Test Efficacy Study on the Recommended Antimalarial Drugs in the Democratic Republic of the Congo

NCT ID: NCT06076213

Last Updated: 2024-11-05

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE4
• Total Enrollment: 1260 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-05-01
• Study Completion Date: 2024-09-30

Brief Summary

Malaria remains a public health concern, despite efforts that are invested in the disease control. The Democratic Republic of the Congo (DRC) is one of the most affected countries in Sub Saharan Africa. Artemisinin-based combination treatments (ACTs) are recommended for the treatment of uncomplicated malaria. However, reported cases of mutations that confer to Plasmodium falciparum resistance to artemisinin (the main component of ACTs) constitute a threat to malaria control, particularly in Sub Saharan Africa. Therefore, the recommendation of the World Health Organization to conduct regularly test efficacy studies in endemic countries is paramount.

The purpose of this trial is to assess efficacy and safety of artesunate-amodiaquine (ASAQ Winthrop®) and artemether-lumefantrine (Coartem Dispersible®) at day 28 for the treatment of uncomplicated Plasmodium falciparum malaria in eight surveillance sites around DRC.

Detailed Description

This is a phase IV, randomized, open label, 2-arm trial. It will be performed in eight malaria sentinel sites around DRC. Children aged 6 to 59 months with confirmed Plasmodium falciparum uncomplicated malaria will be enrolled after informed consent granted by a parent or guardian. They will be randomized to receive either artesunate-amodiaquine or artemether lumefrantrine during 3 days (directly observed treatment) and then followed up until day 28. At each visit, clinical examination (including collection of safety data) will be done and malaria testing as well. Dried blood spots will also be prepared whenever microscopy is performed, in order to assess resistance markers and perform the genotyping of the parasite for PCR-adjusted efficacy. Hemoglobin level will be measured on the recruitment day and then every two weeks until day 28.

Conditions

Uncomplicated Plasmodium Falciparum Malaria

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Artesunate-amodiaquine

tablets of ASAQ Winthrop®

Group Type: EXPERIMENTAL

Artesunate-amodiaquine

Intervention Type: DRUG

Tablets

Artemether-lumefantrine

tablets of Coartem Dispersible®

Group Type: EXPERIMENTAL

Artemether-lumefantrine

Intervention Type: DRUG

Tablets

Interventions

Artesunate-amodiaquine

Tablets

Intervention Type: DRUG

Artemether-lumefantrine

Tablets

Intervention Type: DRUG

Other Intervention Names

ASAQ Winthrop®; Coartem Dispersible®

Eligibility Criteria

Inclusion Criteria

• children aged 6 to 59 months
• monoinfection with Plasmodium falciparum with asexual parasite count of 2,000 to 200,000/µL
• axillary temperature ≥ 37.5 °C
• ability to swallow oral medication
• ability and willingness to comply with the protocol for the duration of the study and to comply with the study visit schedule;
• informed consent from a parent or a guardian
• living within the study catchment area
• absence of severe manutrition
• absence of infectious diseases that can be responsible of fever
• absence of allergy to the study drugs

Exclusion Criteria

• presence of general danger signs or signs of severe falciparum malaria according to the definitions of WHO;
• body weight < 5kg
• hemoglobin level < 5g/ dL or hematocrit < 15%
• presence of severe malnutrition
• presence of febrile conditions due to diseases other than malaria (e.g. measles, acute lower respiratory tract infection, severe diarrhoea with dehydration) or other known underlying chronic or severe diseases (e.g. cardiac, renal and hepatic diseases, HIV/AIDS);
• regular medication, which may interfere with antimalarial pharmacokinetics;
• malaria treatment within 2 days prior to recruitment
• history of hypersensitivity reactions or contraindications to any of the medicines being tested or used as alternative treatment;
• body weight below 5 kg

• Minimum Eligible Age: 6 Months
• Maximum Eligible Age: 59 Months
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Centers for Disease Control and Prevention

FED

Sponsor Role: collaborator

Global Fund

OTHER

Sponsor Role: collaborator

Ministry of Public Health, Democratic Republic of the Congo

OTHER_GOV

Sponsor Role: lead

Responsible Party

Prof. Gauthier Mesia Kahunu

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Centre de santé de Coopération

Kimpese, Bas-Congo Province, Democratic Republic of the Congo

Centre de santé Lupidi 1

Kapolowe, Haut-Katanga, Democratic Republic of the Congo

Centres de santé de Mikalayi et Matamba

Kazumba, Kasai-Central, Democratic Republic of the Congo

Centre de Santé de Vanga

Vanga, Kwilu, Democratic Republic of the Congo

Centre de santé de Kalima

Kalima, Maniema Province, Democratic Republic of the Congo

Centres de santé Umoja et Foyer social

Kabondo, Tshopo, Democratic Republic of the Congo

Centre de santé Boende 2 Nsele

Boende, Tshuapa, Democratic Republic of the Congo

Countries

Democratic Republic of the Congo

Other Identifiers

ASAQ-AL 2022

Identifier Type: -

Identifier Source: org_study_id