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Momordica Charantia and Dihydroartemisinin-piperaquined-primaquine for Uncomplicated Plasmodium Falciparum Malaria Patients in Southwest Sumba Regency

Phase 2
Completed
Conditions
Uncomplicated Plasmodium Falciparum
Interventions
Registration Number
NCT05829187
Lead Sponsor
Syamsudin Abdillah,Ph.D, Pharm D
Brief Summary

Currently, the first-line combination of artemisinin, piperaquine and prima-quine is quite effective in controlling malaria, however, the threat of spread of drug-resistant parasites has been reported. A study is conducted to assess the efficacy and safety extract of bitter melon (Momordica charantia/MC) regimens compared to the combination of dihydroartemisinin piperaquine primaquine (DHP+PQ) on the sexual and asexual stage of P. Falciparum uncomplicated in Sumba Barat Daya District, Indonesia

Detailed Description

The Study was conducted in Kori Primary Health Cender, Sumba Barat Daya District, East Nusa Tenggara Province on Sumba Island.

The study subject received either 3 day of dihydroartemisinin-piperaquine and primaquine 1 day on first day (DHP+PQ) or extract of bitter melon (Momordica charantia/MC) + Placebo 1 day on first day according to their body weight.

Patients with fever or history of fever within the past 24 hours were screened by microscopic examination of giemsa stained tihick blood films to detect Plasmodium falciparum infection.

All Patient were allocated by single blind randomization to receive DHP (on day 0 to day 2)+PQ (on day 0 only) or extract of bitter melon (Momordica charantia/MC) (on day 0 to day 2)+placebo (on day 0 only). The procedures of drug administration in the study were as follows:

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
36
Inclusion Criteria
  1. Age ≥ 18 years old male or female up to 60 years old
  2. Single Plasmodium falciparum infection based on microscopic examination.
  3. Count the parasites for Plasmodium falciparum at least 2 large visual field asexual parasites (LPB) by examining 15 LPB
  4. Density of parasites 1000-100,000/micro liter
  5. Has no history of uncontrolled comorbidities
  6. History of fever in the last 24 hours for falciparum malaria
  7. Not taking other antimalarial drugs in the last 2 weeks.
  8. Have no previous history of malaria.
  9. Willing to come to the health facility according to the specified follow-up schedule.
  10. Willing to participate in research and established procedures.
  11. There is no history of allergy to antimalarial drugs.
Exclusion Criteria
  1. Signs of general weakness, or decreased consciousness or recurrent seizures or circulation failure or pulmonary edema or signs of anemia or yellow body and slightly red urine.
  2. If the examination results show mixed Plasmodium and non-Plasmodium falciparum.
  3. Has a history of severe liver, kidney and heart dysfunction, bradycardia and heart rhythm disturbances.
  4. Does not control regularly according to the research schedule
  5. Pregnant and lactating women
  6. There are signs of severe malaria
  7. Patients with chronic diseases, for example: heart, kidney, liver, HIV.
  8. Mixed infection.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Dihydro artemisinin Piperakuin (Fixed Dose Combination) and PrimaquineDihydroartemisininFixed Dose Combination content in the form of 40 mg dihydroartemisinin and 320 mg piperaquine administered for 3 days with a dose of dihydroartemisinin 2-4 mg/Kg body weight, piperaquine at a dose of 16-32 mg/Kg body weight in the form of a combination set out in the table based on body weight and age. Primaquine dose of 0.25 mg/Kg body weight is given only on the first day. Dihydroartemisinin-piperaquine was local product by PT Mersi Pharmaceuticals, batch No 220610, produced on Jun/22 and expiring on Jun/24. primaquine was local product by PT Phapros Indonesia, Batch No 56386001, produced on Jan/22 and expiring date jan/25.
Dihydro artemisinin Piperakuin (Fixed Dose Combination) and PrimaquinePiperaquineFixed Dose Combination content in the form of 40 mg dihydroartemisinin and 320 mg piperaquine administered for 3 days with a dose of dihydroartemisinin 2-4 mg/Kg body weight, piperaquine at a dose of 16-32 mg/Kg body weight in the form of a combination set out in the table based on body weight and age. Primaquine dose of 0.25 mg/Kg body weight is given only on the first day. Dihydroartemisinin-piperaquine was local product by PT Mersi Pharmaceuticals, batch No 220610, produced on Jun/22 and expiring on Jun/24. primaquine was local product by PT Phapros Indonesia, Batch No 56386001, produced on Jan/22 and expiring date jan/25.
Dihydro artemisinin Piperakuin (Fixed Dose Combination) and PrimaquinePrimaquineFixed Dose Combination content in the form of 40 mg dihydroartemisinin and 320 mg piperaquine administered for 3 days with a dose of dihydroartemisinin 2-4 mg/Kg body weight, piperaquine at a dose of 16-32 mg/Kg body weight in the form of a combination set out in the table based on body weight and age. Primaquine dose of 0.25 mg/Kg body weight is given only on the first day. Dihydroartemisinin-piperaquine was local product by PT Mersi Pharmaceuticals, batch No 220610, produced on Jun/22 and expiring on Jun/24. primaquine was local product by PT Phapros Indonesia, Batch No 56386001, produced on Jan/22 and expiring date jan/25.
Extract Capsul Momordica CharantiaMomordica Charantia ExtractMomordica Charantia 325 mg in 500 mg capsules is given to patients with uncomplicated plasmodium falsiparum malaria as one capsule per day for three days for body weight less than 60 kg. Patients with a body weight of more than 60 kg are given two capsules per day for three days.
Primary Outcome Measures
NameTimeMethod
development of sexual and asexual stages of Plasmodium falciparum28 day post treatment

Finger prick blood samples are collected for malaria blood smear. Thick and thin blood smear were stained with 3% giemsa solution for 45 minutes and were read under binocular microscope with 1,000x magnification

Secondary Outcome Measures
NameTimeMethod
Number of adverse event28 days
Parasite clearence times28-days

parasite reduction ratio

Fever clearence time28 days

time taken for the axilla temperature to fall below 37.5°C in patients who were febrile at inclusion

Trial Locations

Locations (1)

Kori Puskesmas

🇮🇩

Tambolaka, East Nusa Tenggara, Indonesia

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