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Trial registered on ANZCTR
Registration number
ACTRN12618001349235
Ethics application status
Approved
Date submitted
3/08/2018
Date registered
9/08/2018
Date last updated
9/08/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluate the efficacy and safety of Artesunate-mefloquine (ASMQ) and low dose primaquine to treat uncomplicated Plasmodium falciparum and Plasmodium vivax malaria in Champasack province, Lao PDR
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Scientific title
Efficacy and safety of Artesunate-mefloquine with low dose primaquine for the treatment of uncomplicated Plasmodium falciparum and Plasmodium vivax malaria in Champasack province, Lao PDR
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Secondary ID [1]
295734
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None
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Universal Trial Number (UTN)
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Trial acronym
TES ( Therapeuty Efficacy Study )
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Linked study record
None
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Health condition
Health condition(s) or problem(s) studied:
Malaria
309132
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Condition category
Condition code
Infection
308012
308012
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0
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Studies of infection and infectious agents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
One oral tablet for children contains 25 mg artesunate+ 55 mg Mefloquine (ASMQ), and for adults it contains 100 mg artesunate+ 220 mg Mefloquine. Drug will be administered under direct supervision according to body weight, once daily for 3 days for both P. vivax and P. falciparum.
For children:
5-8 kg one tablet daily for 3 days
9-17 kg two tablets daily for 3 days
For adults:
18-29 kg one tablet daily for 3 days
Equal to or more than 30 kg 2 tablets daily for 3 days
Oral primaquine will be administered under direct supervision as a single 15-mg adult dose (0.25 mg base/kg) on day 0 for P. falciparum cases only, and once daily (0.25 base/kg) for 14 days for G6PD defficient P. vivax participants.
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Intervention code [1]
312055
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Treatment: Drugs
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Proportion of treatment success confirmed by using blood smears for microscopy and dry blood spot for Polymerase Chain-Reaction (PCR).
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Assessment method [1]
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Timepoint [1]
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42 days after treatment is the primary timepoint. Patients will be assessed daily on Day 0, 1, 2 and 3, and weekly thereafter (D7, D14, D21, D28, D35) until Day 42.”
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Secondary outcome [1]
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Evaluate safety by the incidence of adverse events assessed by clinical observation of symptoms. For example: vomiting, abdominal pain, and rashes.
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Assessment method [1]
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Timepoint [1]
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Any time adverse events occur between Day 0 and Day 7.
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Eligibility
Key inclusion criteria
- Age between aged between 6 months and above
- Mono-infection with P. falciparum and P. vivax confirmed by positive blood smear (no mixed infection);
- P. falciparum parasitaemia of 250 to 100,000 per µl asexual forms;
- P. vivax parasitaemia of 250 to 60,000 per µl asexual forms
- Presence of axillary temperature equal or more then 37.5 °C or history of fever during the past 24 hours
- ability to swallow oral medication;
- ability and willingness to comply with the study protocol for the duration of the study and to comply with the study visit schedule;
- informed consent from the patient or from a parent or guardian in the case of children aged less than age of majority;
- informed assent from any minor participant aged from 12 to age of majority years; and
- consent for pregnancy testing from female of child-bearing age (defined as age more than 12 years and sexually active) and from their parent or guardian if under the age of majority years.
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Minimum age
6
Months
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
-presence of general danger signs in children aged under 12 years or signs of severe falciparum malaria according to the definitions of WHO
- female aged from 12 years and age of majority
- weight under 5 kg;
- haemoglobin less than 8 g per dl
-mixed or mono-infection with another Plasmodium species detected by microscopy;
- presence of severe malnutrition defined as a child aged between 6to 60 months whose weight-for-high is below –3 z-score
- presence of febrile conditions due to diseases other than malaria (e.g. measles, acute lower respiratory tract infection, severe diarrhea with dehydration) or other known underlying chronic or severe diseases (e.g. cardiac, renal and hepatic diseases, HIV/AIDS);
- regular medication, which may interfere with antimalarial pharmacokinetics;
- history of hypersensitivity reactions or contraindications to any of the medicine(s) being tested or used as alternative treatment(s);
- glucose-6-phosphate dehydrogenase deficiency for patient treated with 14 day primaquine;
- unmarried women 12 to 18 years old;
- a positive pregnancy test or breastfeeding; and
- unable to or unwilling to take pregnancy test or to use contraception for women of child-bearing age (defined as age more than 12 years and sexually active).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
None
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
None
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
As the Pf treatment failure rate to artemether-lumefantrine in the area is 0-10% (CMPE 2015), and unknown in P. vivax, and also unknown to ASMQ in both species, 90% has been chosen. At a confidence level of 95% and a precision around the estimate of 5%, a minimum of 50 patients for each species must be included. With a 20% increase to allow loss to follow-up and withdrawals during the 42-day follow-up period, 60 patients should be included in the study per malaria species and per drug tested
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
10/08/2018
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Actual
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Date of last participant enrolment
Anticipated
15/02/2019
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Actual
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Date of last data collection
Anticipated
29/03/2019
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Actual
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Sample size
Target
120
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
20726
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Lao People's Democratic Republic
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State/province [1]
20726
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Champasack province
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Funding & Sponsors
Funding source category [1]
300324
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Other
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Name [1]
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World Health Organization
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Address [1]
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WHO Lao PDR, 125 saphanthong road, Unit 5, Ban saphanthong Tai, Vientiane Capital
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Country [1]
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Lao People's Democratic Republic
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Funding source category [2]
300325
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Government body
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Name [2]
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Ministry of Health
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Address [2]
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Samsenthai road, Ban thatkhao, Sisattanak district, Vientiane Capital
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Country [2]
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Lao People's Democratic Republic
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Primary sponsor type
Government body
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Name
Ministry of Health
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Address
Samsenthai road, Ban thatkhao, Sisattanak district, Vientiane Capital
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Country
Lao People's Democratic Republic
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Secondary sponsor category [1]
299762
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None
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Name [1]
299762
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Address [1]
299762
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Country [1]
299762
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
301136
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National Ethics Committee for Health Research
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Ethics committee address [1]
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Samsenthai road, Ban kaoyot, sisattanak district,vientiane capital
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Ethics committee country [1]
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Lao People's Democratic Republic
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Date submitted for ethics approval [1]
301136
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02/05/2018
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Approval date [1]
301136
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20/06/2018
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Ethics approval number [1]
301136
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061/NECHR
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Ethics committee name [2]
301137
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WHO Ethics Research Committee
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Ethics committee address [2]
301137
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WHO western Pacific Regional office , UN Avenue, Manila
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Ethics committee country [2]
301137
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Philippines
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Date submitted for ethics approval [2]
301137
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26/06/2018
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Approval date [2]
301137
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25/07/2018
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Ethics approval number [2]
301137
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2018.7.LAO.2.MVP
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Summary
Brief summary
This study is an open prospective evaluation of clinical and parasitological responses to directly observed treatment for uncomplicated malaria. People with uncomplicated malaria who meet the study inclusion criteria will be enrolled, treated on site with ASMQ and low dose primaquine for both Pf and Pv, and monitored for 42 days and 28 days for Pv. The follow-up will consist of a fixed schedule of check-up visits and corresponding clinical and laboratory examinations. On the basis of the results of these assessments, the patients will be classified as having therapeutic failure (early or late) or an adequate response. The proportion of patients experiencing therapeutic failure during the follow-up period will be used to estimate the efficacy of the study drug. PCR analysis will be used to distinguish between true recrudescence due to treatment failure and episodes of reinfection.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
2940
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/AnzctrAttachments/375730-Ethics approval CPS.pdf
(Ethics approval)
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Contacts
Principal investigator
Name
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Dr Bouasy Hongvathong
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Address
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Center of Malariology, Parasitology and Entomology
Nongdouang road, Ban khoualuang Tai, Chanthabouly district, vientian capital
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Country
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Lao People's Democratic Republic
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Phone
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+856 21 214040
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Fax
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+ 856 21 218131
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Email
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[email protected]
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Contact person for public queries
Name
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Viengxay Vanisaveth
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Address
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Center of Malariology, Parasitology and Entomology
Nongdouang road, Ban khoualuang Tai, Chanthabouly district, vientian capital
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Country
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Lao People's Democratic Republic
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Phone
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+ 856 21 214040
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Fax
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+ 856 21 218131
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Email
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[email protected]
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Contact person for scientific queries
Name
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Pascal Ringwald
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Address
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World Health Organization, 20 Av, Appia, 12211 Geneva 27
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Country
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Switzerland
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Phone
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+41227913469
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Fax
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+41227914824
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF