MalariaNCT01240603
Plasmodium Falciparum Clearance Rates in Response to Artesunate in Eastern Cambodia
An observational study of Malaria, run by National Institute of Allergy and Infectious Diseases (NIAID) at 1 site in Cambodia.
Trial summary
Plasmodium falciparum parasite clearance rates (PCRs) after oral artesunate treatment of patients with uncomplicated malaria were recently found to be significantly slower in Pailin (Western Cambodia) compared to Wang Pha (Eastern Thailand). Read more about this study
- Who is it for?
- Ages 1 year and older
- Conditions the study is for
- Malaria
- How many people
- 415 participants
- Where
- 1 siteCambodia
- Study dates
- 24 Oct 2010to 11 Sep 2013
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 1 year and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Age 2 to 65 years, inclusive
- Uncomplicated P. falciparum malaria.
- Tympanic temperature greater than or equal to 37.5 degree C or history of fever within the last 24 h.
- calciparum asexual parasite density 10,000 200,000/microL, Inclusive.
- Willingness to allow the storage of blood samples collected as part of the study.
- Willingness and ability of the patient/guardians to comply with the protocol for the duration of the study.
Who cannot join
- Severe malaria: diminished consciousness, respiratory distress, severe prostration, anuria, jaundice, hemoglobinuria, repetitive vomiting, or cessation of eating and drinking.
- Non-malaria etiology of febrile illness (e.g., respiratory tract infection) evident on clinical examination.
- Hematocrit < 25 percent
- Treatment of present symptoms with an artemisinin compound or artemisinin-based combination therapy within the previous 7 days.
- Pregnancy or breastfeeding
- History or allergy or known contraindication to artemisinins or piperaquine
- Splenectomy.
Trial locations and contacts
1 site in 1 country.
Cambodia1 site
National Center for Parasitology, Entomology, and Malaria Controk, Ministry of H
Phnom Penh
About this study
Plasmodium falciparum parasite clearance rates (PCRs) after oral artesunate treatment of patients with uncomplicated malaria were recently found to be significantly slower in Pailin (Western Cambodia) compared to Wang Pha (Eastern Thailand). This difference in PCRs has been attributed to different histories of artesunate drug pressure in the two areas. In Pailin, artesunate monotherapy has been used inappropriately for 30 years and is hypothesized to have selected for artemisinin-resistant parasites (slow PCRs). To investigate the potential contribution of human factors to the artemisinin resistance phenotype, we have identified a study site in Eastern Cambodia where artemisinin-resistant parasites are not believed to be present. The main aims of this study are to 1) determine whether the artemisinin resistance phenotype (i.e., a half-life longer than the 2-hour half-life observed in Wang Pha) is present in Eastern Cambodia, 2) determine whether hemoglobin E affects parasite clearance rates in vivo, 3) determine whether age-associated acquired immunity affects parasite clearance rates in vivo, and 4) identify parasite-heritable traits that are associated with slow parasite clearance rates in vivo. To meet these aims, we are conducting a prospective, longitudinal study to recruit Cambodian residents of Lumphat District in Ratanakiri Province who complain of fever and/or symptoms of malaria. Patients diagnosed with uncomplicated malaria will be treated with weight-based doses of artesunate given orally each day for 3 days followed by mefloquine given orally for 2 days. During this time, finger prick blood smears will be obtained every 6 hours until parasite density is zero. From these data, we will estimate parasite clearance rates using a half-life parameter. We will also collect parasitized red blood cell samples from malaria patients prior to antimalarial drug administration. These parasites will be tested in short-term in vitro culture experiments to determine their susceptibility to artemisinins and other antimalarial drugs.
Read the detailed description
Plasmodium falciparum parasite clearance rates (PCRs) after oral artesunate treatment of patients with uncomplicated malaria were recently found to be significantly slower in Pailin (Western Cambodia) compared to Wang Pha (Eastern Thailand). This difference in PCRs has been attributed to different histories of artesunate drug pressure in the two areas. In Pailin, artesunate monotherapy has been used inappropriately for 30 years and is hypothesized to have selected for artemisinin-resistant parasites (slow PCRs). To investigate the potential contribution of human factors to the artemisinin resistance phenotype, we have identified a study site in Eastern Cambodia where artemisinin-resistant parasites are not believed to be present. The main aims of this study are to 1) determine whether the artemisinin resistance phenotype (i.e., a half-life longer than the 2-hour half-life observed in Wang Pha) is present in Eastern Cambodia, 2) determine whether hemoglobin E affects parasite clearance rates in vivo, 3) determine whether age-associated acquired immunity affects parasite clearance rates in vivo, and 4) identify parasite-heritable traits that are associated with slow parasite clearance rates in vivo. To meet these aims, we are conducting a prospective, longitudinal study to recruit Cambodian residents of Lumphat District in Ratanakiri Province who complain of fever and/or symptoms of malaria. Patients diagnosed with uncomplicated malaria will be treated with weight-based doses of artesunate given orally each day for 3 days followed by mefloquine given orally for 2 days. During this time, finger prick blood smears will be obtained every 6 hours until parasite density is zero. From these data, we will estimate parasite clearance rates using a half-life parameter. We will also collect parasitized red blood cell samples from malaria patients prior to antimalarial drug administration. These parasites will be tested in short-term in vitro culture experiments to determine their susceptibility to artemisinins and other antimalarial drugs.
- Conditions
- Malaria
- Keywords
- Artemisinin, Malaria, Drug Resistance, Hemoglobin E
- Medical subject headings
- Malaria
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Nov 2010 (estimated)
- Study start24 Oct 2010
- Study completion11 Sep 2013
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for MalariaStudies of the same condition, open and under way.
- More trials run by National Institute of Allergy and Infectious Diseases (NIAID)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Time perspective
- Prospective
- Enrolment
- 415 participants (actual)
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
- Collaborators
- National Centre for Parasitology, Entomology and Malaria Control, Cambodia
- Investigators
- Rick M Fairhurst, M.D., Principal investigator, National Institute of Allergy and Infectious Diseases (NIAID)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01240603
- Sponsor's protocol ID
- 999911017
- Other IDs
- 11-I-N017
- Status last verified
- 11 Sep 2013
- First submitted
- 11 Nov 2010
- Last updated
- 5 Apr 2018
- Results posted
- No
Study at a glance
From the registry record, last updated by the sponsor on 5 Apr 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Plasmodium Falciparum Clearance Rates in Response to Artesunate in Eastern Cambodia
- ClinicalTrials.gov ID
- NCT01240603
- Acronym / sponsor ID
- 999911017
- Conditions
- Malaria
- Keywords
- Artemisinin, Malaria, Drug Resistance, Hemoglobin E
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 415 participants (actual)
- Lead sponsor
- National Institute of Allergy and Infectious Diseases (NIAID)US National Institutes of Health
- Collaborators
- National Centre for Parasitology, Entomology and Malaria Control, Cambodia
- Study start
- 24 Oct 2010
- Study completion
- 11 Sep 2013
- First posted
- 15 Nov 2010 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Plasmodium falciparum parasite clearance rates (PCRs) after oral artesunate treatment of patients with uncomplicated malaria were recently found to be significantly slower in Pailin (Western Cambodia) compared to Wang Pha (Eastern Thailand). This difference in PCRs has been attributed to different histories of artesunate drug pressure in the two areas. In Pailin, artesunate monotherapy has been used inappropriately for 30 years and is hypothesized to have selected for artemisinin-resistant parasites (slow PCRs). To investigate the potential contribution of human factors to the artemisinin resistance phenotype, we have identified a study site in Eastern Cambodia where artemisinin-resistant parasites are not believed to be present. The main aims of this study are to 1) determine whether the artemisinin resistance phenotype (i.e., a half-life longer than the 2-hour half-life observed in Wang Pha) is present in Eastern Cambodia, 2) determine whether hemoglobin E affects parasite clearance rates in vivo, 3) determine whether age-associated acquired immunity affects parasite clearance rates in vivo, and 4) identify parasite-heritable traits that are associated with slow parasite clearance rates in vivo. To meet these aims, we are conducting a prospective, longitudinal study to recruit Cambodian residents of Lumphat District in Ratanakiri Province who complain of fever and/or symptoms of malaria. Patients diagnosed with uncomplicated malaria will be treated with weight-based doses of artesunate given orally each day for 3 days followed by mefloquine given orally for 2 days. During this time, finger prick blood smears will be obtained every 6 hours until parasite density is zero. From these data, we will estimate parasite clearance rates using a half-life parameter. We will also collect parasitized red blood cell samples from malaria patients prior to antimalarial drug administration. These parasites will be tested in short-term in vitro culture experiments to determine their susceptibility to artemisinins and other antimalarial drugs.
Detailed description
Plasmodium falciparum parasite clearance rates (PCRs) after oral artesunate treatment of patients with uncomplicated malaria were recently found to be significantly slower in Pailin (Western Cambodia) compared to Wang Pha (Eastern Thailand). This difference in PCRs has been attributed to different histories of artesunate drug pressure in the two areas. In Pailin, artesunate monotherapy has been used inappropriately for 30 years and is hypothesized to have selected for artemisinin-resistant parasites (slow PCRs). To investigate the potential contribution of human factors to the artemisinin resistance phenotype, we have identified a study site in Eastern Cambodia where artemisinin-resistant parasites are not believed to be present. The main aims of this study are to 1) determine whether the artemisinin resistance phenotype (i.e., a half-life longer than the 2-hour half-life observed in Wang Pha) is present in Eastern Cambodia, 2) determine whether hemoglobin E affects parasite clearance rates in vivo, 3) determine whether age-associated acquired immunity affects parasite clearance rates in vivo, and 4) identify parasite-heritable traits that are associated with slow parasite clearance rates in vivo. To meet these aims, we are conducting a prospective, longitudinal study to recruit Cambodian residents of Lumphat District in Ratanakiri Province who complain of fever and/or symptoms of malaria. Patients diagnosed with uncomplicated malaria will be treated with weight-based doses of artesunate given orally each day for 3 days followed by mefloquine given orally for 2 days. During this time, finger prick blood smears will be obtained every 6 hours until parasite density is zero. From these data, we will estimate parasite clearance rates using a half-life parameter. We will also collect parasitized red blood cell samples from malaria patients prior to antimalarial drug administration. These parasites will be tested in short-term in vitro culture experiments to determine their susceptibility to artemisinins and other antimalarial drugs.
Study design
- Time perspective
- Prospective
Who may qualify
- Ages
- 1 year and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (6 listed)
- Age 2 to 65 years, inclusive
- Uncomplicated P. falciparum malaria.
- Tympanic temperature greater than or equal to 37.5 degree C or history of fever within the last 24 h.
- calciparum asexual parasite density 10,000 200,000/microL, Inclusive.
- Willingness to allow the storage of blood samples collected as part of the study.
Key exclusion criteria (7 listed)
- Severe malaria: diminished consciousness, respiratory distress, severe prostration, anuria, jaundice, hemoglobinuria, repetitive vomiting, or cessation of eating and drinking.
- Non-malaria etiology of febrile illness (e.g., respiratory tract infection) evident on clinical examination.
- Hematocrit < 25 percent
- Treatment of present symptoms with an artemisinin compound or artemisinin-based combination therapy within the previous 7 days.
- Pregnancy or breastfeeding
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Not reported in the source record.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Apr 2018.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Rick M Fairhurst, M.D. principal investigator
National Institute of Allergy and Infectious Diseases (NIAID)
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Malaria, run by National Institute of Allergy and Infectious Diseases (NIAID) at 1 site in Cambodia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 5 Apr 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Cambodia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Apr 2018.