Evaluating the Effects of Community Delivery of Malaria Intermittent Preventive Treatment on Pregnant Women and Babies

NCT ID: NCT03600844

Last Updated: 2022-03-31

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

10602 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-04-02

Study Completion Date

2021-10-31

Brief Summary

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This study evaluates the effectiveness of community delivery of sulfadoxine-pyrimetamine (SP) for intermittent preventive treatment of malaria in pregnancy (IPTp) in increasing the coverage of IPTp among pregnant women in selected districts in Democratic Republic of Congo (DRC), Madagascar, Mozambique and Nigeria, compared to comparison districts where SP for IPTp is distributed as usual in facilities through routine antenatal care (ANC).

Detailed Description

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The specific objectives of this study are to determine the change in the following indicators during the course of the TIPTOP project: 1) Proportion of women who have had a pregnancy that ended in the past 12 months and have received 1 or more, 2 or more and 3 or more doses of IPTp-SP; proportion of women with pregnancy in the past 12 months who attended ANC clinics at least once, and who attended at least four times; proportion of pregnant women attending the first ANC visit before or at week 14; proportion of women who have had a pregnancy that ended in the past 12 months who know about the IPTp service provided by CHWs; and acceptability of C-IPTp for community delivery of IPTp (note: results will be disaggregated by provider type, age, gravidity and distance from facility). To assess these changes, the study will implement structured household surveys targeting potential beneficiaries of the project (pregnant women) in the intervention and comparison areas, implemented at three time points: baseline, mid- and end-points. In each country an initial implementation area (Phase I) and two expansion areas (Phase II) have been selected for the project. This study will establish if community deliver of IPTp is effective and feasible and whether it influences antenatal care service coverage rates. It is expected that the study will provide information to scale up the approach the 4 study countries for the prevention of malaria in pregnancy. This information is also meant to inform global guidelines on community IPTp delivery and may also be used by other countries.

Conditions

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Malaria in Pregnancy

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Districts in high malaria transmission zones were assigned to intervention and comparison areas.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Phase 1 Intervention

Phase 1 intervention communities will be offered Community distribution of SP for IPTp in addition to routine ANC IPTp distribution throughout the project.

Group Type EXPERIMENTAL

Community distribution of SP for IPTp

Intervention Type BEHAVIORAL

SP is distributed to eligible pregnant women by trained Community Health Workers (CHWs) at community level. Demand creation activities are implemented within the community as well.

Phase 1 Comparison/Phase 2 Intervention

During Phase 1 (intervention months 1 through 12), these communities will be offered only usual treatment--SP for IPTp at in facilities during routine ANC. During Phase 2 (intervention month 13 through the end of the project), these communities will be offered Community distribution of SP for IPTp, in addition to routine ANC IPTp distribution.

Group Type ACTIVE_COMPARATOR

Community distribution of SP for IPTp

Intervention Type BEHAVIORAL

SP is distributed to eligible pregnant women by trained Community Health Workers (CHWs) at community level. Demand creation activities are implemented within the community as well.

Interventions

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Community distribution of SP for IPTp

SP is distributed to eligible pregnant women by trained Community Health Workers (CHWs) at community level. Demand creation activities are implemented within the community as well.

Intervention Type BEHAVIORAL

Other Intervention Names

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C-IPTp-SP

Eligibility Criteria

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Inclusion Criteria

* Women who had a pregnancy that ended in the 12 months preceding the survey
* Being resident in the study area during for at least 4 months before the end of the pregnancy
* Willing to participate in the household survey (signing informed consent/assent, in line with country guidelines)

Exclusion Criteria

* Anyone considered to be a minor in their country.
* Not willing to provide informed consent
Minimum Eligible Age

15 Years

Maximum Eligible Age

49 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Barcelona Institute for Global Health

OTHER

Sponsor Role collaborator

Jhpiego

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clara Menendez, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Barcelona Institute for Global Health

Locations

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Kenge District, Community Setting

Kenge, Kwango, Democratic Republic of the Congo

Site Status

Bulungu District, Community Setting

Bulungu, Kwilu, Democratic Republic of the Congo

Site Status

Community Setting

Kunda, Maniema Province, Democratic Republic of the Congo

Site Status

Mananjary District, Community Setting

Mananjary, Fianarantsoa, Madagascar

Site Status

Community Setting

Toliara, Fianarantsoa, Madagascar

Site Status

Community Setting

Vohipeno, Vatovavy-Fitovinany, Madagascar

Site Status

Meconta District, Community Setting

Meconta, Nampula, Mozambique

Site Status

Community Setting

Murrupula, Nampula, Mozambique

Site Status

Nhamatanda District, Community Setting

Nhamatanda, Sofala, Mozambique

Site Status

Community Setting

Ohaukwu District, Ebonyi State, Nigeria

Site Status

Community Setting

Bosso, Niger State, Nigeria

Site Status

Community Setting

Akure South, Ondo State, Nigeria

Site Status

Countries

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Democratic Republic of the Congo Madagascar Mozambique Nigeria

References

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Gonzalez R, Manun'Ebo MF, Meremikwu M, Rabeza VR, Sacoor C, Figueroa-Romero A, Arikpo I, Macete E, Mbombo Ndombe D, Ramananjato R, LIach M, Pons-Duran C, Sanz S, Ramirez M, Cirera L, Maly C, Roman E, Pagnoni F, Menendez C. The impact of community delivery of intermittent preventive treatment of malaria in pregnancy on its coverage in four sub-Saharan African countries (Democratic Republic of the Congo, Madagascar, Mozambique, and Nigeria): a quasi-experimental multicentre evaluation. Lancet Glob Health. 2023 Apr;11(4):e566-e574. doi: 10.1016/S2214-109X(23)00051-7.

Reference Type DERIVED
PMID: 36925177 (View on PubMed)

Pons-Duran C, Llach M, Sanz S, Ramirez M, Mendez S, Roman E, Tholandi M, Pagnoni F, Menendez C, Gonzalez R. Community delivery of malaria intermittent preventive treatment in pregnancy: protocol of a quasi-experimental evaluation through multistage cluster sampling household surveys in four sub-Saharan African countries. BMJ Open. 2021 Mar 25;11(3):e044680. doi: 10.1136/bmjopen-2020-044680.

Reference Type DERIVED
PMID: 33766844 (View on PubMed)

Other Identifiers

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2017-13-TIPTOP

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

TIPTOP_HHS_2018

Identifier Type: -

Identifier Source: org_study_id

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