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Comparing Chemoprevention Drugs for School-based Malaria Control

Phase 4
Completed
Conditions
Anemia in Children
Malaria,Falciparum
Interventions
Registration Number
NCT05980156
Lead Sponsor
University of Maryland, Baltimore
Brief 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). 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).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
646
Inclusion Criteria

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
Exclusion Criteria

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
  • 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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intermittent Preventive Treatment with dihydroartemisinin-piperaquine (IPT-DP)Dihydroartemisinin-PiperaquineAll 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)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).
Intermittent Preventive Treatment with dihydroartemisinin-piperaquine (IPT-DP)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)ChloroquineAll 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).
Primary Outcome Measures
NameTimeMethod
Number of participants with P. falciparum infection6-8 weeks after the last intervention

detected by polymerase chain reaction (PCR, binary)

Secondary Outcome Measures
NameTimeMethod
Total parasite density6-8 weeks after the last intervention

log transformed (continuous)

Rate of clinical malariathrough study completions, approximately 6 months

cumulative incidence

P. falciparum prevalence among children less than 5 years old living in households with study participants6-8 weeks after the last intervention

detected by PCR

sustained attention6-8 weeks after the last intervention

code transmission test score (continuous)

Number of participants with anemia6-8 weeks after the last intervention

World Health Organization age-sex definitions (binary)

Mean hemoglobin concentration6-8 weeks after the last intervention

g/dL (continuous)

selective attention6-8 weeks after the last intervention

selective attention test score (continuous)

Literacy skills6-8 weeks after the last intervention

onetest reading test score (continuous)

Math skills6-8 weeks after the last intervention

onetest math score (continuous)

Trial Locations

Locations (1)

Kamuzu University of Health Sciences

🇲🇼

Blantyre, Malawi

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