Molecular Surveillance of Artemisinin Resistance Malaria in Myanmar
Completed
- Conditions
- Drug ResistancePlasmodium Falciparum Malaria
- Interventions
- Drug: First line antimalarial in Myanmar (artemether-lumefrantrine, dihydroartemisinin-piperaquine, and artesunate-mefloquine)
- Registration Number
- NCT02792816
- Lead Sponsor
- Department of Medical Research, Lower Myanmar
- Brief Summary
Efficacy and safety of the artemisinin combination therapy (ACT) in uncomplicated falciparum malaria patients in Myanmar and artemisinin molecular markers analysis
- Detailed Description
The investigators assessed the efficacy and safety of the ACT in uncomplicated falciparum malaria in different sentinel sites in Myanmar. The recruited patients were follow-up until day 28 or day-42 based on the ACTs. Day-0 samples were analysed for artemisinin molecular markers, (K13 kelch propeller, Pfmdr2, Pffd and Pfarps10).
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 550
Inclusion Criteria
- Plasmodium falciparum mono infection by microscopy
- Presence of axillary equal to or more than 37.5 degrees centigrade or history of fever during the past 24 hours
- Ability to swallow oral medication
- Ability and willingness to comply with the study protocol for the duration of the study and to comply with the study visit schedule
- Informed consent from the patient or from a parent or guardian in the case of children
Exclusion Criteria
- Presence of signs of severe falciparum malaria according to the definitions of World Health Organisation (WHO)
- Mixed or mono-infection with another Plasmodium species detected by microscopy
- Presence of severe malnutrition (defined as a child whose growth standard is below 3 z-score, has symmetrical oedema involving at least the feet or has a mid-upper arm circumference below 110 mm)
- Presence of febrile conditions due to diseases other than malaria (e.g. measles, acute lower respiratory tract infection, severe diarrhoea with dehydration) or other known underlying chronic or severe diseases (e.g. cardiac, renal and hepatic diseases, Human Immune Deficiency Virus (HIV)/Acquired Immune Deficiency Syndrom (AIDS)
- Regular medication, which may interfere with antimalarial pharmacokinetics
- History of hypersensitivity reactions or contraindications to any of the medicine(s) being tested or used as alternative treatment(s)
- A positive pregnancy test or breastfeeding
- Unable to or unwilling to take a pregnancy test or contraceptives
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Myawaddy Site First line antimalarial in Myanmar (artemether-lumefrantrine, dihydroartemisinin-piperaquine, and artesunate-mefloquine) The efficacy and safety of the ACT in different sentinel sites will be assessed. The administrated anti-malarial were same and all will be administrated under direct observation. The dosage will be calculated by weight of the patients. Myawaddy is one of the sentinel site and located at the northern part of the Southern Myanmar. Kawthaung Site First line antimalarial in Myanmar (artemether-lumefrantrine, dihydroartemisinin-piperaquine, and artesunate-mefloquine) The efficacy and safety of the ACT in different sentinel sites will be assessed. The administrated anti-malarial were same and all will be administrated under direct observation. The dosage will be calculated by weight of the patients. Kawthaung is one of the sentinel site and located at the Southern Myanmar. Thanbyuzayat Site First line antimalarial in Myanmar (artemether-lumefrantrine, dihydroartemisinin-piperaquine, and artesunate-mefloquine) The efficacy and safety of the ACT in different sentinel sites will be assessed. The administrated anti-malarial were same and all will be administrated under direct observation. The dosage will be calculated by weight of the patients. Thanbyuzayat is one of the sentinel site and located at the northern part of the Southern Myanmar. Shwegyin Site First line antimalarial in Myanmar (artemether-lumefrantrine, dihydroartemisinin-piperaquine, and artesunate-mefloquine) The efficacy and safety of the ACT in different sentinel sites will be assessed. The administrated anti-malarial were same and all will be administrated under direct observation. The dosage will be calculated by weight of the patients. Shwegyin is one of the sentinel site and located at the southern part of the central Myanmar. Magway Site First line antimalarial in Myanmar (artemether-lumefrantrine, dihydroartemisinin-piperaquine, and artesunate-mefloquine) The efficacy and safety of the ACT in different sentinel sites will be assessed. The administrated anti-malarial were same and all will be administrated under direct observation. The dosage will be calculated by weight of the patients. Magway is one of the sentinel site and located at the middle part of the central Myanmar. Rakhine Site First line antimalarial in Myanmar (artemether-lumefrantrine, dihydroartemisinin-piperaquine, and artesunate-mefloquine) The efficacy and safety of the ACT in different sentinel sites will be assessed. The administrated anti-malarial were same and all will be administrated under direct observation. The dosage will be calculated by weight of the patients. Rakhine is one of the sentinel site and located at the western Myanmar.
- Primary Outcome Measures
Name Time Method Proportion of adequate clinical and parasitological response (ACPR) day 28 or day 42 after initial dose of ACT For artesunate-mefloquine or dihydroartemisinin-piperaquine, 42 days follow-ups and for artemether-lumefrantrine combinations, 28 days followe-ups
- Secondary Outcome Measures
Name Time Method Proportion of the day-3 parasite positivity after ACT by microscopy 3rd day after initial dose of ACT 72 hr after ACT is one of the indicator for delayed clearance of parasitaemia in falciparum malaria
Treatment failure rate anytime within observation period (28/42 days after treatment with one of ACTs) Early Treatment Failure (ETF), Late Clinical Failure (LCF), Late Parasitological Failure (LPF) based on the WHO standard protocol and definitions
Mutant rate Day-0 samples Day-0 samples were used to amplify the artemisinin resistance molecular markers to know the mutant rate in each study sites
Trial Locations
- Locations (1)
Dr. Myat Phone Kyaw
🇲🇲Yangon, Myanmar