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PlagueSMARTPRTNCT04688996

Yersinia Pestis Lateral Flow Immunoassay for Blood Samples

An observational study of Plague and Plague, Bubonic, run by Brimrose Technology Corporation at 2 sites in 2 countries.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

Plague is a deadly but highly treatable disease caused by the bacterium Y. pestis. Due to the historical development of Y. pestis as a bioweapon by several nation states, it is listed by the US as a potential bioweapon that could be used against US warfighters. Read more about this study

Who is it for?
Ages 5 to 75 years
Conditions the study is for
Plague, Plague, Bubonic, Plague, Pneumonic
What is being tested?
Lateral Flow Assay for Pathogens of the Plague
How many people
500 participants
Where
2 sitesin 2 countries
Study dates
19 Oct 2020to Jan 2023
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 5 to 75 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: Malagasy Participants. Subjects will be recruited at rural health centers throughout Madagascar. Participants will be comprised of rural people with symptoms consistent with plague. The Madagascar Ministry of Public Health requires declaration of all suspected human plague cases and collection of biological samples (sputum and/or bubo aspirates) from these cases for medical workup for confirmation. USN Health Center Participants. The subject population will consist of active duty US Naval personnel and DoD beneficiaries presenting to participating study sites in the United States with influenza-like symptoms (fever, cough, sore throat). Since the US is non-endemic for plague, all participants will be presumed to be negative for Y. pestis.

Who may be able to join

  • Adults 18 to 75 years old (male and female): Able to receive and give verbal communication.
  • Children 5 to 17 years old (vulnerable population): Parents or legal guardian must be available to give permission. Parents or legal guardian to consent for children (5-6 years).
  • Suspected human plague case by local medical professional. Include at least one of the following: For bubonic plague: high fever, chills, and/or presence of painful bubo; For pneumonic plague: high fever, chills, cough for less than 5 days, bloody sputum, and/or chest pains; patients may be recruited from both plague surveillance program and non-plague surveillance programs.
  • Active duty personnel and DoD beneficiaries that present to participating study sites with influenza-like-illness (fever, cough, sore throat).
  • Age range >=13 to 75 y.o.
  • Able to receive/give consent (or assent if <18 y.o.) 4, Presenting with influenza-like-illness (fever of 100.5 F or higher, cough and/or sore throat)
  • 5. USN Special Categories: Minors/children (45CFR Subpt. D/DoDI 3216.02, Encl 3, Para 7d); Students; Active duty military personnel (3216.02, Encl.3 Para. 7.e); Economically disadvantaged persons (32CFR 219.11(b); Educationally disadvantaged persons (32CFR 219.11(b).

Who cannot join

  • Children under the age of 5 years old
  • Children between the age of 5 years to 17 years without a parent or legal guardian
  • Not compliant with the study procedure (blood sampling)
  • <13 y.o.
  • Unable to give written consent (if under 18)

Trial locations and contacts

2 sites in 2 countries.

David P Trudil contact

410-499-7062

Davidt@nhdetect.com

Gregory R Siragusa, Ph.D. contact

262-309-5360

gsiragusa@nhdiag.com

2 sites in 2 countries

United States1 site, 1 recruiting
  • US Naval Health Research Center

    San Diego, California, 92101

    Christopher A Myers, Ph.D., 619-756-8483, christopher.a.meyers48.civ@mail.mil

    Caroline J Balagout, 619-553-8950, caroline.j.balagot.ctr@mail.mil

    Recruiting

Other trials in United States

Madagascar1 site, 1 recruiting
  • Institut Pasteur de Madagascar

    Antananarivo, Analamanga Region, 101

    Voahangy Andrianaivoarimanana, Ph.D., 00261340654145, kekely@pasteur.mg

    Minoarisoa RAJERISON, Ph.D>, 00261341983916, mino@pasteur.mg

    Recruiting

Other trials in Madagascar

About this study

Official title: Point of Care Diagnostic to Identify the Causative Agent of the Plague in Blood Samples

Plague is a deadly but highly treatable disease caused by the bacterium Y. pestis. Due to the historical development of Y. pestis as a bioweapon by several nation states, it is listed by the US as a potential bioweapon that could be used against US warfighters. Although this bacterium is ecologically established worldwide, it mostly affects impoverished people who live in rural low-resource areas of Madagascar. Plague is acquired directly from bites of infected fleas but, if left untreated, it can progress to the highly lethal pneumonic form that can result in human to human transmission. With the dangers of pneumonic plague in the context of both natural outbreak and as a bioweapon used against warfighter, the goal of this study is to investigate a diagnostic test that is able to rapidly and locally diagnose this disease in low-resource settings. This study aims to evaluate a US-developed new LFI (Lateral Flow Immunoassay) assay intended for capillary blood (finger-prick) to diagnose humans infected with Y. pestis. The investigators will rigorously validate with assay on human populations from active plague sites and correlate the results with the results of paired clinical samples used in standard medical workup using existing diagnostics tests.

Read the detailed description

The purpose of this study will be to generate the data required to thoroughly validate the ability of plague LFI assay (Lateral Flow Immunoassay) to accurately diagnose human infections with Y. pestis. These validation data will eventually be presented to US Food and Drug Administration (FDA; along with data from other studies that NAU will not participate) to seek approval for commercial license. The objective will be to validate this assay on the capillary blood of humans suspected to have plague as well as a study cohort likely to not have plague. From the suspected population; the specific aims of this study are to enroll up to 300 participants who present clinical signs of illness based on specific inclusion criteria. We will collect two types of blood samples from enrolled participants 1) capillary blood from a finger prick and 2) venous blood. The capillary blood will be used for direct testing on the LFI assay and the venous blood will be used to perform independent validations. This study is designed as a correlation study to understand 1) how LFI assay results compare with results from traditional diagnostic methods based on DNA detection methods and bacterial culture isolate on bubo aspirate or sputum and 2) effectiveness of capillary blood to serve as a diagnostic clinical sample as compared with traditional biological samples (venous blood, bubo and sputum). The study is designed to evaluate the outcome of LFI and how LFI results correlate with the standard plague diagnostics methods used in Madagascar and other methods. We are not examining the relationship between the results of the LFI and health outcomes of the participants. Decision of participant's medical treatment is solely based on the clinical judgment of the physician and guidelines set forth by Madagascar National Plague Control Program (PNLP); no formal test is involved with medical decision. All participants who are tested by LFI will have received medical treatment prior to the start of the study and the continuation of their medical treatment is guided by PNLP and physician judgment only. Again, we are not looking at the relationship between the results of the LFI and health outcomes of the participants.

From the non-suspect cohort, greater detail will be provided as obtained. In brief, this subject population will consist of active duty US Naval personnel and DoD beneficiaries presenting to participating study sites in the United States with influenza-like symptoms (fever, cough, sore throat). Since the US is non-endemic for plague, all participants will be presumed to be negative for Y. pestis.

Being tested
Lateral Flow Assay for Pathogens of the Plague
Keywords
Yersinia pestis Lateral Flow Device, Lateral Flow Device, Point of Care testing, plague, Point of Need testing, plague, Plague, Yersinia pestis, Yersinia pestis antigens, Yersinia pestis LcrV antigen, Plague rapid test, Yersinia rapid test, Bubonic plague, Sputum, Bubo aspirate, Pneumonic plague, Yersinia pestis ELISA, Yersinia pestis EIA, Black plague, Black death, Yersinia LcrV protein, Yersinia F1 antigen
Medical subject headings
Plague

What participants receive

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

  • Lateral Flow Assay for Pathogens of the PlagueDiagnostic test

    Also called Lateral Flow Immunoassay for the Plague, SMART Plague Rapid Test, SMARTPRT, PRT

    A dipstick type of rapid test for antigens of the plague bacterium Yersinia pestis in samples from enrolled participants from both a known geography of plague activity (Madagascar) as well as samples from a geographically separated population of likely plague free status (US Naval Health Research Center, San Diego, CA).

Study groups in NCT04688996
Study groupRoleWhat they receive
Malagasy ParticipantsMalagasy Participants. Subjects will be recruited at rural health centers throughout Madagascar. Participants will be comprised of rural people with symptoms consistent with plague. The Madagascar Ministry of Public Health requires declaration of all suspected human plague cases and collection of biological samples (sputum and/or bubo aspirates) from these cases for medical workup for confirmation.
Receives: Diagnostic Test: Lateral Flow Assay for Pathogens of the Plague
USN Health Research CenterUSN Health Center Participants. The subject population will consist of active duty US Naval personnel and DoD beneficiaries presenting to participating study sites in the United States with influenza-like symptoms (fever, cough, sore throat). Since the US is non-endemic for plague, all participants will be presumed to be negative for Y. pestis.
Receives: Diagnostic Test: Lateral Flow Assay for Pathogens of the Plague

What is being measured

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

  1. LFI results on finger-prick blood correlate with the results of standard WHO-approved diagnostic tests for plague

    Description: Standard WHO-approved diagnostic testing uses bubo aspirates or sputum as clinical matrices to perform the following tests: F1RDT, qPCR analysis, and culture.

    WHO defines a confirmatory positive plague case when the bubo or sputum is positive on F1RDT and positive on either qPCR or culture.

    Measured: Up to 3 weeks post sample collection and processing of each participant.

Secondary outcomes (1)
  1. LFI results on finger-prick blood correlate with LFI results from bubo aspirate or sputum clinical matrices.

    Standard WHO-approved diagnostic testing uses bubo aspirates or sputum as clinical matrices to perform the following tests: F1RDT, qPCR analysis, and culture.

    WHO defines a confirmatory positive plague case when the bubo or sputum is positive on F1RDT and positive on either qPCR or culture.

    Measured: Up to 3 weeks post sample collection and processing of each participant.

Timeline

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

  1. First posted30 Dec 2020
  2. Study start19 Oct 2020
  3. Primary completionDec 2022 (estimated)
  4. Study completionJan 2023 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
500 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04688996
Sponsor's protocol ID
Plague Lateral Flow Assay
Other IDs
Evaluation of diagnostic tools
Acronym
SMARTPRT
Status last verified
Aug 2022
First submitted
24 Nov 2020
Last updated
14 Dec 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Inglesby TV, Dennis DT, Henderson DA, Bartlett JG, Ascher MS, Eitzen E, Fine AD, Friedlander AM, Hauer J, Koerner JF, Layton M, McDade J, Osterholm MT, O'Toole T, Parker G, Perl TM, Russell PK, Schoch-Spana M, Tonat K. Plague as a biological weapon: medical and public health management. Working Group on Civilian Biodefense. JAMA. 2000 May 3;283(17):2281-90. doi: 10.1001/jama.283.17.2281.

    PubMed 10807389
  • International meeting on preventing and controlling plague: the old calamity still has a future. Wkly Epidemiol Rec. 2006 Jul 14;81(28):278-84. No abstract available. English, French.

    PubMed 16841399
  • Chanteau S, Rahalison L, Ralafiarisoa L, Foulon J, Ratsitorahina M, Ratsifasoamanana L, Carniel E, Nato F. Development and testing of a rapid diagnostic test for bubonic and pneumonic plague. Lancet. 2003 Jan 18;361(9353):211-6. doi: 10.1016/S0140-6736(03)12270-2.

    PubMed 12547544
  • Stenseth NC, Atshabar BB, Begon M, Belmain SR, Bertherat E, Carniel E, Gage KL, Leirs H, Rahalison L. Plague: past, present, and future. PLoS Med. 2008 Jan 15;5(1):e3. doi: 10.1371/journal.pmed.0050003.

    PubMed 18198939
  • Andrianaivoarimanana V, Kreppel K, Elissa N, Duplantier JM, Carniel E, Rajerison M, Jambou R. Understanding the persistence of plague foci in Madagascar. PLoS Negl Trop Dis. 2013 Nov 7;7(11):e2382. doi: 10.1371/journal.pntd.0002382. eCollection 2013 Nov.

    PubMed 24244760
  • Rasoamanana B, Leroy F, Boisier P, Rasolomaharo M, Buchy P, Carniel E, Chanteau S. Field evaluation of an immunoglobulin G anti-F1 enzyme-linked immunosorbent assay for serodiagnosis of human plague in Madagascar. Clin Diagn Lab Immunol. 1997 Sep;4(5):587-91. doi: 10.1128/cdli.4.5.587-591.1997.

    PubMed 9302210

Questions about this trial

What is this clinical trial studying?

An observational study of Plague and Plague, Bubonic, run by Brimrose Technology Corporation at 2 sites in 2 countries.

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 7 inclusion and 5 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 14 Dec 2022. 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 United States, Madagascar. 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?

Results are not available in the source record.

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

Contact David P Trudil (410-499-7062, Davidt@nhdetect.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

LFI results on finger-prick blood correlate with the results of standard WHO-approved diagnostic tests for plague (time frame: Up to 3 weeks post sample collection and processing of each participant.). 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 NCT04688996, which also lists 6 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 14 Dec 2022.

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