Skin Ulcer Clinical Trial
— WOUNDCAREOfficial title:
Treat Early and Broad: Thermotherapy of Buruli Ulcer Integrated Into WHO-recommended Wound Management in West Africa
NCT number | NCT03957447 |
Other study ID # | WOUNDCAREV2 |
Secondary ID | |
Status | Recruiting |
Phase | |
First received | |
Last updated | |
Start date | May 7, 2019 |
Est. completion date | September 30, 2024 |
The project rolls out combined innovative low-tech thermotherapy with heat packs and WHO recommended wound management in a Buruli ulcer (BU)-endemic district of West Africa. It addresses three key areas of considerable clinical and public health importance in the region: - to better help people managing the disabling disease BU that primarily affects children in West Africa - to implement WHO recommended general wound management for all types of wounds with tools available at the peripheral level of the health care system - to prevent systemic life threatening sequelae (e.g. sepsis and rheumatic fever) and permanent local damage (e.g. motor and sensory disability) by early recognition and treatment of wounds at the community level. The project translates available research findings already validated on the secondary health care level into clinical practice at the periphery (primary health care level). The string of the investigator's previous work from the development of the BU thermotherapy-wound management-package to the proof of its efficacy provides all necessary skills, tools and documents to immediately proceed into practical community application. Operational endpoints are - coverage and quality of WHO recommended wound management training of health care personnel at the primary health care level (health posts); - coverage, success rate and quality of care for patients with BU and other wounds; denominator controlled at health post level and high-quality Health and Demographic Surveillance Systems (HDSS) data. The project is embedded into a stable multidisciplinary working environment at Côte d'Ivoire, including an HDSS with a longstanding record of partnership and successful community-based operational research. The project builds on the principles laid out by the Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC) and - targets all patients with a broken down skin barrier independent of the cause (patient centred health care) - brings diagnosis and treatment close to the community - educates and trains both community members and health care workers - measures the health intervention outcome The project is fully in line with the new integrated strategy for the skin NTDs of WHO's Department of Control of NTDs (WHO/NTD).
Status | Recruiting |
Enrollment | 5000 |
Est. completion date | September 30, 2024 |
Est. primary completion date | June 30, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | N/A and older |
Eligibility | Inclusion Criteria: Survey All HDSS population members Wound management study Patients with wounds defined as broken skin barrier. Thermotherapy study Buruli ulcer patients of the main study with ulcers < 2cm. Exclusion Criteria: none |
Country | Name | City | State |
---|---|---|---|
Côte D'Ivoire | CSRS | Abidjan |
Lead Sponsor | Collaborator |
---|---|
University Hospital Heidelberg | Centre Suisse de Recherches Scientifiques en Cote d'Ivoire, Institut Pasteur de Côte d'Ivoire, Abidjan Cocody CHU, Côte d'Ivoire |
Côte D'Ivoire,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Prevalence of skin ulcers in inhabitants of the Taabo health district, Ivory Coast | To measure the frequency and the severity of skin lesions (broken skin barrier) in the community and the health services | 2 years | |
Primary | Qualitative description of factors determining public health services-based skin ulcer managment | Description of facilitating and obstructive factors for recognition and treatment of ulcers (questionnaires, interviews, patient and institution-related documentation of costs) | 2 years | |
Primary | Frequency and severity of skin ulcers after community health service intervention | To measure the impact of the wound management intervention (main study and substudy 1) on the frequency, spectrum and severity of wounds including systemic complications in the community and at the health posts / district hospital compared To the baseline study before intervention and over time after implementation of the intervention. | 2 years | |
Primary | Number of patients with healed skin ulcers identified in the survey (see outcome 1) | To measure the proportion of ulcers healed at each cycle of clinical diagnosis and corresponding presumptive treatment | 2 years | |
Primary | Number of patients presenting at the health posts level with skin ulcers identified in the survey (see above) | To describe the clinical epidemiology of different types of skin ulcers (wounds) presented (presumptive clinical and confirmed diagnoses) | 2 years | |
Primary | Quality of care for patients with skin ulcers identified in the survey (see above) | Coverage and quality of skin ulcer (wound) management training of health care personnel at the peripheral health care level (health posts) | 2 years | |
Primary | Outcome of patients with Buruli ulcers < 2cm and willing to participate in thermotherapy study | Number of patients completing thermotherapy exhibiting no more signs of clinically Buruli ulcer (BU) specific features' according to WHO guidelines or 'wound closure' within 6 months after completion of heat treatment ("primary cure") and 'absence of BU recurrence for 12 months after completion of heat treatment' ("definite cure"). | 2 years | |
Secondary | Drop out rate of patients with Buruli ulcers < 2cm and willing to participate in thermotherapy substudy | Number of participants of the thermotherapy substudy not included in analysis of healing rate (see outcome 7) due to lack of cooperation or failure to return for assessment | 2 years | |
Secondary | Withdrawal of patients with Buruli ulcers < 2cm and willing to participate in thermotherapy substudy | Number of participants with consent withdrawal | 2 years | |
Secondary | Patients with Buruli ulcers < 2cm and willing to participate in thermotherapy substudy | Rating of skin ulcer thermotherapy by health staff of the Taabo health distric, Ivory Coast, measured by a score based on a questionnaire | 2 years |
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