Cluster RCT of Co-administration Azithromycin, Albendazole & Ivermectin

Phase 4

Completed

• Conditions: Trachoma; Lymphatic Filariases
• Interventions: Drug: Administration of Albendazole on Day 1; Drug: Administration of Ivermectin on Day 1; Drug: Administration of Azithromycin on Day 15; Drug: Administration of Azithromycin on Day 1

• Registration Number: NCT03570814
• Lead Sponsor: London School of Hygiene and Tropical Medicine

Brief Summary

Cluster-randomised trial comparing co-administration of Azithromycin/Ivermectin/Albendazole with separate administration of Azithromycin and Ivermectin/Albendazole.

The study will be conducted in Beneshangul-Gumuz region, Ethiopia. Within this district, a study group of 8,000 people (in approximately 40 clusters) will receive the azithromycin, ivermectin \& albendazole at a single time. A control group of 8,000 people (in approximately 40 clusters) within the same district will receive the current MDA treatment schedule beginning with Ivermectin/Albendazole followed two weeks later with azithromycin. All drug dosing will be in line with standard FMOH and WHO Guidelines for MDA for trachoma and lymphatic filariasis.

The study will randomly sort subdistrict communities (Gotes) into the trial arm and the control arm. The study will compare the number of adverse events (AEs) and severe adverse events (SAEs) between the two arms to determine if co-administration is not inferior to the standard treatment. The primary outcome will be to demonstrate the safety of the triple-drug administration as measured by incidence of AEs/SAEs following the MDA.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2018-06-04
• Study First Submitted QC: 2018-06-25
• Study First Posted: 2018-06-27
• Study Start: 2021-12-01
• Primary Completion: 2022-02-01
• Study Completion: 2022-02-01
• Status Verified: 2022-04
• Last Update Submitted: 2022-08-18
• Last Update Posted: 2022-08-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 13511

Inclusion Criteria

1. Residing in the community for at least three months;
2. Eligible to receive all three agents according to standard MDA criteria

Exclusion Criteria

1. Not eligible to receive one or more drugs according to standard MDA criteria;

2. Less than 5 years of age (not eligible for ivermectin)**

3. Pregnant women (azithromycin only, not eligible for albendazole and ivermectin)

4. Lactating women (Only administered azithromycin and albendazole, not eligible for ivermectin)**

5. History of allergies to the drugs being studied (azithromycin, ivermectin, albendazole)

6. Residents who cannot swallow tablets

   • Note that patients that are not eligible for IVM, will receive azithromycin and albendazole. Patients that receive azithromycin and albendazole will be followed up through the same procedure as the triple drug therapy to try to track any AEs attributed to the two drug combination.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Separate Administration	Administration of Ivermectin on Day 1	Standard administration of Albendazole/Ivermectin separated from administration of azithromycin
Separate Administration	Administration of Azithromycin on Day 15	Standard administration of Albendazole/Ivermectin separated from administration of azithromycin
Co-administration	Administration of Ivermectin on Day 1	Combined administration of Albendazole/Ivermectin/Azithromycin at a single time point
Co-administration	Administration of Azithromycin on Day 1	Combined administration of Albendazole/Ivermectin/Azithromycin at a single time point
Separate Administration	Administration of Albendazole on Day 1	Standard administration of Albendazole/Ivermectin separated from administration of azithromycin
Co-administration	Administration of Albendazole on Day 1	Combined administration of Albendazole/Ivermectin/Azithromycin at a single time point

Primary Outcome Measures

Name	Time	Method
Self Reported Adverse Event	1 Month	The incidence of self-reported adverse events following MDA. We will collect data on the presence of common symptoms/signs prior to drug administration. All patients will be reviewed 24-48 hours after treatment and asked to report adverse events. We will calculate the proportion of newly occurring adverse events following treatment and calculate the whether the proportion of patients experiencing an adverse event differs between study arms,

Secondary Outcome Measures

Name	Time	Method
Community perceptions	1 month	An analysis of community perceptions of benefits of co-administration at a single time point vs standard separated MDA will be conducted by conducting focus groups and in-depth interviews with study participants.
Cost of Administration Drug Separately compared to Cost of Co-Administration of Drugs	1 month	Analysis of the cost effectiveness of co-administration compared to separate administration of drugs

Trial Locations

Locations (1)

Community Recruitment across whole district; 🇪🇹 Community Recruitment Across Whole District, Ethiopia