Malaria,FalciparumPhase 4NCT05980156
Comparing Chemoprevention Drugs for School-based Malaria Control
A Phase 4 study testing Dihydroartemisinin-Piperaquine, Chloroquine and Sulfadoxine pyrimethamine in people with Malaria,Falciparum and Anemia in Children, run by University of Maryland, Baltimore at 1 site in Malawi.
Trial summary
This is an individually randomized, controlled, single blind three arm clinical trial of malaria chemoprevention strategies Arm 1: Intermittent preventive treatment with dihydroartemisinin-piperaquine (IPT-DP). Read more about this study
- Who is it for?
- Ages 6 months and olderHealthy volunteers can take part
- Conditions the study is for
- Malaria,Falciparum, Anemia in Children
- What is being tested?
- Dihydroartemisinin-Piperaquine, Chloroquine and Sulfadoxine pyrimethamine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 646 participants
- Where
- 1 siteMalawi
- Study dates
- 13 Feb 2023to 28 Jul 2023
- 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 6 months and older
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- Students (enrolled in the primary intervention)
- Previously enrolled in NCT05244954
- Currently enrolled in the study school
- Plan to attend the study school for the remainder of the school year
- Parent/guardian available to provide written informed consent Younger children in participant households (enrolled in the Household Prevalence survey)
- Slept in the household for most nights in the last month
- Age 6-59 months
- Parent/guardian available to provide written informed consent
Who cannot join
- Students (enrolled in the primary intervention)
- Current evidence of severe malaria or danger signs
- Known adverse reaction to the study drugs
- History of cardiac problems or fainting
- Taking medications known to prolong QT
- Family history of prolonged QT
Show all 11Show fewer
- Taking trimethoprim-sulfamethoxazole aka Bactrim or Cotrimoxazole
- Epilepsy
- Psoriasis Household members (enrolled in the Household Prevalence survey)
- Household with more than one school-age child enrolled in the study
- Current evidence of severe malaria or danger signs
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Clinical Trial to Evaluate Intermittent Screening and Treatment and Intermittent Preventive Treatment of Malaria in Asymptomatic Schoolchildren to Decrease P. Falciparum Infection and Transmission: Phase 2 Comparing Drug Regimens
This is an individually randomized, controlled, single blind three arm clinical trial of malaria chemoprevention strategies Arm 1: Intermittent preventive treatment with dihydroartemisinin-piperaquine (IPT-DP). Arm 2: Intermittent preventive treatment with sulfadoxine-pyrimethamine (SP) plus chloroquine (CQ) (IPT-SPCQ). Arm 3: Control - students will receive standard of care (no preventive treatment). Outcomes include P. falciparum infection and parasite density, anemia, cognitive function and educational testing, as well as infection prevalence in young children sleeping student's households to assess the impact on transmission.
Read the detailed description
Students attending a single primary school in Machinga District, Malawi who were enrolled in NCT05244954 were offered enrollment in this follow-on study. The intervention will be conducted every 6-weeks during the two school terms which coincide with peak malaria transmission. Students in the IPT-DP arm will be treated with with dihydroartemisinin-piperaquine (DP) (females less than 10 years old and all males) or chloroquine (females 10 years old or older. Students in the IPT-SPCQ arm will be treated with sulfadoxine-pyrimethamine plus chloroquine (females less than 10 years old and all males) or chloroquine alone (females 10 years old or older).
- Conditions
- Malaria,Falciparum, Anemia in Children
- Being tested
- Dihydroartemisinin-Piperaquine, Chloroquine, Sulfadoxine pyrimethamine
- Keywords
- malaria, school, chemoprevention, preventive treatment, education, cognitive function, adolescent, hemoglobin
- Medical subject headings
- Malaria, Falciparum, Malaria
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Dihydroartemisinin-PiperaquineDrug
Also called DP, D-Artepp, DuoCotecxin, Artekin
Treatment will be with DP (females less than 10 years old and all males) or chloroquine alone (females 10 years old or older).
ChloroquineDrug
Also called Aralen, Hydroxychloroquine, Lariago
Treatment of females 10 years old and older in Arm 1 and treatment of all participants in Arm 2.
Sulfadoxine pyrimethamineDrug
Also called SP
Treatment will be with SP and chloroquine (females less than 10 years old and all males) or chloroquine alone (females 10 years old or older).
| Study group | Role | What they receive |
|---|---|---|
| Intermittent Preventive Treatment with dihydroartemisinin-piperaquine (IPT-DP) | Experimental | All students are treated at each intervention. Treatment will be with DP (females less than 10 years old and all males) or chloroquine (females 10 years old or older). Receives: Drug: Dihydroartemisinin-Piperaquine; Drug: Chloroquine |
| Intermittent Preventive Treatment with sulfadoxine-pyrimethamine plus chloroquine (IPT-SPCQ) | Experimental | All students are treated at each intervention. Treatment will be with SP + CQ (females less than 10 years old and all males) or chloroquine (females 10 years old or older). Receives: Drug: Chloroquine; Drug: Sulfadoxine pyrimethamine |
| Control | No intervention | Students will not receive preventive treatment. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of participants with P. falciparum infection
detected by polymerase chain reaction (PCR, binary)
Measured: 6-8 weeks after the last intervention
Secondary outcomes (9)
Number of participants with anemia
World Health Organization age-sex definitions (binary)
Measured: 6-8 weeks after the last intervention
Mean hemoglobin concentration
g/dL (continuous)
Measured: 6-8 weeks after the last intervention
Total parasite density
log transformed (continuous)
Measured: 6-8 weeks after the last intervention
Rate of clinical malaria
cumulative incidence
Measured: through study completions, approximately 6 months
P. falciparum prevalence among children less than 5 years old living in households with study participants
detected by PCR
Measured: 6-8 weeks after the last intervention
sustained attention
code transmission test score (continuous)
Measured: 6-8 weeks after the last intervention
selective attention
selective attention test score (continuous)
Measured: 6-8 weeks after the last intervention
Literacy skills
onetest reading test score (continuous)
Measured: 6-8 weeks after the last intervention
Math skills
onetest math score (continuous)
Measured: 6-8 weeks after the last intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Aug 2023
- Study start13 Feb 2023
- Primary completion28 Jul 2023
- Study completion28 Jul 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Malaria,FalciparumStudies of the same condition, open and under way.
- 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
- Interventional
- Phase
- Phase 4
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Students were randomized to three arms in the original trial. In this follow-on study, students will remain in their study arms. Arm 1 which previously received intermittent screening-and-treatment will now receive intermittent preventive treatment with sulfadoxine-pyrimethamine plus chloroquine. Arm 2 which received intermittent preventive treatment with dihydroartemisinin-piperaquine will again receive intermittent preventive treatment with dihydroartemisinin-piperaquine. Arm 3 the control arm will continue as a control. Females 10 years and older (potentially post-menarche) in Arms 1 and 2 will receive chloroquine alone.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 646 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Maryland, Baltimore
- Sponsor type
- University, hospital or other
- Collaborators
- Kamuzu University of Health Sciences, Doris Duke Charitable Foundation
- Responsible party
- Principal investigator, Lauren Cohee, University of Maryland, Baltimore
- Investigators
- Lauren Cohee, MD MS, Principal investigator, University of Maryland, Baltimore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05980156
- Sponsor's protocol ID
- HP-00098250v3
- Status last verified
- Aug 2023
- First submitted
- 28 Jul 2023
- Last updated
- 7 Aug 2023
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: all individual participant data that underlie results in a publication
Publications
Cohee LM, Valim C, Coalson JE, Nyambalo A, Chilombe M, Ngwira A, Bauleni A, Seydel KB, Wilson ML, Taylor TE, Mathanga DP, Laufer MK. School-based screening and treatment may reduce P. falciparum transmission. Sci Rep. 2021 Mar 25;11(1):6905. doi: 10.1038/s41598-021-86450-5.
PubMed 33767384Cohee LM, Opondo C, Clarke SE, Halliday KE, Cano J, Shipper AG, Barger-Kamate B, Djimde A, Diarra S, Dokras A, Kamya MR, Lutumba P, Ly AB, Nankabirwa JI, Njagi JK, Maiga H, Maiteki-Sebuguzi C, Matangila J, Okello G, Rohner F, Roschnik N, Rouhani S, Sissoko MS, Staedke SG, Thera MA, Turner EL, Van Geertruyden JP, Zimmerman MB, Jukes MCH, Brooker SJ, Allen E, Laufer MK, Chico RM. Preventive malaria treatment among school-aged children in sub-Saharan Africa: a systematic review and meta-analyses. Lancet Glob Health. 2020 Dec;8(12):e1499-e1511. doi: 10.1016/S2214-109X(20)30325-9. Epub 2020 Oct 22.
PubMed 33222799
Study at a glance
From the registry record, last updated by the sponsor on 7 Aug 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Clinical Trial to Evaluate Intermittent Screening and Treatment and Intermittent Preventive Treatment of Malaria in Asymptomatic Schoolchildren to Decrease P. Falciparum Infection and Transmission: Phase 2 Comparing Drug Regimens
- ClinicalTrials.gov ID
- NCT05980156
- Acronym / sponsor ID
- HP-00098250v3
- Conditions
- Malaria,Falciparum, Anemia in Children
- Keywords
- malaria, school, chemoprevention, preventive treatment, education, cognitive function, adolescent, hemoglobin
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 646 participants (actual)
- Lead sponsor
- University of Maryland, BaltimoreUniversity, hospital or other
- Collaborators
- Kamuzu University of Health Sciences, Doris Duke Charitable Foundation
- Study start
- 13 Feb 2023 (actual)
- Primary completion
- 28 Jul 2023 (actual)
- Study completion
- 28 Jul 2023 (actual)
- First posted
- 7 Aug 2023 (actual)
- 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.
This is an individually randomized, controlled, single blind three arm clinical trial of malaria chemoprevention strategies Arm 1: Intermittent preventive treatment with dihydroartemisinin-piperaquine (IPT-DP). Arm 2: Intermittent preventive treatment with sulfadoxine-pyrimethamine (SP) plus chloroquine (CQ) (IPT-SPCQ). Arm 3: Control - students will receive standard of care (no preventive treatment). Outcomes include P. falciparum infection and parasite density, anemia, cognitive function and educational testing, as well as infection prevalence in young children sleeping student's households to assess the impact on transmission.
Detailed description
Students attending a single primary school in Machinga District, Malawi who were enrolled in NCT05244954 were offered enrollment in this follow-on study. The intervention will be conducted every 6-weeks during the two school terms which coincide with peak malaria transmission. Students in the IPT-DP arm will be treated with with dihydroartemisinin-piperaquine (DP) (females less than 10 years old and all males) or chloroquine (females 10 years old or older. Students in the IPT-SPCQ arm will be treated with sulfadoxine-pyrimethamine plus chloroquine (females less than 10 years old and all males) or chloroquine alone (females 10 years old or older).
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
- Model description
- Students were randomized to three arms in the original trial. In this follow-on study, students will remain in their study arms. Arm 1 which previously received intermittent screening-and-treatment will now receive intermittent preventive treatment with sulfadoxine-pyrimethamine plus chloroquine. Arm 2 which received intermittent preventive treatment with dihydroartemisinin-piperaquine will again receive intermittent preventive treatment with dihydroartemisinin-piperaquine. Arm 3 the control arm will continue as a control. Females 10 years and older (potentially post-menarche) in Arms 1 and 2 will receive chloroquine alone.
| Arm | Type | Receives |
|---|---|---|
| Intermittent Preventive Treatment with dihydroartemisinin-piperaquine (IPT-DP) | Experimental | Drug: Dihydroartemisinin-Piperaquine, Drug: ChloroquineAll students are treated at each intervention. Treatment will be with DP (females less than 10 years old and all males) or chloroquine (females 10 years old or older). |
| Intermittent Preventive Treatment with sulfadoxine-pyrimethamine plus chloroquine (IPT-SPCQ) | Experimental | Drug: Chloroquine, Drug: Sulfadoxine pyrimethamineAll students are treated at each intervention. Treatment will be with SP + CQ (females less than 10 years old and all males) or chloroquine (females 10 years old or older). |
| Control | No intervention | –Students will not receive preventive treatment. |
Who may qualify
- Ages
- 6 months and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (8 listed)
- Students (enrolled in the primary intervention)
- Previously enrolled in NCT05244954
- Currently enrolled in the study school
- Plan to attend the study school for the remainder of the school year
- Parent/guardian available to provide written informed consent Younger children in participant households (enrolled in the Household Prevalence survey)
Key exclusion criteria (11 listed)
- Students (enrolled in the primary intervention)
- Current evidence of severe malaria or danger signs
- Known adverse reaction to the study drugs
- History of cardiac problems or fainting
- Taking medications known to prolong QT
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Dihydroartemisinin-PiperaquineAlso: DP, D-Artepp, DuoCotecxin, ArtekinTreatment will be with DP (females less than 10 years old and all males) or chloroquine alone (females 10 years old or older). | Drug | Intermittent Preventive Treatment with dihydroartemisinin-piperaquine (IPT-DP) |
| ChloroquineAlso: Aralen, Hydroxychloroquine, LariagoTreatment of females 10 years old and older in Arm 1 and treatment of all participants in Arm 2. | Drug | Intermittent Preventive Treatment with dihydroartemisinin-piperaquine (IPT-DP), Intermittent Preventive Treatment with sulfadoxine-pyrimethamine plus chloroquine (IPT-SPCQ) |
| Sulfadoxine pyrimethamineAlso: SPTreatment will be with SP and chloroquine (females less than 10 years old and all males) or chloroquine alone (females 10 years old or older). | Drug | Intermittent Preventive Treatment with sulfadoxine-pyrimethamine plus chloroquine (IPT-SPCQ) |
Primary outcome
Number of participants with P. falciparum infection
Time frame: 6-8 weeks after the last intervention
detected by polymerase chain reaction (PCR, binary)
9 secondary outcomes
Number of participants with anemia
Time frame: 6-8 weeks after the last intervention
Mean hemoglobin concentration
Time frame: 6-8 weeks after the last intervention
Total parasite density
Time frame: 6-8 weeks after the last intervention
Rate of clinical malaria
Time frame: through study completions, approximately 6 months
P. falciparum prevalence among children less than 5 years old living in households with study participants
Time frame: 6-8 weeks after the last intervention
sustained attention
Time frame: 6-8 weeks after the last intervention
selective attention
Time frame: 6-8 weeks after the last intervention
Literacy skills
Time frame: 6-8 weeks after the last intervention
Math skills
Time frame: 6-8 weeks after the last intervention
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 7 Aug 2023.
- Background: PubMed 33767384Cohee LM, Valim C, Coalson JE, Nyambalo A, Chilombe M, Ngwira A, Bauleni A, Seydel KB, Wilson ML, Taylor TE, Mathanga DP, Laufer MK. School-based screening and treatment may reduce P. falciparum transmission. Sci Rep. 2021 Mar 25;11(1):6905. doi: 10.1038/s41598-021-86450-5.
- Background: PubMed 33222799Cohee LM, Opondo C, Clarke SE, Halliday KE, Cano J, Shipper AG, Barger-Kamate B, Djimde A, Diarra S, Dokras A, Kamya MR, Lutumba P, Ly AB, Nankabirwa JI, Njagi JK, Maiga H, Maiteki-Sebuguzi C, Matangila J, Okello G, Rohner F, Roschnik N, Rouhani S, Sissoko MS, Staedke SG, Thera MA, Turner EL, Van Geertruyden JP, Zimmerman MB, Jukes MCH, Brooker SJ, Allen E, Laufer MK, Chico RM. Preventive malaria treatment among school-aged children in sub-Saharan Africa: a systematic review and meta-analyses. Lancet Glob Health. 2020 Dec;8(12):e1499-e1511. doi: 10.1016/S2214-109X(20)30325-9. Epub 2020 Oct 22.
- Individual participant dataSharing planned: Yes. all individual participant data that underlie results in a publication
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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.
Lauren Cohee, MD MS principal investigator
University of Maryland, Baltimore
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Dihydroartemisinin-Piperaquine, Chloroquine and Sulfadoxine pyrimethamine in people with Malaria,Falciparum and Anemia in Children, run by University of Maryland, Baltimore at 1 site in Malawi.
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 8 inclusion and 11 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 7 Aug 2023. 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 Malawi. 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?
Number of participants with P. falciparum infection (time frame: 6-8 weeks after the last intervention). 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 NCT05980156, 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 7 Aug 2023.