Malaria Risk Prior to and During Early Pregnancy in Nulliparous Women Receiving Long-term Weekly Iron and Folic Acid Supplementation (WIFS): a Non-inferiority Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Malaria
- Sponsor
- Liverpool School of Tropical Medicine
- Enrollment
- 1959
- Locations
- 1
- Primary Endpoint
- Prevalence of peripheral parasitaemia at first antenatal clinic visit (13-16 weeks gestation)
- Status
- Completed
- Last Updated
- 12 years ago
Overview
Brief Summary
A randomized double-blind controlled trial will be carried out in which young, nulliparous (having never given birth) women will be randomly assigned to receive weekly supplementation with either iron and folic acid or folic acid alone. Women will be followed-up weekly up to 18 months. Women who become pregnant will be followed-up until delivery. Malaria risk in both groups will be compared by assessing the prevalence of peripheral parasitaemia at the first antenatal clinic visit for pregnant women and at the end of the first malaria transmission season for non-pregnant women. The incidence of clinical malaria will be assessed by active and passive case detection throughout the follow-up period.
Investigators
Eligibility Criteria
Inclusion Criteria
- •At least 15 and less than 25 years old at enrolment
- •Never given birth
- •Resident within the Demographic Surveillance System (DSS) area
- •Willing to adhere to the study requirements (including weekly observed drug intake)
- •Provision of written informed consent (if non emancipated minor by guardian/parent with minor's assent
Exclusion Criteria
- •No menses for \>3 months and/or palpable uterus or positive pregnancy test if history unclear
- •Concurrent enrolment in another study
- •Intention to move out of the study area for more than 2 months within the next 18 months
- •Any significant illness at the time of screening that requires hospitalization, including clinical signs of severe anaemia (conjunctival or mucosal pallor, tachycardia, respiratory distress)
- •History or presence of major clinical disease likely to influence pregnancy outcome (sickle cell disease, diabetes mellitus, severe renal or heart disease, open tuberculosis, epilepsy)
Outcomes
Primary Outcomes
Prevalence of peripheral parasitaemia at first antenatal clinic visit (13-16 weeks gestation)
Time Frame: Nov 2013
Completed
Secondary Outcomes
- a) In the pregnant cohort: Prevalence of placental malaria(Jan 2014)
- a) In the non-pregnant cohort: Prevalence of bacterial vaginosis at end assessment(Nov 2013)
- a) In the pregnant cohort: Incidence of clinical malaria during the first and subsequent trimesters(Jan 2014)
- a) In the pregnant cohort: Mean gestational age at delivery(Jan 2014)
- a) In the non-pregnant cohort: Prevalence of iron deficiency at key study visits(Nov 2013)
- a) In the non-pregnant cohort: Prevalence of peripheral parasitaemia during the first rainy season after at least six months of supplementation(Nov 2012)
- In the non-pregnant cohort: Prevalence of bacterial vaginosis at end assessment(Nov 2013)
- a) In the non-pregnant cohort: Prevalence of bacterial vaginosis at first antenatal visit(Nov 2013)
- a) In the pregnant cohort: Prevalence of anaemia at first antenatal clinic visit(Sept 2013)
- a) In the pregnant cohort: Incidence of adverse pregnancy outcomes(Jan 2014)
- a) In the pregnant cohort: Mean birth weight and prevalence of low birth weight (<2500g)(Jan 2014)
- a) In the non-pregnant cohort: Prevalence of anaemia after at least 18 months supplementation(Nov 2013)
- a) In the pregnant cohort: Prevalence of iron deficiency at first antenatal visit(Sept 2013)
- a) In the non-pregnant cohort: Incidence of gastrointestinal adverse events(Nov 2013)
- a) In the non-pregnant cohort: Incidence of clinical malaria(Nov 2013)
- a) In the non-pregnant cohort: Prevalence of iron deficiency after at least 18 months supplementation(Nov 2013)
- a) In the non-pregnant cohort: Adherence to supplementation(Nov 2013)
- a) In the non-pregnant cohort: Acceptability of weekly supplementation(June 2013)
- a) In the non-pregnant cohort: Prevalence of peripheral parasitaemia at end assessment(Nov 2013)