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Schistosomiasis HematobiumPhase 3FreebiLyGABNCT03779347

Schistosomiasis Diagnosis Using a CAA Antigen Test

A Phase 3 study testing Praziquantel, UCP-LF CAA and composite diagnostic in people with Schistosomiasis Hematobium and Diagnostic, run by Centre de Recherche Médicale de Lambaréné at 2 sites in Gabon.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Schistosomiasis is one of most important human parasitic diseases worldwide. Pregnant women and their infants are two vulnerable population groups, particularly in sub-Saharan Africa, where - amongst other infectious agents - they are heavily exposed to infections with S. haematobium. Read more about this study

Who is it for?
Any age, women only
What is being tested?
Praziquantel, UCP-LF CAA and composite diagnostic
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
2 sitesGabon
Study dates
1 May 2019to 1 May 2022
Phase
Phase 3
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 Any age
  • Women only
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Pregnant women with a gestational age comprised between 16 and 30 weeks (based on last date of menses)
  • Willing to deliver in one of the four maternities: three in Lambaréné and one in Fougamou
  • Provide a written informed consent for both themselves and for newborn follow-up or the written informed consent by the legal guardian if pregnant woman is a minor

Who cannot join

  • - Willing to move out of the study area within the coming 24 months
  • Known having a medically confirmed complicated pregnancy a complicated pregnancy.

Trial locations and contacts

2 sites in 1 country.

Ayola A ADEGNIKA, MD, PhD contact

+24106244472

aadegnika@cermel.org

Josiane Y Honkpehedji, MD contact

+24104584616

hyjosy@gmail.com

Gabon2 sites, 2 recruiting
  • Centre de Recherches Médicales de Lambaréné

    Lambaréné, Moyen-Ogooué Province, BP 242

    Ayola A ADEGNIKA, PhD, 06244472, aadegnika@cermel.org

    Jean C Dejon, MD

    Not yet recruiting
  • Centre de Recherches Medicales de Lambaréné

    Lambaréné

    Ayola A ADEGNIKA, +24106244472, aadegnika@cermel.org

    Recruiting

Other trials in Gabon

About this study

Official title: Prospective, Observational Study to Assess the Performance of CAA Measurement as a Diagnostic Tool for the Detection of Schistosoma Haematobium Infections in Pregnant Women and Their Newborn and Child in Lambaréné, Gabon

Schistosomiasis is one of most important human parasitic diseases worldwide. Pregnant women and their infants are two vulnerable population groups, particularly in sub-Saharan Africa, where - amongst other infectious agents - they are heavily exposed to infections with S. haematobium. Adoption of the recommendation and implementation by national disease control programs was however delayed in most African countries, due to the lack of safety data in humans and in the unborn babies. First results from randomized controlled trials with PZQ in pregnant women meanwhile have provided evidence for the safety of PZQ also in newborns.

In Gabon, S. haematobium is the primarily prevalent Schistosoma species infection. As it is true for most of observational and interventional studies on schistosomiasis, the power of the study is weakened due to the low sensitivity of reference schistosomiasis diagnosis applied, and one might correctly assume that a considerable proportion of samples were misclassified as negative in the control groups. Therefore, diagnostic tests that are highly sensitive and specific are essential to the detection of Schistosoma infections and are urgently needed for a test-and-treat strategy to control schistosomiasis in pregnancy as well as tools to determine efficacy of new interventions tested in clinical trials. Circulating anodic antigen (CAA) and circulating cathodic antigen (CCA) have levels correlating with the number of worms and have also been shown to clear within a few days or weeks after successful treatment. Assays measuring serum levels of these antigens (POC-CCA, UCP-LF CAA) are therefore deemed to assess drug efficacy.

Based on above mentioned tools, we decided to assess the accuracy of CAA measurement to determine the Schistosoma infection in two specific conditions: A) as a diagnostic tool for S. haematobium to prepare for the future implementation of a PZQ test-and-treat strategy and B) as a diagnostic tool to measure efficacy of praziquantel in schistosomiasis and pregnancy intervention trials.

Read the detailed description

Study design

The freeBILy-GAB study is a set of interlinked prospective, observational studies conducted in Gabon to comprehensively assess the performance of CAA measurement for the detection of S. haematobium infections in pregnant women and infants. The study is composed of 3 sub-studies each targeted to assess a specific objective (see figure 1 for a schematic trial design, procedures and stages). The study activities will also contribute to safety reporting of PZQ use in pregnant women.

Sub-study A: At baseline, a diagnostic study will be conducted that will also allow to select sub-study B study participants. The approach is a prospective, cross-sectional, observational study conducted in pregnant women to determine the sensitivity and specificity of the UCP-LF CAA test for the detection of S. haematobium infections using urine samples. In the absence of a sensitive reference standard test, the index test (UCP-LF CAA) will be compared against a composite diagnostic reference test based on extensive egg microscopy, serology, qPCR on egg DNA, and POC-CCA. Sampling will include standardized urine collection of 3 consecutive days for S. haematobium diagnosis by egg microscopy, UCP-LF CAA testing, qPCR, and POC-CCA, one (1) stool sample (within the 3 days of urine sampling) to control for S. intercalatum and soil-transmitted helminths infections, and 1 blood sample (within the 3 days of urine sampling) to measure anti-Schistosoma antibodies and to detect any other parasitic infections endemic in the region including filarial and Plasmodia spps. and to provide blood cell counts and hemoglobin to assess pregnant women health status. The laboratory staff involved in performing the laboratory assays using the new techniques will be trained prior to the start of the study. Volunteers positive for any parasitic infection except filaria will be treated for the respective parasitic infection (S. haematobium, STH and malaria parasites) following national treatment guidelines. Women positive for S. haematobium by egg microscopy or UCP-LF CAA at baseline will receive either PZQ treatment (1x 40 mg/kg) within 7 days after the third urine sample (early PZQ treatment) or after delivery (late PZQ treatment) following an allocation ratio of 3:1. The late PZQ treatment group serves as a safety control group of PZQ administration to pregnant women and exposure of their offspring (s). Maternal and perinatal safety and efficacy outcomes will be assessed. For efficacy in offspring, birthweight (with low birthweight defined as weight at birth <2.5 kg) and small gestational age (used as an indicator for possible intrauterine growth restriction) will be investigated. In addition, the exposure to PZQ during pregnancy will be evaluated in infants at the age of 12 and 24 months. For efficacy in mothers, maternal anemia (defined as Hb < 11 g/dl) at inclusion and at delivery will be investigated.

Sub-study B is an observational, follow-up study of pregnant women infected with S. haematobium by egg microscopy and/or UCP-LF CAA test and treated with PZQ or intended for late PZQ treatment (see sub-study A). The aim of this sub-study is to assess if the UCP-LF CAA test can be used to evaluate treatment efficacy of PZQ during pregnancy. Women positive for S. haematobium by egg microscopy and/or UCP-LF CAA test and treated with PZQ (see sub-study A) will be actively followed-up. Urine will be collected on day 2, day 4 and day 6 after PZQ treatment to determine the kinetics of CAA decay and then once a week until both egg microscopy as well UCP-LF CAA assay become negative but no longer than 6 weeks after PZQ treatment.

Sub-study C is an observational, longitudinal study on mothers and their newborn babies. This sub-study aims to determine the incidence of S. haematobium infections and age to first S. haematobium infection in life time in infants born from mothers included in the study. Therefore, between 6 and 24 months post-delivery, mother and her infant will be asked to provide urine every three month until UCP-LF CAA test becomes positive for S. haematobium detection. In addition a questionnaire addressing water contact of mother and infant will be applied. If UCP-LF CAA test becomes positive, mothers will be treated with 1x 40 mg/kg PZQ.

Furthermore, outcome of PZQ treatment during pregnancy on infant development will be assessed at the age of 12 and 24 months after delivery in the two groups (early and late PZQ treatment groups). This allows for a comparison to the freeBILy-MAD study in Madagascar.

Being tested
Praziquantel, UCP-LF CAA, composite diagnostic
Keywords
pregnancy, UPC-LF CAA, Schistosomiasis, children
Medical subject headings
Disease, Drug-Related Side Effects and Adverse Reactions, Schistosomiasis

What participants receive

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

  • PraziquantelDrug

    Also called PZQ

    Praziquantel to treat schistosomiasis during pregnancy

  • UCP-LF CAADiagnostic test

    Also called CAA

    UCP-LF CAA to diagnose Schistosomiasis during pregnancy

  • composite diagnosticDiagnostic test

    Also called Composite

    composite diagnostic reference test based on extensive egg microscopy, serology, qPCR on egg DNA, and POC-CCA to diagnose Schistosomiasis during pregnancy

Study groups in NCT03779347
Study groupRoleWhat they receive
Schistosomiasis treated during pregnancyExperimentalPraziquantel 40mg/kg once will be given during pregnancy at second to third trimester
Receives: Drug: Praziquantel
Schistosomiasis treated after pregnancyActive comparatorPraziquantel 40mg/kg once will be given to parturient after delivery during lactation
Receives: Drug: Praziquantel
All study participantsExperimentalUCP-LF CAA and composite diagnostic reference test based on extensive egg microscopy, plus serology, plus qPCR on egg DNA, and plus POC-CC will be used to detect schistosomiasis infection in pregnant women
Receives: Diagnostic Test: UCP-LF CAA; Diagnostic Test: composite diagnostic

What is being measured

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

  1. UPC-LF CAA performance

    Test performance of the UCP-LF CAA test for the detection of S. haematobium infection in pregnancy (sub-study A)

    Measured: first two years of the study

  2. Egg reduction rate

    Egg reduction rate after PZQ treatment (sub-study B)

    Measured: first two years of the study

  3. CAA reduction rate

    CAA reduction and after PZQ treatment (sub-study B)

    Measured: first two years of the study

  4. Prevalence of S. hematobium in children using UCP-LF CAA

    Prevalence of S. haematobium infections in infants below two years of age in our study areas as determined by UCP-LF CAA test (sub-study C)

    Measured: last two years of the study

  5. Prevalence of S. hematobium in children using microscopy

    Prevalence of S. haematobium infections in infants below two years of age in our study areas as determined by egg microscopy

    Measured: last two years of the study

Secondary outcomes (3)
  1. Clinical safety assessment upon PZQ intake

    Adverse events related and or unrelated to PZQ administration to pregnant women will be assessed clinically:

    • During pregnancy
    • At delivery
    • During the first two years of unborn child

    Measured: anytime after drug administration until the last born child reach two years old.

  2. Efficacy rate using microscopy

    PZQ Cure rate for S. haematobium treatment in pregnancy (sub-study B) assessed by microscopy test

    Measured: first two years of the study

  3. Efficacy rate using UCP-LF CAA test

    PZQ Cure rate for S. haematobium treatment in pregnancy (sub-study B) assessed by UCP-LF CAA test

    Measured: first two years of the study

Timeline

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

  1. First posted19 Dec 2018
  2. Study start1 May 2019
  3. Primary completion1 Apr 2022 (estimated)
  4. Study completion1 May 2022 (estimated)

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 3
Primary purpose
Diagnosis
Allocation
Randomised
Intervention model
Factorial
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03779347
Sponsor's protocol ID
FreebiLyGAB
Acronym
FreebiLyGAB
Status last verified
Jul 2021
First submitted
8 Dec 2018
Last updated
27 Jul 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Honkpehedji YJ, Adegnika AA, Dejon-Agobe JC, Zinsou JF, Mba RB, Gerstenberg J, Rakotozandrindrainy R, Rakotoarivelo RA, Rasamoelina T, Sicuri E, Schwarz NG, Corstjens PLAM, Hoekstra PT, van Dam GJ, Kreidenweiss A; freeBILy Consortium. Prospective, observational study to assess the performance of CAA measurement as a diagnostic tool for the detection of Schistosoma haematobium infections in pregnant women and their child in Lambarene, Gabon: study protocol of the freeBILy clinical trial in Gabon. BMC Infect Dis. 2020 Sep 29;20(1):718. doi: 10.1186/s12879-020-05445-1.

    PubMed 32993559

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Praziquantel, UCP-LF CAA and composite diagnostic in people with Schistosomiasis Hematobium and Diagnostic, run by Centre de Recherche Médicale de Lambaréné at 2 sites in Gabon.

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 3 inclusion and 2 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: status not confirmed, as of the sponsor's last update on 27 Jul 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Gabon. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Ayola A ADEGNIKA, MD, PhD (+24106244472, aadegnika@cermel.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

UPC-LF CAA performance (time frame: first two years of the study). The study lists 5 primary outcomes in all. 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 NCT03779347, which also lists 1 linked publication.

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 27 Jul 2021.

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