Serological Testing and Treatment for Plasmodium Vivax Malaria: a Trial in Ethiopia and Madagascar

NCT ID: NCT06923592

Last Updated: 2025-09-10

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

19200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-12

Study Completion Date

2027-04-28

Brief Summary

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The resilience of P. vivax to malaria elimination efforts is due to its ability to form dormant liver stages (hypnozoites) that reactivate weeks to months after the initial infection causing recurrent episodes of malaria (relapses) and ongoing parasite transmission. Relapses account for a majority of recurrent infections and clinical cases of P. vivax malaria, and therefore have a significant effect on morbidity at the individual level.

With current technology, it is not possible to directly measure hypnozoite biomarkers. Rather than directly detecting hypnozoites, our team developed an indirect approach by measuring antibodies induced by the primary blood-stage infection. Antibodies to different blood-stage antigens decay at different rates. Measuring antibodies to a carefully selected panel of P. vivax antigens can aid to identify individuals who have been infected within the previous 9 months (approximately the lifespan of hypnozoites).

A serological test based on selected P. vivax antigens can detect recent exposure and predict future relapses. Coupling this test with a safe and efficacious primaquine treatment regimen, results in a population-based intervention to target the hypnozoite reservoir. This intervention is referred to as Plasmodium vivax Serological Testing and Treatment (PvSeroTAT).

PvSTATEM is a cluster randomised trial in Madagascar and Ethiopia. This study will provide insights into the feasibility, acceptability, and efficacy of the PvSeroTAT approach. In this study, individuals, randomised by clusters, will be tested for the presence of serological markers of a recent P. vivax infection, followed by a targeted drug treatment intervention aimed at killing P. vivax hypnozoites.

Detailed Description

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In each country, 24 clusters (48 clusters in total) will be randomly allocated using computer generated numbers to one of the two interventions:

Arm 1 (PvSeroTAT intervention) or Arm 2 (Control arm). Within each cluster, approximately 400 participants (range 100-600) will be enrolled, based on the trial's inclusion and exclusion criteria. At baseline (month 0) and month 6 serology for P. vivax infections will be performed in all study participants. In the clusters in the PvSeroTAT arm, participants with a positive P. vivax serology at baseline or month 6 will be approached for treatment. First G6PD enzyme activity will be measured. If the enzyme activity is normal and no other contra-indication for treatment are found, the participants will be treated with 7 days of primaquine 0.5mg/kg/day and a three-day course of either chloroquine (Ethiopia) or artesunate-amodiaquine (Madagascar). It is possible that a participant could receive a radical P. vivax treatment at both baseline (month 0) and month 6. Participants will be monitored for side effects and adherence during the first 7 days after the start of antimalarial treatments. In addition, blood samples will be taken to measure hemoglobin levels to monitor for post-treatment hemolysis.

In the clusters in both arms, the incidence of malaria will be monitored through passive case detection in health posts up to 18 months after the first intervention. All cases that are detected during the passive case detection will be treated according to the national guidelines.

At month 12 and month 18 of the study, a cross sectional survey will be conducted in all study clusters. Blood samples will be taken to determine the prevalence of P. vivax and P. falciparum through PCR assays.

Conditions

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Malaria Vivax Malaria Falciparum Plasmodium Vivax Plasmodium Falciparum

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

In each country, 24 clusters (48 clusters in total) will be randomly allocated to one of the two interventions: Arm 1 (PvSeroTAT intervention) or Arm 2 (Control arm). Within each cluster, approximately 400 participants (range 100-600) that fulfill the inclusion and exclusion criteria will be enrolled. At baseline (month 0) and month 6 serology for P. vivax infections will be performed in all study participants. In the clusters in the PvSeroTAT arm, participants with a positive P. vivax serology at baseline or month 6 will be treated with 7 days of primaquine 0.5mg/kg/day and a three-day course of either chloroquine (Ethiopia) or artesunate-amodiaquine (Madagascar).
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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PvSeroTAT intervention

Group Type EXPERIMENTAL

PvSeroTAT

Intervention Type COMBINATION_PRODUCT

Two rounds (month 0 and month 6) of serological screening for antibodies against P. vivax in the blood of all eligible cluster inhabitants. In the clusters in the PvSeroTAT arm, participants with a positive P. vivax serology at baseline or month 6 will be treated with 7 days of primaquine 0.5mg/kg/day and a three-day course of either chloroquine (Ethiopia) or artesunate-amodiaquine (Madagascar).

Control arm

Group Type OTHER

Control

Intervention Type DIAGNOSTIC_TEST

Two rounds (month 0 and month 6) of serological screening for antibodies against P. vivax in the blood of a subset of eligible cluster inhabitants. Serological status will be assessed at a later stage (months later) and will not lead to treatment of sero-positive individuals.

Interventions

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PvSeroTAT

Two rounds (month 0 and month 6) of serological screening for antibodies against P. vivax in the blood of all eligible cluster inhabitants. In the clusters in the PvSeroTAT arm, participants with a positive P. vivax serology at baseline or month 6 will be treated with 7 days of primaquine 0.5mg/kg/day and a three-day course of either chloroquine (Ethiopia) or artesunate-amodiaquine (Madagascar).

Intervention Type COMBINATION_PRODUCT

Control

Two rounds (month 0 and month 6) of serological screening for antibodies against P. vivax in the blood of a subset of eligible cluster inhabitants. Serological status will be assessed at a later stage (months later) and will not lead to treatment of sero-positive individuals.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Participant will remain in the study area for at least the next month.
* Participant is older than 12 months

Exclusion Criteria

• Participant is unwilling to participate.
Minimum Eligible Age

12 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut Pasteur

INDUSTRY

Sponsor Role collaborator

Institut Pasteur de Madagascar

OTHER

Sponsor Role collaborator

Armauer Hansen Research Institute (AHRI), Ethiopia

UNKNOWN

Sponsor Role collaborator

London School of Hygiene and Tropical Medicine

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Chris Drakeley

Role: PRINCIPAL_INVESTIGATOR

London School of Hygiene and Tropical Medicine

Michael T White

Role: PRINCIPAL_INVESTIGATOR

Institut Pasteur

Rindra Randremanana

Role: PRINCIPAL_INVESTIGATOR

Institut Pasteur de Madagascar

Fitsum G Tadesse

Role: PRINCIPAL_INVESTIGATOR

Armauer Hansen Research Institute

Locations

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Armauer Hansen Research Institute

Addis Ababa, , Ethiopia

Site Status NOT_YET_RECRUITING

Institut Pasteur de Madagascar

Antananarivo, , Madagascar

Site Status RECRUITING

Countries

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Ethiopia Madagascar

Central Contacts

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Rob W van der Pluijm

Role: CONTACT

0033145688000

Facility Contacts

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Fitsum T Girma, PhD

Role: primary

+251113483752

Rindra Randremanana, PhD

Role: primary

+261209741272

Related Links

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https://www.pvstatem.eu

PvSTATEM project website

Other Identifiers

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29643

Identifier Type: -

Identifier Source: org_study_id

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