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Measles VaccinationPhase 4RE-CAMPNCT03460002

Vaccine Campaign Effects on General Hospital Admissions and Mortality Among Children

A Phase 4 study testing Measles vaccine and Oral polio vaccine in people with Measles Vaccination and Oral Polio Vaccine, run by Bandim Health Project at 1 site in Guinea-Bissau.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The world is set on eradicating measles and polio infections in the coming decade. Once both infections are under control, campaigns with measles and oral polio vaccines will be phased out. This might do more harm than good for child survival in low-income countries. Read more about this study

Who is it for?
Ages 0 to 59 monthsHealthy volunteers can take part
What is being tested?
Measles vaccine and Oral polio vaccine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
28,612 participants
Where
1 siteGuinea-Bissau
Study dates
Nov 2016to Aug 2022
Phase
Phase 4
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 0 to 59 months
  • All sexes
  • Healthy volunteers accepted
  • Child

Who may be able to join

None listed.

Who cannot join

  • the child has temperature > 39.0◦C or a severe acute illness as defined by the examining nurse
  • OR
  • the child has as a mid upper arm circumference < 110 mm and is older than 6 months (most feasible local indicator of AIDS and chronic immunosuppressive disease)
  • OR
  • the child has experienced a severe allergic reaction after previous vaccination, drug or food.
  • OR
Show all 9Show fewer
  • the child is enrolled in an ongoing study of Bacillus Calmette Guerin vaccine and is < 2 months old
  • OR
  • For the RECAMP-MV trial: the child is enrolled in RECAMP-OPV

Trial locations and contacts

1 site in 1 country.

Guinea-Bissau1 site
  • Bandim Health Project

    Bissau

Other trials in Guinea-Bissau

About this study

Official title: A Cluster Randomized Controlled Trial on the Campaign Effect of Measles Vaccine and Oral Polio Vaccine on General Hospital Admissions and Mortality Among Children

The world is set on eradicating measles and polio infections in the coming decade. Once both infections are under control, campaigns with measles and oral polio vaccines will be phased out. This might do more harm than good for child survival in low-income countries. Studies from the Bandim Health Project in Guinea-Bissau, and elsewhere, have revealed, that the live measles and oral polio vaccines have beneficial non-specific effects, i.e. effects on child morbidity and mortality unrelated to prevention of the targeted diseases.

The campaigns are presumed to be most beneficial for children not reached by routine vaccination programs, as they are not already protected. However, studies show that prior routine or campaign vaccination may boost resistance against unrelated infections. If we phase out measles and oral polio campaigns after eradicating their target infections without considering the impact on child survival, the drastic decline in child mortality since 1990 could change direction. We will conduct the first cluster randomized controlled trial to evaluate the effect of measles and oral polio campaigns on general child morbidity and mortality via the Bandim Health Project. Bandim Health Project runs a Health and Demographic Surveillance System in Guinea-Bissau since 1978 and assesses child health interventions' real-life effects, via continuous registration of all interventions given to all children, and follow-up of individuals. We will conduct the trials in rural Guinea-Bissau monitoring all nine health regions.

Read more

The hypotheses are:

RECAMP-MV: Measles vaccination campaign in Guinea-Bissau reduce morbidity and mortality among children between 9 and 59 months of age by 80% during the subsequent 18 months in a context of limited measles infection.

RECAMP-OPV: Oral polio vaccination campaigns in Guinea-Bissau reduce morbidity and mortality among children between 0 and 8 months of age by 25% during the subsequent 12 months in a context with no polio infection.

Originally, the trials were meant to be implemented in 182 clusters, enrolling 21000 children. Following revised sample size calculations and discussions with the Data Safety and Monitoring Board, the number of clusters were increased to 222 and the planned number of enrolments increased from 21,000 to 28,000 (RECAMP-MV: 18000, RECAMP-OPV: 10000).

To explore the hypothesis that at least part of the beneficial non-specific effects of OPV is driven by changes in the gut and/or respiratory microbiome, we will collect microbiome samples in a sub-group:

A nasal swab and a rectal swab will be collected from 50 infants allocated to the intervention group, and 50 infants allocated to the control group. Two sample will be collected for each infant one when recruited for RECAMP-OPV and a second two months later.

Being tested
Measles vaccine, Oral polio vaccine
Keywords
Measles vaccine, Oral polio vaccine, Campaign, Child mortality, Child morbidity, Non-specific effects

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Measles vaccineBiological

    A measles vaccine prequalified from the World Health Organization will be administered in one dose by deep subcutaneous injection into the left subscapular region by a local nurse.

  • Oral polio vaccineBiological

    A bivalent oral polio vaccine prequalified by the World Health Organization will be administered in one or two doses directly into the mouth of the vaccinee with two drops per dose by a local nurse.

Study groups in NCT03460002
Study groupRoleWhat they receive
Measles vaccineExperimentalIn intervention villages children will be weighed and receive standard measles vaccine in one dose if they are between 9-59 months old.
Receives: Biological: Measles vaccine
Oral polio vaccineExperimentalIn intervention villages children will be weighed and receive standard oral polio vaccine in one or two doses if they are between 0-8 months old.
Receives: Biological: Oral polio vaccine
Weighing-MVNo interventionIn control villages children aged 9-59 months acting as controls to the MV-intervention arm will be weighed only.
Weighing-OPVNo interventionIn control villages children aged 0-8 months acting as controls to the OPV-intervention arm will be weighed only.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Composite outcome: mortality and hospital admission (measured as a rate)

    Death (registered through follow-up visits, verified by verbal autopsies) or first admission (overnight stay at hospital registered by interview at follow up visits)

    Correction: Non-accidental death (registered through follow-up visits, verified by verbal autopsies) or first admission not caused by accident (overnight stay at hospital registered by interview at follow up visits) The outcomes were correctly specified in the protocol paper and analysis plan (doi: 10.1186/s12889-019-7813-y)

    Measured: Enrolment to end of study (longest follow-up 2 years)

Secondary outcomes (3)
  1. Nutritional status

    Mid-upper-arm-circumference registered with measurement tape as per UNICEF recommendations

    Measured: Enrolment to end of study (longest follow-up 2 years)

  2. Mortality

    Death (registered through follow-up visits, verified by verbal autopsies)

    Corrections: Non-accidental death (registered through follow-up visits, verified by verbal autopsies) The outcome was correctly specified in the protocol paper and analysis plan (doi: 10.1186/s12889-019-7813-y)

    Measured: Enrolment to end of study (longest follow-up 2 years)

  3. Hospital admission

    admission (overnight stay at hospital registered by interview at follow up visits)

    Correction: admission not caused by accident (overnight stay at hospital registered by interview at follow up visits) The outcome was correctly specified in the protocol paper and analysis plan (doi: 10.1186/s12889-019-7813-y)

    Measured: Enrolment to end of study (longest follow-up 2 years)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Mar 2018
  2. Study startNov 2016
  3. Primary completionOct 2021
  4. Study completionAug 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
The RECAMP trials test two separate hypotheses relating to the potential beneficial non-specific effects of providing live vaccines in general vaccination campaigns. The RECAMP-MV trial tests the effect of a Measles Vaccination campaign among children aged 9-59 months The RECAMP-OPV trial tests the effect of an Oral Polio Vaccination campaign in children aged 0-8 months
Masking
Single blind
Who is masked
Care provider
Enrolment
28,612 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03460002
Sponsor's protocol ID
RE-CAMP
Acronym
RE-CAMP
Status last verified
Aug 2024
First submitted
21 Nov 2016
Last updated
3 Sep 2024
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • World Health Organization. Global measles and rubella strategic plan: 2012-2020. 2012.

  • World Health Organization. Polio eradication and endgame strategic plan: 2013-2018. 2013.

  • Meeting of the Strategic Advisory Group of Experts on immunization, October 2015 - conclusions and recommendations. Wkly Epidemiol Rec. 2015 Dec 11;90(50):681-99. No abstract available. English, French.

    PubMed 26685390
  • Kristensen I, Aaby P, Jensen H. Routine vaccinations and child survival: follow up study in Guinea-Bissau, West Africa. BMJ. 2000 Dec 9;321(7274):1435-8. doi: 10.1136/bmj.321.7274.1435.

    PubMed 11110734
  • Aaby P, Samb B, Simondon F, Seck AM, Knudsen K, Whittle H. Non-specific beneficial effect of measles immunisation: analysis of mortality studies from developing countries. BMJ. 1995 Aug 19;311(7003):481-5. doi: 10.1136/bmj.311.7003.481.

    PubMed 7647643
  • Aaby P, Garly ML, Bale C, Martins C, Jensen H, Lisse I, Whittle H. Survival of previously measles-vaccinated and measles-unvaccinated children in an emergency situation: an unplanned study. Pediatr Infect Dis J. 2003 Sep;22(9):798-805. doi: 10.1097/01.inf.0000083821.33187.b5.

    PubMed 14506371
  • Aaby P, Martins CL, Garly ML, Bale C, Andersen A, Rodrigues A, Ravn H, Lisse IM, Benn CS, Whittle HC. Non-specific effects of standard measles vaccine at 4.5 and 9 months of age on childhood mortality: randomised controlled trial. BMJ. 2010 Nov 30;341:c6495. doi: 10.1136/bmj.c6495.

    PubMed 21118875
  • Lund N, Andersen A, Hansen AS, Jepsen FS, Barbosa A, Biering-Sorensen S, Rodrigues A, Ravn H, Aaby P, Benn CS. The Effect of Oral Polio Vaccine at Birth on Infant Mortality: A Randomized Trial. Clin Infect Dis. 2015 Nov 15;61(10):1504-11. doi: 10.1093/cid/civ617. Epub 2015 Jul 28.

    PubMed 26219694
  • Lund N, Biering-Sorensen S, Andersen A, Monteiro I, Camala L, Jorgensen MJ, Aaby P, Benn CS. Neonatal vitamin A supplementation associated with a cluster of deaths and poor early growth in a randomised trial among low-birth-weight boys of vitamin A versus oral polio vaccine at birth. BMC Pediatr. 2014 Aug 28;14:214. doi: 10.1186/1471-2431-14-214.

    PubMed 25163399
  • Martins CL, Benn CS, Andersen A, Bale C, Schaltz-Buchholzer F, Do VA, Rodrigues A, Aaby P, Ravn H, Whittle H, Garly ML. A randomized trial of a standard dose of Edmonston-Zagreb measles vaccine given at 4.5 months of age: effect on total hospital admissions. J Infect Dis. 2014 Jun 1;209(11):1731-8. doi: 10.1093/infdis/jit804. Epub 2014 Jan 16.

    PubMed 24436454
  • Sorup S, Benn CS, Poulsen A, Krause TG, Aaby P, Ravn H. Live vaccine against measles, mumps, and rubella and the risk of hospital admissions for nontargeted infections. JAMA. 2014 Feb 26;311(8):826-35. doi: 10.1001/jama.2014.470.

    PubMed 24570246
  • Sorup S, Stensballe LG, Krause TG, Aaby P, Benn CS, Ravn H. Oral Polio Vaccination and Hospital Admissions With Non-Polio Infections in Denmark: Nationwide Retrospective Cohort Study. Open Forum Infect Dis. 2015 Dec 17;3(1):ofv204. doi: 10.1093/ofid/ofv204. eCollection 2016 Jan.

    PubMed 26885538
  • Aaby P, Hedegaard K, Sodemann M, Nhante E, Veirum JE, Jakobsen M, Lisse I, Jensen H, Sandstrom A. Childhood mortality after oral polio immunisation campaign in Guinea-Bissau. Vaccine. 2005 Feb 25;23(14):1746-51. doi: 10.1016/j.vaccine.2004.02.054.

    PubMed 15705481
  • Andersen A, Fisker AB, Rodrigues A, et al. National immunization campaigns with oral polio vaccine (OPV) reduce the general all-cause mortality rate: An analysis of the effect of campaign-OPV on child mortality within seven randomised trials (submitted). 2016.

  • Fisker AB, Rodrigues A, Martins C, Ravn H, Byberg S, Thysen S, Storgaard L, Pedersen M, Fernandes M, Benn CS, Aaby P. Reduced All-cause Child Mortality After General Measles Vaccination Campaign in Rural Guinea-Bissau. Pediatr Infect Dis J. 2015 Dec;34(12):1369-76. doi: 10.1097/INF.0000000000000896.

    PubMed 26379164

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Measles vaccine and Oral polio vaccine in people with Measles Vaccination and Oral Polio Vaccine, run by Bandim Health Project at 1 site in Guinea-Bissau.

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 0 inclusion and 9 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 3 Sep 2024. 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 Guinea-Bissau. 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.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

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.

What does the primary outcome measure?

Composite outcome: mortality and hospital admission (measured as a rate) (time frame: Enrolment to end of study (longest follow-up 2 years)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03460002, which also lists 42 linked publications.

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 3 Sep 2024.

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