimethamine, SP) delivered to infants in the context of routine immunisation services during the first two year of life. PMC has been shown to be safe, efficacious in reducing clinical malaria, anaemia and hospital admissions, and to be highly cost-effective; for all these reasons, the World Health Organization (WHO) recommended in 2010 Intermittent Preventive Treatment for Infants (IPTi) for malaria prevention. Only one African country - Sierra Leone -put IPTi into policy and practice. Concerned with this slow adoption, WHO in 2019 recommended adaptations be urgently tested through pilots assessing impact, operational feasibility and cost effectiveness. In 2022, WHO expanded that recommendation to cover children through the age of two because of studies documenting the value in children aged 12 to 24 months. The name for this preventive treatment has consequently changed to Perennial Malaria Chemoprevention (PMC) as the updated recommendation is no longer just for infants. MULTIPLY is the pilot implementation of PMC in selected districts in Mozambique, Sierra Leone and Togo to maximise the delivery and uptake of PMC, to achieve the full potential of this intervention. Working with the ministries of health in Mozambique, Sierra Leone and Togo, MULTIPLY will give up to 6 doses of PMC in the first two years of life. PMC will be given at health facilities and EPI mobile outreach clinics using a paediatric dispersible formulation of SP, alongside routine vaccinations and vitamin A supplementation.
Status | Recruiting |
Enrollment | 45000 |
Est. completion date | October 2025 |
Est. primary completion date | December 2024 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 10 Weeks to 18 Months |
Eligibility | Inclusion Criteria: All infants attending their 2nd EPI contact who are eligible to receive the corresponding immunisations. Exclusion Criteria: Infants/children; with acute malaria; known to have sulfa allergies; who have taken SP in the past 4 weeks; who are HIV-exposed or HIV-infected |
Country | Name | City | State |
---|---|---|---|
Mozambique | Fundaçao Manhiça | Manhiça | |
Sierra Leone | College of Medicine & Allied Health Sciences (COMAHS), University of Sierra Leone | Freetown | |
Togo | University of Lomé | Lomé |
Lead Sponsor | Collaborator |
---|---|
Barcelona Institute for Global Health | Centro de Investigação em Saúde de Manhiça, Institut de Recherche pour le Developpement, Medicines for Malaria Venture, University of Lomé (UL), Togo, University of Sierra Leone |
Mozambique, Sierra Leone, Togo,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Proportion of children having received at least three doses of IPTi | Month 24 | ||
Secondary | Malaria prevalence in under 2 year old children living in project districts | Month 24 | ||
Secondary | Malaria incidence in under 2 year old children living in project districts | Month 24 | ||
Secondary | Coverage of EPI routine vaccines in children living in project districts | Month 24 |
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