Treatment of Fever Due to Malaria With Ibuprofen

NCT ID: NCT00167713

Last Updated: 2005-09-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-04-30

Study Completion Date

2004-01-31

Brief Summary

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Drugs to treat fever are widely used in children with fever. But there is a controversy about the benefit of reducing fever in children with malaria. Ibuprofen is often used to treat malarial fever. This study evaluates the capacity of ibuprofen to reduce fever in malaria. The effect of ibuprofen on fever compared to only mechanical measures is investigated in children with malaria.

Detailed Description

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Fever is the most apparent clinical manifestation of Plasmodium falciparum infection during the acute phase. The role of fever in defence against malaria or in other infectious diseases remains unclear. However, it has been shown that febrile temperatures inhibit the growth of P. falciparum in vitro.

Antipyretic drugs are commonly and widely used to treat malarial fever in endemic areas. There is however a controversy about the benefit of reducing fever in children with malaria. Data from Gabon have revealed that neither paracetamol, nor naproxen or metamizol - antipyretics often used in this area - had an effect on fever clearance time. Worryingly, paracetamol increased parasite-clearance times (i.e. inhibited clearance of parasites) and decreased significantly the production of oxygen radicals and tumour necrosis factor (TNF), mechanisms of the innate immune response, pivotal to combat infections.

Another antipyretic drug often used to treat malarial fever in endemic areas is ibuprofen. However, the rationale of its use and its capacity of reducing fever due to P. falciparum infections has never been proven in this area.

Comparison: The effect of ibuprofen plus mechanical fever "treatment" (continuous fanning, tepid sponging, and cooling blankets) is compared to mechanical treatment alone to treat fever in children with malaria.

Conditions

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Fever

Keywords

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Malaria Fever Ibuprofen Gabon

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Interventions

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Ibuprofen

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Uncomplicated falciparum malaria
* Asexual parasitaemia between 20,000 and 200,000/µL
* Fever with temperature above 38 °C or history of fever during the preceding 24 hours
* Informed consent

Exclusion Criteria

* Effective anti-malarial treatment for the present attack
* Antipyretic use within 6 hours of presentation
* Contraindications to the use of ibuprofen (history of asthma, dyspeptic symptoms, gastro-intestinal bleeding, or allergy to ibuprofen)
* Mixed plasmodial infection
* Haemoglobin \< 7 g/dL
* Packed-cell volume \< 20%
* White cell count \> 16,000/L
* Platelet count \< 40,000/µL
* Schizontaemia \> 50/µL
* Impaired consciousness
* Convulsions or history of convulsions
* Concomitant diseases masking assessment of response
Minimum Eligible Age

2 Years

Maximum Eligible Age

7 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Albert Schweitzer Hospital

OTHER

Sponsor Role lead

Principal Investigators

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Michel A. Missinou, PhD

Role: PRINCIPAL_INVESTIGATOR

Albert Schweitzer Hospital

Locations

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Medical research Unit, Lambaréné

Lambaréné, Moyen-Ogooué Province, Gabon

Site Status

Countries

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Gabon

References

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Kwiatkowski D. Febrile temperatures can synchronize the growth of Plasmodium falciparum in vitro. J Exp Med. 1989 Jan 1;169(1):357-61. doi: 10.1084/jem.169.1.357.

Reference Type BACKGROUND
PMID: 2642531 (View on PubMed)

Long HY, Lell B, Dietz K, Kremsner PG. Plasmodium falciparum: in vitro growth inhibition by febrile temperatures. Parasitol Res. 2001 Jul;87(7):553-5. doi: 10.1007/s004360100374.

Reference Type BACKGROUND
PMID: 11484852 (View on PubMed)

Kluger MJ. Drugs for childhood fever. Lancet. 1992 Jan 4;339(8784):70. No abstract available.

Reference Type BACKGROUND
PMID: 1346006 (View on PubMed)

Brandts CH, Ndjave M, Graninger W, Kremsner PG. Effect of paracetamol on parasite clearance time in Plasmodium falciparum malaria. Lancet. 1997 Sep 6;350(9079):704-9. doi: 10.1016/S0140-6736(97)02255-1.

Reference Type BACKGROUND
PMID: 9291905 (View on PubMed)

Lell B, Sovric M, Schmid D, Luckner D, Herbich K, Long HY, Graninger W, Kremsner PG. Effect of antipyretic drugs in children with malaria. Clin Infect Dis. 2001 Mar 1;32(5):838-41. doi: 10.1086/319217. Epub 2001 Feb 23.

Reference Type BACKGROUND
PMID: 11229858 (View on PubMed)

Krishna S, Pukrittayakamee S, Supanaranond W, ter Kuile F, Ruprah M, Sura T, White NJ. Fever in uncomplicated Plasmodium falciparum malaria: randomized double-'blind' comparison of ibuprofen and paracetamol treatment. Trans R Soc Trop Med Hyg. 1995 Sep-Oct;89(5):507-9. doi: 10.1016/0035-9203(95)90087-x.

Reference Type BACKGROUND
PMID: 8560525 (View on PubMed)

Nwanyanwu OC, Ziba C, Kazembe PN. Paracetamol and ibuprofen for treatment of fever in Malawian children aged less than five years. Trans R Soc Trop Med Hyg. 1999 Jan-Feb;93(1):84. doi: 10.1016/s0035-9203(99)90191-8. No abstract available.

Reference Type BACKGROUND
PMID: 10492798 (View on PubMed)

Matsiegui PB, Missinou MA, Necek M, Mavoungou E, Issifou S, Lell B, Kremsner PG. Antipyretic effect of ibuprofen in Gabonese children with uncomplicated falciparum malaria: a randomized, double-blind, placebo-controlled trial. Malar J. 2008 May 26;7:91. doi: 10.1186/1475-2875-7-91.

Reference Type DERIVED
PMID: 18503714 (View on PubMed)

Related Links

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http://www.malaria.org

General information on malaria at the website of the Malaria Foundation International

http://www.lambarene.org

Homepage of the Medical Research Unit, Lambaréné

Other Identifiers

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04/2003/IBU

Identifier Type: -

Identifier Source: org_study_id