MedPath

Targeted Antimalarial Drug Administration for Seasonal Migrant Populations in Amhara Region, Ethiopia

Phase 3
Active, not recruiting
Conditions
Plasmodium Falciparum
Malaria
Interventions
Registration Number
NCT06516042
Lead Sponsor
PATH
Brief Summary

The purpose of the study is to assess the effectiveness, feasibility, and acceptability of targeted drug administration for seasonal migrant populations in Metema District, Amhara Region, Ethiopia

Detailed Description

A cluster randomized controlled trial will be used to evaluate the effectiveness, feasibility, and acceptability of targeted antimalarial drug administration (TDA) for seasonal migrant farmworkers in the Delello farm sites in Metema district, Amhara Region. Individual farm sites will be randomized 1:1:1 to either of two intervention options or control, where all farmworkers at intervention sites will receive either two or three rounds of dihydro artemisinin piperaquine over the primary farming season.

All study farm-sites will receive enhanced case management conducted by mobile health teams throughout the study period.

Cross-sectional surveys will be conducted in all arms at baseline and 4 to 6 weeks following the third round of TDA to assess the effectiveness of the intervention for reducing parasite prevalence.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
10350
Inclusion Criteria
  • At the time of the study, be a seasonal farm worker at one of the selected farm sites in Metema district
  • Available and willingness to participate in the study and provide consent (or parental/guardian consent and asset in the case of minors)
Exclusion Criteria
  • Severe illness (will be referred for care)
  • Inability to provide informed consent
  • Age 14-17 years old and not having a parent/guardian at the farm who can provide consent
  • Age <14 years old

Additional exclusion criteria for the intervention group:

  • Having received an antimalarial drug within the last 2 weeks

  • Having any of the contraindications to receiving DP:

    • History of cardiac rhythm disturbances, bradycardia, or heart failure
    • Concomitant treatment with drugs that prolong the QT interval (fluconazole, fluoroquinolones, hydroxyzine, macrolides, ondansetron, etc.) or drugs containing any of the following: flecainide, metoprolol, imipramine, amitriptyline, clomipramine
    • Known allergic reactions to DP or other artemisinin derivatives
    • Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention with 2 TDA roundsDihydroartemisinin-piperaquineTDA with DP will be administered two times with a 4 - 6 week interval between rounds to all workers in the selected farm sites
Intervention with 3 TDA roundsDihydroartemisinin-piperaquineTDA with DP will be administered three times with a 4 - 6 week interval between rounds to all workers in the selected farm sites
Primary Outcome Measures
NameTimeMethod
Feasibility of TDAUp to 6 months

Feasibility of TDA measured through intervention coverage (% of participants treated among the total farm population) and cost effectiveness

Plasmodium falciparum (Pf) parasite prevalenceUp to 6 months

Prevalence of Pf as determined by PCR at the end of the study

Acceptability of TDA amongst farmworkers, farm-site owners, and local health authoritiesUp to 6 months

Acceptability of TDA amongst farmworkers, farm-site owners, and local health authorities measured through drug adherence (% of participants completing the drugs as prescribed, as reported in the endline survey), survey response (self-reported values provided during endline survey), and qualitative interview data

Secondary Outcome Measures
NameTimeMethod
Feasibility and acceptability of enhanced case management through mobile clinics based on endline survey responsesUp to 6 months

Feasibility and acceptability of providing enhanced case management among the study team based on endline survey responses

Pf parasite prevalence in a subset of migrant farmworkersUp to 2 months

Pf parasite prevalence measured in a subset of migrant farmworkers upon return to their home village in the western highlands

Feasibility of enhanced case management through mobile clinics based on cost per case detectedUp to 6 months

A cost assessment of providing enhanced case management through mobile clinics

Feasibility and acceptability of enhanced case management through mobile clinics based on qualitative interview dataUp to 6 months

Feasibility and acceptability of enhanced case management through mobile clinics based on information shared during qualitative interviews

Safety and tolerability of TDAUp to 6 months

Safety and tolerability of TDA measured through the incidence of adverse events and survey responses

Trial Locations

Locations (1)

Delello Farm Sites

🇪🇹

Gondar, Metema District, Ethiopia

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