None listed
Conditions
Brief summary
The efficacy and safety of artesunate-amodiaquine, artemether+lumefantrine and dihydroartemisinin-piperaquine for the treatment of uncomplicated P. falciparum malaria infections will be assessed in 6 sites during September 2016 to January 2017. It is 3 arms arm sequential prospective study for each drug combination. Febrile patients aged 6 to 59 months with confirmed uncomplicated P. falciparum infection will be enrolled. A sample Size of 88 patients per drug per site will be targeted. Patients will be treated with the WHO recommended standard doses of artesunate-amodiaquine (daily dose for 3 days) and artemether-lumefantrine (twice daily for 3 days) and dihydroartemisinin-piperaquine ( daily dose for 3 days). Clinical and parasitological parameters will be monitored over a 42-day follow-up period to evaluate drug efficacy and safety. Primary endpoints: The proportion of patients with early treatment failure, late clinical failure, late parasitological failure or an adequate clinical and parasitological response as indicators of efficacy. Recrudescence will be distinguished from re-infection by polymerase chain reaction (PCR) analysis. Day 3 malaria positivity rate will determined. Secondary endpoints: 1. The frequency of adverse events. 2. Frequency of molecular markers for artemisinin resistance (K13)
Interventions
To assess the efficacy and safety of the three drugs, the following dosages will be give:
Artesunate-amodiaquine: 4 mg/kg artesunate + 10mg/kg amodiaquine once daily for 3 consecutive days will be given.
Artemether-lumefantrine containing 2o mg artemether+ 120 mg lumefantrine in each tablet (twice a day for 3 days) will be administered according to the recommended weight bands as follows: 1 tablet to those weighing 5 to 14 kg; 2 tablets for 15 to 24 kg; 3 tablets for 25 to 34 kg and 4 tablets fo
To assess the efficacy and safety of the three drugs, the following dosages will be give: Artesunate-amodiaquine: 4 mg/kg artesunate + 10mg/kg amodiaquine once daily for 3 consecutive days will be given. Artemether-lumefantrine containing 2o mg artemether+ 120 mg lumefantrine in each tablet (twice a day for 3 days) will be administered according to the recommended weight bands as follows: 1 tablet to those weighing 5 to 14 kg; 2 tablets for 15 to 24 kg; 3 tablets for 25 to 34 kg and 4 tablets for equal or greater than 35 kg. The total target dose ranges are 5-24 mg/kg bw of artemether and 29-144 mg/kg bw of lumefantrine. Dihydroartemisinin-piperaquine: 4 mg/kg dihydroartemisinin and 18 mg/kg piperaquine once a day for 3 days. All treatments will be taken orally under direct supervision by the health worker. These three artemisinin-based combinations will be tested separately. The patient will be given either artesunate+amodiaquine, artemether+lumefantrine or dihydroartemisinin+piperaquine. enrolled patients will be followed up for 28 days (artesunate+amodiaquine, artemether+lumefantrine) for or 42 days (dihydroartemisinin+piperaquine).
Sponsors
Ministry of Health
Study design
Allocation
Non-randomised trial
Intervention model
Other
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
6 Months to 59 Months
Healthy volunteers
No
Inclusion criteria
1. age between six to 59 months; 2. mono-infection with P. falciparum detected by microscopy; 3. parasitaemia of 2000–200,000/microliter asexual forms; 4. presence of axillary temperature greater or equal to 37.5 degrees C or history of fever during the past 24 h 5. ability to swallow oral medication; 6. ability and willingness to comply with the study protocol for the duration of the study and to comply with the study visit schedule; 7. informed consent from the parent or guardian.
Exclusion criteria
1. presence of general danger signs in children aged under 5 years or signs of severe falciparum malaria according to the definitions of WHO; 2. weight under 5 kg; 3. Haemoglobin < 8g/dl; 4. mixed or mono-infection with another Plasmodium species detected by microscopy; 5. presence of severe malnutrition defined as a child aged 6-60 months has a mid-upper arm circumference belo 115 mm) 6. 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); 7. regular medication, which may interfere with antimalarial pharmacokinetics; 8. history of hypersensitivity reactions or contraindications to any of the medicine(s) being tested or used as alternative treatment(s);
Outcome results
None listed