Comparison of Two Different Doses of Azithromycin for Treatment of Yaws

Phase 3

Completed

Brief Summary: The study will be a single blinded, randomized, controlled open label non-inferiority phase III, trial with two parallel groups, conducted in Ghana and Papua New Guinea (PNG). The ultimate goal is to establish if a 20mg/kg dose of azithromycin is as effective as a 30mg/kg dose in the treatment of yaws. Approximately 600 clinically and serologically diagnosed yaws patients will be included in the study. Patients will be randomized to receive treatment with the two antibiotic regimens as follow: (i) Regimen I (AZT20): Single oral dose of 20 mg/kg azithromycin (ii) Regimen II (AZT30): Single oral dose of 30 mg/kg azithromycin. The follow-up period of patients will be 6 months. Assessments before, during and after the antibiotic treatment will include full medical history, clinical assessment of the lesion and, laboratory investigations. The primary efficacy parameters are healing of the lesion at 4 weeks and a four-fold decline in RPR titre at 6 months after start of treatment.

Recruitment & Eligibility

Inclusion Criteria

Aged 6 to 16 years
Clinical lesion consistent with primary or secondary yaws -Primary ulcer or papilloma
Dually-Positive Chembio DPP Syphilis Screen & Confirm
Informed Consent and Assent (for children 12-16 years)

Exclusion Criteria

Known allergy to azithromycin or macrolides.
Treatment with long-acting penicillin or alternative antibiotic with activity against T. pallidum within the last 3 months (ceftriaxone, azithromycin or doxycycline, amoxicillin).
Patients with current treatment with any drugs likely to interact with the study medication.
Patients who are unable to take oral medication or having gastrointestinal disease likely to interfere with drug absorption.
Patients who may not be able to comply with the requirements of the study protocol including follow up visits.
Patients who are not willing to give informed consent (patient and/or parent/legal representative), or who withdraw consent.

Arm && Interventions

Group	Intervention	Description
AZT30	Azithromycin	Single dose of azithromycin at a dose of 30mg/kg - max 2 Grams
AZT20	Azithromycin	Single dose of azithromycin at a dose of 20mg/kg - max 1 Grams

Primary Outcome Measures

Name	Time	Method
Number of Participants With Clinical and Serological Cure	6 Months	Clinical resolution of skin lesion at 4 weeks and at least four-fold decline in Rapid Plasma Reagin titre or seroreversion at 6-month (compared to baseline) in T.pallidum subsp. pertenue Polymerase Chain Reaction-confirmed subjects with yaws.

Secondary Outcome Measures

Name	Time	Method
Number of Participants With Clinical and Serological Cure in Latent Yaws	6 Months	Clinical resolution of skin lesion at 4 weeks and at least four-fold decline in Rapid Plasma Reagin titre or seroreversion at 6-month (compared to baseline) in T.pallidum subsp. pertenue Polymerase Chain Reaction-negative.
Number of Participants With Adverse Events	6 months	To compare the incidences and relative risk of all Adverse Events (AEs), including treatment-related AEs, Serious Adverse Events (SAEs) and grade 3-4 toxicity in patients treated with AZT20 and AZT30 regimens

Locations (3): London School of Hygiene and Tropical Medicine
🇬🇧
London, United Kingdom
Community Based Recruitment
🇵🇬
Kavieng Subdistrict, New Ireland Province, Papua New Guinea
School Based Recruitment
🇬🇭
Nkwanta North District, Volta Region, Ghana