Age of Exposure and Immunity to Malaria in Infants

NCT ID: NCT00231452

Last Updated: 2011-10-28

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

NA

Total Enrollment

349 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-09-30

Study Completion Date

2009-03-31

Brief Summary

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The overall objective is to evaluate the effect of exposure to Plasmodium (P.) falciparum erythrocytic stage antigens during different periods of infancy on the development of naturally acquired immunity (NAI).

Hypothesis: Exposure to P. falciparum prior to 5 months of age does not result in the development of NAI, while exposure to P. falciparum after 5 months of age leads to the development of NAI. The risks of clinical malaria and anaemia during the second year of life will be compared between cohorts, as well as their correlations with the type and quality of immune responses (antibodies to several P. falciparum antigens, cytokines), oxidative stress markers and host genetic factors. These results should shed light on the determinants of the development of anti-P. falciparum responses early in life and the potential constraints to early life immunisation.

Detailed Description

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Conditions

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Malaria

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Late exposure group

Participants received monthly Sulfadoxine-Pyrimethamine (SP) plus Artesunate (AS) from 2.5-4.5 months of age and monthly placebo from 5.5-9.5 months of age.

Group Type EXPERIMENTAL

Sulfadoxine-pyrimethamine (SP) + Artesunate (AS)

Intervention Type DRUG

Monthly chemoprophylaxis with SP (Fansidar® 500/25 mg) plus Artesunate (AS, Arsumax® 50 mg) or placebo (provided by Roche and Sanofi-Aventis) was administered according to the following age-based dosing schedule: ½ tablet of SP or placebo and ½ tablet of AS or placebo on the first day and ½ tablet of AS or placebo on the second and third days.

Early exposure group

Participants received monthly placebo from 2.5-4.5 months of age and monthly SP+AS from 5.5-9.5 months of age.

Group Type EXPERIMENTAL

Sulfadoxine-pyrimethamine (SP) + Artesunate (AS)

Intervention Type DRUG

Monthly chemoprophylaxis with SP (Fansidar® 500/25 mg) plus Artesunate (AS, Arsumax® 50 mg) or placebo (provided by Roche and Sanofi-Aventis) was administered according to the following age-based dosing schedule: ½ tablet of SP or placebo and ½ tablet of AS or placebo on the first day and ½ tablet of AS or placebo on the second and third days.

Control group

Participants received monthly placebo from 2.5 to 9.5 months of age.

Group Type PLACEBO_COMPARATOR

Sulfadoxine-pyrimethamine (SP) + Artesunate (AS)

Intervention Type DRUG

Monthly chemoprophylaxis with SP (Fansidar® 500/25 mg) plus Artesunate (AS, Arsumax® 50 mg) or placebo (provided by Roche and Sanofi-Aventis) was administered according to the following age-based dosing schedule: ½ tablet of SP or placebo and ½ tablet of AS or placebo on the first day and ½ tablet of AS or placebo on the second and third days.

Interventions

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Sulfadoxine-pyrimethamine (SP) + Artesunate (AS)

Monthly chemoprophylaxis with SP (Fansidar® 500/25 mg) plus Artesunate (AS, Arsumax® 50 mg) or placebo (provided by Roche and Sanofi-Aventis) was administered according to the following age-based dosing schedule: ½ tablet of SP or placebo and ½ tablet of AS or placebo on the first day and ½ tablet of AS or placebo on the second and third days.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Healthy HIV-negative pregnant females less than 50 years of age who attend the voluntary counseling and testing (VCT) center at the Maragra or Manhiça antenatal clinic,
* Permanent residents of the Manhiça area and expecting to be living in the area with their infant for at least 2 years.


* Healthy infants, weighing \>= 2 kg and having an alive mother.

Exclusion Criteria

* Plan to leave the area in less than 2 years from the start of the study;
* Women not willing to get tested for HIV infection at the VCT center;
* Test positive for HIV;
* Not willing to provide informed consent;
* Cannot understand either Portuguese or Changana (consent forms are written in these languages).


* Any obvious congenital malformation;
* Any signs of cerebral asphyxia;
* Any obvious neonatal infection;
* Same gender Twins;
* Low birth weight (\<2 kg).
Maximum Eligible Age

1 Week

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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European Commission

OTHER

Sponsor Role collaborator

Hospital Clinic of Barcelona

OTHER

Sponsor Role lead

Principal Investigators

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Pedro Alonso, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Barcelona Center for International Health Research, Hospital Clinic/University of Barcelona

Carlota Dobaño, PhD

Role: PRINCIPAL_INVESTIGATOR

Barcelona Center for International Health Research, Hospital Clinic/University of Barcelona

Locations

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Centro de Investigaçao em Saude da Manhiça

Manhiça, Maputo Province, Mozambique

Site Status

Countries

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Mozambique

References

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Dobano C, Nhabomba AJ, Manaca MN, Berthoud T, Aguilar R, Quinto L, Barbosa A, Rodriguez MH, Jimenez A, Groves PL, Santano R, Bassat Q, Aponte JJ, Guinovart C, Doolan DL, Alonso PL. A Balanced Proinflammatory and Regulatory Cytokine Signature in Young African Children Is Associated With Lower Risk of Clinical Malaria. Clin Infect Dis. 2019 Aug 16;69(5):820-828. doi: 10.1093/cid/ciy934.

Reference Type DERIVED
PMID: 30380038 (View on PubMed)

Nhabomba AJ, Guinovart C, Jimenez A, Manaca MN, Quinto L, Cistero P, Aguilar R, Barbosa A, Rodriguez MH, Bassat Q, Aponte JJ, Mayor A, Chitnis CE, Alonso PL, Dobano C. Impact of age of first exposure to Plasmodium falciparum on antibody responses to malaria in children: a randomized, controlled trial in Mozambique. Malar J. 2014 Mar 27;13:121. doi: 10.1186/1475-2875-13-121.

Reference Type DERIVED
PMID: 24674654 (View on PubMed)

Guinovart C, Dobano C, Bassat Q, Nhabomba A, Quinto L, Manaca MN, Aguilar R, Rodriguez MH, Barbosa A, Aponte JJ, Mayor AG, Renom M, Moraleda C, Roberts DJ, Schwarzer E, Le Souef PN, Schofield L, Chitnis CE, Doolan DL, Alonso PL. The role of age and exposure to Plasmodium falciparum in the rate of acquisition of naturally acquired immunity: a randomized controlled trial. PLoS One. 2012;7(3):e32362. doi: 10.1371/journal.pone.0032362. Epub 2012 Mar 7.

Reference Type DERIVED
PMID: 22412865 (View on PubMed)

Related Links

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http://www.cresib.cat

Barcelona Center for International Health Research

Other Identifiers

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AgeMal

Identifier Type: -

Identifier Source: org_study_id