Feasibility, Acceptability and Costs of a Multiple First-lines Artemisinin-based Combination Therapies

NCT ID: NCT04265573

Last Updated: 2022-03-25

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

Total Enrollment

150000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-11-10

Study Completion Date

2021-02-25

Brief Summary

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A simultaneous deployment of multiple first line therapies (MFT) for uncomplicated malaria using artemisisin based combination therapies as showed by theoretical models, may extend the useful therapeutic life of the current Artemisinin-based combination thérapies (ACTs) by reducing drug pressure and slowing the spread of resistance without putting life at risk. We therefore hypothesized that a simultaneous deployment of three ACTs targeting three segments of the population is feasible, acceptable and can achieve high coverage rate if potential barriers are well identified, well addressed and the key implementers are well-trained and adequately supported. To test this hypothesis, a quasi-experimental study will be conducted.

Detailed Description

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The study will be conducted through four overlapping phases: formative research phase, the MFTs deployment phase, the evaluation phase and the post-evaluation phase.

1. Formative research phase

1.1 Objective

Generate baseline information and to develop intervention tools for the pilot implementation of MFTs for uncomplicated malaria in the study area.

1.2 Design

Cross-sectional surveys using desk reviews, qualitative and quantitative research methods:
* Individual in-depth Interviews
* Focus group discussions
* Household surveys for the assessment of malaria-related morbidity and mortality at community level as well as the healthcare system utilisation
* Health facility-based surveys for malaria morbidity and mortality, antimalarial drugs and malaria rapid diagnostic tests availability.

1.3 Duration

Six months from obtaining the approval of the ethics committee for health research.
2. MFTs deployment phase

2.1 Objective

Implement the MFTs for uncomplicated malaria in the health district of Kaya that is feasible, acceptable and achieve high coverage rate.

2.2 Drugs deployment

Study ACTs and respective target populations:
* Artesunate-Pyronaridine for children less than five years of age
* Artemether-Lumefantrine for pregnant women
* Dihydroartemisinin-Piperaquine for individuals five years of age and above

NB: Community case management of malaria using Artemether-Lumefantrine as per National Malaria Control Program recommendation.

2.3 Duration

Twelve months including low and high malaria transmission seasons in the study area.
3. Monitoring and evaluation phase

3.1 Objectives

Assess the feasibility, the acceptability, the cost and the effects of the pilot MFTs pilot programme for uncomplicated malaria in the health district of Kaya.

3.2 Design

Cross-sectional surveys using desk review, qualitative and quantitative research methods:
* Individual in-depth Interviews
* Focus group discussions
* Household surveys for the assessment of malaria-related morbidity and mortality at community level as well as the healthcare system utilisation
* Health facility-based surveys for malaria-related morbidity and mortality, the availability and use of antimalarial drugs and malaria rapid diagnostic tests.
* Costs assessments.

3.3 Duration

Four months.
4. Post-evaluation phase

4.1 Objectives

Communicating and disseminating the findings of the pilot implementation of multiple first-lines artemisinin-based combination therapies for uncomplicated malaria in the health district of Kaya, Burkina Faso;

4.2 Methodology

* Feedback meetings for reporting to local communities
* National workshop aiming at reporting the programme findings
* Final report to be submitted to the donor
* Oral presentations of findings at congresses, conferences, seminars and publication of findings in peer-reviewed scientific journals

Conditions

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Malaria

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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Children under-five

Uncomplicated malaria case in this group will be managed using Pyronaridine-Artesunate at health facility level. This drug is registered in Burkina Faso for routine medical care for uncomplicated malaria case.

No interventions assigned to this group

Individuals five years of age and above

Uncomplicated malaria case in this group will be managed using Dihydoartemisinin-Piperaquine health facility level. This drug is registered in Burkina Faso for routine medical care for uncomplicated malaria case.

No interventions assigned to this group

Pregnant women

Uncomplicated malaria case in this group will be managed using Artemether-Lumefantrin health facility level. This drug is registered in Burkina Faso for routine medical care for uncomplicated malaria case.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

Household survey

* Caregivers, adults, pregnant women
* Signed consent form

Exclusion Criteria

\-
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Medicines for Malaria Venture

OTHER

Sponsor Role collaborator

National Malaria Control Programme (NMCP), Burkina Faso

UNKNOWN

Sponsor Role collaborator

Institut de Recherche en Sciences de la Sante, Burkina Faso

OTHER_GOV

Sponsor Role collaborator

Groupe de Recherche Action en Sante

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mohamadou Siribié, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Groupe de Recherche Action en Sante

André-Marie Tchouatieu, MD

Role: PRINCIPAL_INVESTIGATOR

Medicine for Malaria Venture (MMV)

Locations

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Groupe de Recherche Action en Santé

Ouagadougou, , Burkina Faso

Site Status

Countries

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Burkina Faso

References

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Boni MF, White NJ, Baird JK. The Community As the Patient in Malaria-Endemic Areas: Preempting Drug Resistance with Multiple First-Line Therapies. PLoS Med. 2016 Mar 29;13(3):e1001984. doi: 10.1371/journal.pmed.1001984. eCollection 2016 Mar.

Reference Type RESULT
PMID: 27022739 (View on PubMed)

Boni MF, Smith DL, Laxminarayan R. Benefits of using multiple first-line therapies against malaria. Proc Natl Acad Sci U S A. 2008 Sep 16;105(37):14216-21. doi: 10.1073/pnas.0804628105. Epub 2008 Sep 9.

Reference Type RESULT
PMID: 18780786 (View on PubMed)

Kabore JMT, Siribie M, Hien D, Soulama I, Barry N, Nombre Y, Dianda F, Baguiya A, Tiono AB, Burri C, Tchouatieu AM, Sirima SB. Attitudes, practices, and determinants of community care-seeking behaviours for fever/malaria episodes in the context of the implementation of multiple first-line therapies for uncomplicated malaria in the health district of Kaya, Burkina Faso. Malar J. 2022 May 30;21(1):155. doi: 10.1186/s12936-022-04180-z.

Reference Type DERIVED
PMID: 35637506 (View on PubMed)

Siribie M, Tchouatieu AM, Soulama I, Kabore JMT, Nombre Y, Hien D, Kiba Koumare A, Barry N, Baguiya A, Hema A, Dianda F, Savadogo Y, Kouanda S, Tiono AB, Sirima SB. Protocol for a quasi-experimental study to assess the feasibility, acceptability and costs of multiple first-lines artemisinin-based combination therapies for uncomplicated malaria in the Kaya health district, Burkina Faso. BMJ Open. 2021 Feb 15;11(2):e040220. doi: 10.1136/bmjopen-2020-040220.

Reference Type DERIVED
PMID: 33589447 (View on PubMed)

Other Identifiers

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MFTs-ACTs-BF (PO17/01110)

Identifier Type: -

Identifier Source: org_study_id

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