Malaria
Conditions
Keywords
Plasmodium falciparum, malaria, chloroquine, pharmacokinetic, children
Brief summary
Chloroquine (CQ) remains an alternative cheap, safe and widely available drug. Our previous research has shown that double (50 mg/kg) standard dose CQ given in split doses had a 95% efficacy and was well tolerated and safe. Still, safety could be an issue when the dose of CQ is increased. Severe adverse events are caused by high peak concentrations of CQ. Using split doses of CQ avoids high peak concentrations enabling the safe administration of high doses, however, pharmacokinetic data are lacking. Children included in the study will be given 50 mg/kg as split doses over 3 days or 70 mg/kg as split doses over 5 days. Treatment will be observed. Drug concentrations and adverse events will be monitored. On day 1, children and their mother/guardian will be requested to stay at the health centre between 9 am and 6 pm. Fifteen children aged 2-10 years with uncomplicated P. falciparum malaria and fulfilling the inclusion criteria will be recruited into each study arm. Following the end of treatment, the children will be seen on the morning of day 7, 14, 21 and 28. Any child wishing to withdraw during the treatment phase and any child with reparasitaemia during the follow up will be given rescue treatment with arthemeter-lumefantrine or quinine according to treatment guidelines in Guinea-Bissau. Final analysis will include a description of included children, proportions of adverse events and any serious adverse events, drug concentrations and their relation to adverse events, the proportion of children withdrawn or lost to follow up, the cumulative PCR corrected and uncorrected success and failure rates on day 28 and the proportion of early, late clinical and late parasitological treatment failures.
Interventions
DRUGChloroquine-base 50 mg
DRUGChloroquine-base 70 mg
Sponsors
Bandim Health Project
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
2 Years to 9 Years
Healthy volunteers
No
Inclusion criteria
* Age ≥ 2 years and \< 10 years. * Mono-infection with P. falciparum detected by microscopy. Parasitemia of 1.000-100.000/µl asexual forms. * Axillary temperature ≥ 37.5 ˚C or a history of fever within 24 hours. * Ability to swallow oral medication. * Ability and willingness to comply with the study protocol. * Informed consent from a parent or guardian
Exclusion criteria
* Signs or symptoms of severe malaria. * Presence of general danger signs in children under 5. * Persistent vomiting. * Presence of severe malnutrition. * Any evidence of chronic disease or acute infection other than malaria. * Regular medication which may interfere with antimalarial pharmacokinetics. * History of hypersensitivity reactions or contraindications to chloroquine.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Chloroquine serum concentration | Twice daily during treatment, on day 1 an additional 8 measurements. | Filterpaper blood samples will be collected in the morning and evening on the days of treatment. On day 1 hourly during daytime. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Parasitemia | Twice a day dúring treatment and then weekly until day 28. | Blood smear for microscopy will be performed in the morning and evening on the days of treatment, and for the 50 mg group on day 3. During follow-uo weekly until day 28. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Blood pressure | On day 1 and day 28 | Will be measures on day 1 at midday and on day 28. |
| ECG | Will be measures on day 1 and on last treatment day. | — |
| Haemoglobin level | On day 0, 3 and 28. | The haemoglobin level will be measured on the the specified days. |
Countries
Guinea-Bissau
Outcome results
None listed