Safety and Efficacy of Primaquine for P. Vivax

NCT ID: NCT01837992

Last Updated: 2013-11-08

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-05-31

Study Completion Date

2015-05-31

Brief Summary

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The Melanesian states of the Western Pacific (Papua New Guinea, Solomon Islands and Vanuatu) represent a unique and especially prescient challenge to malaria control and elimination.

While the use of bed nets and other vector control and case management measures have achieved major advances in overall malaria control, the P. vivax and P. ovale species account for an ever-increasing burden of clinical disease.

The lack of effective treatment of the hypnozoite stages of infection with these species result in ongoing relapses and a continuing reservoir of infection.

The only known drug effective for treatment of the hypnozoite stage is primaquine; however the safe and effective dose of this drug in malaria treatment is still unclear.

A recent study evaluated the safety and efficacy of two primaquine dosing regimens (0.25mg/kg and 0.5mg/kg) in a population in New Ireland province, PNG. This study aims to replicate this methodology in Vanuatu and Solomon Islands, to provide a more complete picture of primaquine efficacy and safety in each of the three countries of this region.

Detailed Description

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Study Aims

Primary To define and compare the efficacy of standard (0.25mg/kg/day for 14 days) and high-dose (0.5mg/kg/day for 14 days) primaquine in preventing early relapses from P. vivax in Solomon Islands and Vanuatu.

Secondary To measure safety and toxicity of primaquine when administered as a standard or high-dose regimen in Melanesian adults and children in Solomon Islands and Vanuatu.

Conditions

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Malaria

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard dose

Participants will receive a standard 3-day treatment course of artemether-lumefantrine at the standard age-based dosage, and will be administered the standard recommended primaquine dose of 0.25mg/kg for 14 consecutive days.

Group Type ACTIVE_COMPARATOR

Primaquine

Intervention Type DRUG

High dose

Participants will receive a standard 3-day treatment course of artemether-lumefantrine at the standard age-based dosage, and will be administered a primaquine dose of 0.5mg/kg/day for 14 consecutive days.

Group Type ACTIVE_COMPARATOR

Primaquine

Intervention Type DRUG

Control

Participants will receive a standard 3-day treatment course of artemether-lumefantrine at the standard age-based dosage, but will not receive primaquine until the time of confirmed recurrent parasitaemia or completion of 3 months follow up.

Group Type OTHER

delayed primaquine

Intervention Type DRUG

Interventions

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Primaquine

Intervention Type DRUG

delayed primaquine

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Age 12 months to 60 years
2. Melanesian background and living in local area
3. Microscopically (based on field microscopy) or RDT confirmed P.vivax regardless of parasite density. Mixed infections (P.falciparum-P.vivax and P.malariae-P.vivax) can be included.

Exclusion Criteria

1. Any signs of severe malaria (see WHO definitions) including: impaired consciousness, respiratory distress, severe anaemia (Hb\<5), multiple seizures, frequent vomiting/ inability to swallow tablets, prostration, jaundice, hypotension, abnormal bleeding or hypoglycaemia.
2. Clinical evidence of non-malarial illness (such as pneumonia or otitis media)
3. Severe malnutrition (weight-for-age nutritional Z score \[WAZ\] \<60th percentile)
4. Permanent disability, which prevents or impedes study participation.
5. Treatment with primaquine in the previous 14 days
6. Residence or planned travel outside the study area during the follow-up period (precluding supervised treatment and follow-up procedures)
7. Known or suspected pregnancy
8. Currently breastfeeding
9. A positive rapid test for G6PD deficiency (Binax or Carestart RDT)

Following later PCR-based confirmation of malaria speciation, there may be some post-hoc exclusion of subjects in whom it is thought the initial field-based microscopic diagnosis may have been incorrect.
Minimum Eligible Age

12 Months

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Walter and Eliza Hall Institute of Medical Research

OTHER

Sponsor Role collaborator

Ministry of Health, Vanuatu

OTHER_GOV

Sponsor Role collaborator

Ministry of Health, Solomon Islands

OTHER_GOV

Sponsor Role collaborator

World Health Organization

OTHER

Sponsor Role collaborator

Menzies School of Health Research

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Tetere Hospital, Guadalcanal Province

Honiara, Guadalcanal Province, Solomon Islands

Site Status

Aoki Hospital, Malaita Province

Auki, Malaita Province, Solomon Islands

Site Status

Northern Provincial Hospital, Nambauk Aid Post, V.F.H.A Dispensary and Fanafo Dispensary

Luganville, Sanma, Vanuatu

Site Status

Toroa Dispensary, NTM Health Centre and Vila Central Hospital

Port Vila, Shefa Province, Vanuatu

Site Status

Countries

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Solomon Islands Vanuatu

Central Contacts

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Ivo Mueller, PhD

Role: CONTACT

Phone: +61 3 9345 2555

Email: [email protected]

Facility Contacts

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Lyndes Wini

Role: primary

Albino Bobogare

Role: backup

Albino Bobogare

Role: primary

Lyndes Wini

Role: backup

George Taleo

Role: primary

Edward Tambisari

Role: backup

George Taleo

Role: primary

Edward Tambisari, MD

Role: backup

Other Identifiers

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VanSI_2013

Identifier Type: -

Identifier Source: org_study_id