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Malaria,FalciparumPhase 3MATAMALNCT04844905

Adjunctive Ivermectin Mass Drug Administration for Malaria Control

A Phase 3 study testing Ivermectin and Dihydroartemisinin-piperaquine in people with Malaria,Falciparum and Neglected Tropical Diseases, run by London School of Hygiene and Tropical Medicine at 1 site in Guinea-Bissau.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

This is a cluster-randomized placebo-controlled clinical trial to evaluate the additive benefit of Ivermectin (IVM) (or Placebo) mass drug administration (MDA) to dihydroartemisinin-piperaquine (DP) MDA for malaria control in a moderate to low malaria-endemic setting as an adjunctive strategy to existing programmatic… Read more about this study

Who is it for?
Ages 6 months and olderHealthy volunteers can take part
What is being tested?
Ivermectin and Dihydroartemisinin-piperaquine
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
24,000 participants
Where
1 siteGuinea-Bissau
Study dates
3 May 2021to Aug 2023
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 6 months and older
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Age over six months to receive dihydroartemisinin-piperaquine
  • Height over 90cm or weight over 15kg to receive ivermectin or placebo
  • Willingness to adhere to trial procedures
  • Individual written, informed consent from the participant or parent/guardian in the case of participants below the age of 18 years (and assent in young people between the ages of 12 and 17 years of age)

Who cannot join

  • Known severe chronic illness (AIDS, Tuberculosis, chronic malnutrition)
  • Known hypersensitivity to either dihydroartemisinin-piperaquine or ivermectin
  • Pregnancy (any trimester) and breastfeeding (for ivermectin (or placebo)) and pregnancy (first trimester only) (for dihydroartemisinin-piperaquine)
  • Travel to a Loa loa endemic country (eg Central African Republic) (for ivermectin (or placebo))
  • Concomitant drugs that influence cardiac function or affect the corrected QT interval (for dihydroartemisinin-piperaquine)

Trial locations and contacts

1 site in 1 country.

Anna R Last, MBChB PhD contact

0044(0)2072770 ext. 2770

anna.last@lshtm.ac.uk

David CW Mabey contact

david.mabey@lshtm.ac.uk

Guinea-Bissau1 site, 1 recruiting
  • Bijagos Archipelago (islands)

    Bissau

    Amabelia Rodrigues, PhD, a.rodrigues@bandim.org

    Harry Hutchins, MBChB, harry.hutchins@lshtm.ac.uk

    Recruiting

Other trials in Guinea-Bissau

About this study

Official title: Adjunctive Ivermectin Mass Drug Administration for Malaria Control on the Bijagos Archipelago of Guinea Bissau: A Cluster-randomized Placebo-controlled Trial

This is a cluster-randomized placebo-controlled clinical trial to evaluate the additive benefit of Ivermectin (IVM) (or Placebo) mass drug administration (MDA) to dihydroartemisinin-piperaquine (DP) MDA for malaria control in a moderate to low malaria-endemic setting as an adjunctive strategy to existing programmatic malaria control measures. The regime of DP and IVM will target both human reservoirs of Plasmodium falciparum and the Anopheles gambiae vector respectively, with the aim of interrupting transmission. The trial will be conducted on the Bijagos Archipelago, where islands (clusters) will be randomised to receive seasonal DP and IVM or DP and Placebo MDA. The primary outcome will be the prevalence of infection with Plasmodium falciparum in all age groups detected by nucleic acid amplification testing during the peak malaria transmission season after two years of intervention.

Read the detailed description

The objectives of this trial are

  1. To evaluate the impact of adjunctive IVM to DP MDA on malaria transmission in communities with high ITN coverage.
  2. To evaluate the impact of IVM MDA on An. gambiae population density and age-structure.
  3. To evaluate the impact of IVM MDA on the prevalence of co-endemic IVM-susceptible Neglected Tropical Diseases (lymphatic filariasis, soil transmitted helminths and scabies)
  4. To evaluate acceptability, feasibility and access to MDA as a strategy for malaria control and to identify the most acceptable way of achieving and sustaining high coverage MDA with IVM and DP.

This cluster-randomized placebo-controlled trial has two arms. A total of 24 clusters will be randomly assigned to receive DP + IVM MDA or DP+ Placebo MDA using computer-generated random numbers. To mitigate against contamination effects, the majority of clusters will be separate islands and will be separated by distances greater than 2km. On the two islands that are divided (each into two clusters), a buffer zone of 2km between each cluster will be ensured. The total population of the archipelago is 24,000. The investigators will ensure balance between trial arms with respect to population size, baseline Plasmodium falciparum prevalence and access to health care. All clusters will receive the standard programmatic malaria control interventions implemented by the National Malaria Control Programme which includes insecticide-treated nets (ITN), intermittent preventative treatment in pregnancy (IPTp), seasonal malarial chemoprophylaxis (SMC) for children aged 3-59 months and case diagnosis and treatment (CDT) with Artemether-lumefantrine.

Being tested
Ivermectin, Placebo, Dihydroartemisinin-piperaquine
Keywords
Vector Control, Mass Drug Administration, Integrated Disease Control, Malaria, Guinea Bissau, West Africa, Antimalarials, Ivermectin, Dihydroartemisinin, Piperaquine
Medical subject headings
Malaria, Falciparum, Neglected Diseases, Strongyloidiasis, Elephantiasis, Filarial, Scabies, Ancylostomiasis, Malaria

What participants receive

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

  • IvermectinDrug

    Ivermectin will be given as tablets of 3 or 6mg. It will be given at 300-400μg/kg/day for 3 days (to the nearest whole tablet) each month for 3 months. It will be taken on an empty stomach with water.

  • PlaceboDrug

    Placebo will be given as tablets of 3 or 6mg (identical to Ivermectin in colour, size, shape and packaging). It will be given at 300-400μg/kg/day for 3 days (to the nearest whole tablet) each month for 3 months. It will be taken by mouth with water and without food.

  • Dihydroartemisinin-piperaquineDrug

    Also called Eurartesim

    Dihydroartemisinin-piperaquine will be given as tablets of 320/40mg (adult) and 160/20mg (child) piperaquine/dihydroartemisinin per tablet. Administration of a full course of dihydroartemisinin-piperaquine will be given in accordance with the manufacturer's guidelines once daily for 3 days each month for 3 months according to body weight. Dihydroartemisinin-piperaquine will be taken by mouth with water and without food.

Study groups in NCT04844905
Study groupRoleWhat they receive
Ivermectin Mass Drug AdministrationExperimentalIvermectin and Dihydroartemisinin-piperaquine MDA will be given to all eligible participants in each cluster (island) in addition to the standard national malaria control programme interventions.
Receives: Drug: Ivermectin; Drug: Dihydroartemisinin-piperaquine
Placebo Mass Drug AdministrationPlacebo comparatorPlacebo and Dihydroartemisinin-piperaquine MDA will be given to all eligible participants in each cluster (island) in addition to the standard national malaria control programme interventions.
Receives: Drug: Placebo; Drug: Dihydroartemisinin-piperaquine

What is being measured

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

  1. Prevalence of infection with Plasmodium falciparum

    Prevalence of infection with Plasmodium falciparum in all age groups estimated using a cross-sectional survey sample conducted during peak transmission season after 2 years of intervention

    Measured: 2 years

Secondary outcomes (12)
  1. Vector parous rate

    Vector parous rate will be determined by assessment of mosquitoes trapped 7-14 days following MDA. Vector parity will be used to determine Anopheles gambiae age structure to estimate vector survival between arms.

    Measured: 7-14 days post-MDA

  2. Prevalence of infection with Plasmodium falciparum

    Prevalence of infection with Plasmodium falciparum in all age groups estimated using a cross-sectional survey sample conducted after the first year of intervention

    Measured: 1 year

  3. Incidence of clinical malaria (Passive Case Detection)

    Incidence of clinical malaria diagnosed at health facilities confirmed by malaria Rapid Diagnostic Test

    Measured: For six months during the malaria transmission season

  4. Incidence of clinical malaria (Active Case Detection)

    Incidence of clinical malaria confirmed by malaria Rapid Diagnostic Test in a cohort of 50 children per cluster aged 5-14 years

    Measured: For six months during the malaria transmission season

  5. Age-adjusted prevalence of recent exposure to Plasmodium falciparum

    Mean Median Fluorescence Intensity of serological markers associated with recent exposure to Plasmodium falciparum in all age groups estimated using a cross-sectional survey sample during peak transmission season after each year of intervention

    Measured: Peak transmission season at 1 year and 2 years

  6. Vector density

    Total number of trapped mosquitoes per cluster

    Measured: For six months during the malaria transmission season

  7. Vector species composition

    Species characterisation using nucleic acid amplification tests as a proportion of total mosquitoes caught in traps

    Measured: For six months during the malaria transmission season

  8. Prevalence of exposure to Anopheles exposure

    Mean Median Fluorescence Intensity of serological markers associated with exposure to Anopheles salivary antigen in all age groups estimated using a cross-sectional survey sample

    Measured: Peak transmission season at 1 year and 2 years

  9. Vector sporozoite rates

    Proportion of Plasmodium falciparum circumsporozoite antibody (CSP) positive mosquitoes caught in traps

    Measured: For six months during the malaria transmission season

  10. Prevalence of Ivermectin-susceptible Neglected Tropical Diseases (NTDs)

    Prevalence of IVM-susceptible NTDs (scabies, strongyloides, other soil-transmitted helminths and lymphatic filariasis) and head lice using clinical and serological parameters estimated using a cross-sectional survey sample during the dry season after two years of intervention.

    Measured: 2 years

  11. MDA coverage estimates

    Cluster level coverage estimates calculated from MDA distribution and denominator census

    Measured: During MDA in year 1 and year 2

  12. Prevalence of resistance to artemisinin and partner drugs in humans

    Prevalence of resistance to artemisinin and partner drugs in humans using molecular markers of resistance in all age groups estimated using a cross-sectional survey sample

    Measured: Peak transmission season at 1 year and at 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 posted14 Apr 2021
  2. Study start3 May 2021
  3. Primary completionMar 2023 (estimated)
  4. Study completionAug 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
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Two arms with clusters randomized to DP+IVM or DP+Placebo with a 1:1 ratio
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
24,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04844905
Sponsor's protocol ID
19156
Acronym
MATAMAL
Status last verified
Feb 2022
First submitted
17 Mar 2021
Last updated
24 Feb 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: There is a manuscript in preparation detailing the study protocol and statistical analysis plan. The participant information and and informed consent form may be requested from the trial research team. Results and a clinical study report will be made available within six months of completion of the trial. Analytic code will be made available under a Creative Commons license. Publication of results will be open-access and available in pre-print on MedRxiv (The Preprint Server for Health Sciences).

Publications

  • Hutchins H, Pretorius E, Bradley J, Teixeira da Silva E, Vasileva H, Ndiath MO, Jones RT, Soumare HDM, Nyang H, Prom A, Sambou S, Ceesay F, Ceesay S, Moss S, Mabey D, Djata P, Nante JE, Martins C, Logan JG, Slater H, Tetteh K, Drakeley C, D'Alessandro U, Rodrigues A, Last A. Adjunctive ivermectin mass drug administration for malaria control on the Bijagos Archipelago of Guinea-Bissau (MATAMAL): a quadruple-blinded, cluster-randomised, placebo-controlled trial. Lancet Infect Dis. 2025 Apr;25(4):424-434. doi: 10.1016/S1473-3099(24)00580-2. Epub 2024 Nov 14.

    PubMed 39551062
  • Hutchins H, Bradley J, Pretorius E, Teixeira da Silva E, Vasileva H, Jones RT, Ndiath MO, Dit Massire Soumare H, Mabey D, Nante EJ, Martins C, Logan JG, Slater H, Drakeley C, D'Alessandro U, Rodrigues A, Last AR. Protocol for a cluster randomised placebo-controlled trial of adjunctive ivermectin mass drug administration for malaria control on the Bijagos Archipelago of Guinea-Bissau: the MATAMAL trial. BMJ Open. 2023 Jul 7;13(7):e072347. doi: 10.1136/bmjopen-2023-072347.

    PubMed 37419638

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Ivermectin and Dihydroartemisinin-piperaquine in people with Malaria,Falciparum and Neglected Tropical Diseases, run by London School of Hygiene and Tropical Medicine 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 4 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 24 Feb 2022. 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. Some participants in this study may receive a placebo. 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 Anna R Last, MBChB PhD (0044(0)2072770 ext. 2770, anna.last@lshtm.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Prevalence of infection with Plasmodium falciparum (time frame: 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 NCT04844905, which also lists 2 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 24 Feb 2022.

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