Plasmodium Falciparum Artemisinin Resistance Vietnam

NCT ID: NCT01775592

Last Updated: 2013-01-28

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE4
• Total Enrollment: 95 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2012-09-30
• Study Completion Date: 2013-01-31

Brief Summary

Resistance of Plasmodium falciparum toward Artemisinins, the most important drug for the successful treatment of malaria, has been confirmed in Cambodia. There are few reports from neighbouring countries about delayed parasite rates. The investigators therefore aim to assess parasite clearance in malaria patients in central Vietnam when treated according to national standard guidelines.

Detailed Description

General objective To evaluate the efficacy of DHA-PPQ in patients with uncomplicated falciparum malaria in a rural area of Central Vietnam, and to assess the in vitro susceptibility of P.falciparum isolates to DHA and PPQ.

Specific objectives

1. To measure the parasite clearance time in falciparum malaria patients treated with DHA-PPQ.

2. To determine the efficacy of DHA-PPQ at day 42 post-treatment.

3. To assess the in vitro susceptibility of P.falciparum isolates towards DHA and PPQ in Quang Nam Province.

4. To compare genetic profiles of P.falciparum isolates with delayed and those with normal clearance times in order to identify potential markers of resistance;

Conditions

Plasmodium Falciparum

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Arterakin

Number of DHA- PPQ (Arterakin™) tablets per day at 0hour, 8hours, 24hours, 48hours (according to age): 2 - 3 years:0.5, 0.5, 0.5, 0.5 3 - < 8 years: 1.0, 1.0, 1.0, 1.0 8 - < 15 years:1.5, 1.5, 1.5, 1.5

≥ 15 years:2.0, 2.0, 2.0, 2.0

Group Type: OTHER

Arterakin (DHA-PPQ)

Intervention Type: DRUG

Interventions

Arterakin (DHA-PPQ)

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Age: from 6 months of age;
• Fever (body temperature above 37.5C) or history of fever in the previous 24 hours;
• Mono-infection with P.falciparum with parasite density between 500-100,000/µl
• Written informed consent to participate to the trial. For patients aged less than 18 years, an informed consent will be obtained from a parent or a guardian.

Exclusion Criteria

• Mixed malaria infection;
• Pregnancy or lactation (urine test for β human chorionic gonadotropin to be performed on any woman of child bearing age unless menstruating);
• Concomitant acute illness necessitating specific treatment (antibiotics);
• Underlying chronic severe illness (e.g. cardiac, renal, hepatic diseases, HIV/AIDS).
• Severe malnutrition;
• Danger signs:

• not able to drink
• incontrollable vomiting
• recent history of convulsions (>1 in 24 hours)
• unconscious state; neurological impairment
• unable to sit or stand
• Signs of severe malaria:

1. Cerebral malaria (unrousable coma)

2. Severe anaemia (Htc< 15%)

3. Renal failure (serum creatinine > 3 mg/dL)

4. Pulmonary oedema;

5. Hypoglycemia (<40mg/dL)

6. Shock (systolic BP < 70 mmHg in adults, 50 in children)

7. Spontaneous bleeding

8. Repeat generalized convulsions

9. Macroscopic haemoglobinuria

10. Severe jaundice

• Persons who have received quinine, artemisinin or artemisinin derivatives within the last 7 days, 4-aminoquinolines within the last 14 days, pyrimethamine and/or sulfonamides within the last 28 days, or mefloquine within the last 56 days should be excluded from the in vitro testing

• Minimum Eligible Age: 2 Months
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Institute of Tropical Medicine, Belgium

OTHER

Sponsor Role: collaborator

National Institute of Malariology, Parasitology and Entomology, Vietnam

OTHER_GOV

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Annette Erhart, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

ITM

Locations

Health Centre Tra Leng

Tra Leng, Quang Nam, Vietnam

Countries

Vietnam

References

Thriemer K, Hong NV, Rosanas-Urgell A, Phuc BQ, Ha do M, Pockele E, Guetens P, Van NV, Duong TT, Amambua-Ngwa A, D'Alessandro U, Erhart A. Delayed parasite clearance after treatment with dihydroartemisinin-piperaquine in Plasmodium falciparum malaria patients in central Vietnam. Antimicrob Agents Chemother. 2014 Dec;58(12):7049-55. doi: 10.1128/AAC.02746-14. Epub 2014 Sep 15.

Reference Type: DERIVED

PMID: 25224002 (View on PubMed)

Other Identifiers

NIMPE - ITM

Identifier Type: -

Identifier Source: org_study_id