- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00120809
Intermittent Preventative Treatment With Sulfadoxine-Pyrimethamine in Gambian Multigravidae
A Randomised, Placebo Controlled Trial of Intermittent Preventative Treatment With Sulfadoxine-pyrimethamine in Gambian Multigravidae.
Study Overview
Detailed Description
Objective
The objective of this study was to determine whether intermittent preventative treatment (IPTp) with sulfadoxine-pyrimethamine (SP) reduced the prevalence of anemia and low birth weight in Gambian multigravidae.
Study area
The study was carried out in 14 mother and child health (MCH) clinics situated on the north and south banks of the River Gambia near to the town of Farafenni in the centre of the country. In this area, malaria is highly seasonal with an entomological inoculation rate of 10 -50 infectious bites per year.
Study population
All women who attended one of the study clinics during the trial period and who were multigravidae were asked if they wished to join the study. If this was the case, an initial screening questionnaire was administered to assess their suitability to do so. Eligibility criteria were - a pregnancy of more than 15 weeks gestation, a hemoglobin (Hb) concentration of more than 7 g/dL, absence of a history of sensitivity to sulfonamides and absence of any chronic underlying illness.
Randomisation
If a woman met the eligibility criteria, informed written consent was sought and, if this was given, the woman was formally recruited to the study and allocated a trial number and randomised to receive either SP or placebo. Randomisation was done in blocks of 12; each field worker was assigned a number of blocks to ensure balanced recruitment between centers.
Drug administration
Women were allocated to receive SP (pyrimethamine 25 mg + sulfadoxine 500 mg)(Cosmos Pharmaceuticals, Nairobi) or matching placebo. An initial dose of SP or placebo (three tablets) was given at the time of enrolment into the trial and at all subsequent visits to the antenatal clinic up to a maximum of four treatments. All women were given iron and folic acid supplements as recommended by the Ministry of Health guidelines.
Surveillance
Women were visited at home twice per week by a project field worker to assess their health and to encourage them to attend the ante-natal clinic at monthly intervals. Women with a high risk of obstetric complications were encouraged to deliver in hospital but most women delivered at home.
If a delivery occurred in hospital or a health center a finger prick blood sample was obtained and the birth weight was measured. In the case of women who delivered at home, the weight of the new born baby was measured within 5 days of delivery and a finger prick blood sample obtained for measurement of Hb concentration and preparation of blood films.
Women were visited at home six weeks after delivery when an additional blood sample was obtained and one year later to investigate the health of their child.
Laboratory methods
Hemoglobin concentration was measured using a Hemocue (Hemocue AB, Angelholm, Sweden). Thick blood films were stained with Giemsa and examined for malaria parasites. Each slide was read by two microscopists. If discrepant results were obtained, the slide was read by a third microscopist and the majority view accepted.
Trial end-points
The co-primary trial end-points were hemoglobin concentration at, or shortly after, birth and birthweight or weight of the baby shortly after birth.
Sample size
To detect a 20% reduction in the estimated risk of severe anemia (Hb <7 g/dl) among multigravidae, estimated to be 30% in the control group, with 80 % power at the 5% level of significance and allowing for a 30% loss to follow-up it was calculated that a study with 1115 women in each arm was required. To show a reduction in the proportion of low birthweight babies from the expected 18% in the control group to 12% in the SP group with 80% power it was estimated that 2 x 1538 women would be needed. Thus, the target sample size was 3,000.
Data management and analysis
All data were double entered and verified. Prior to the breaking of the code the data base was locked and a copy given to the chair of the Data Safety Monitoring Board (DSMB). Statistical analysis was done using S-plus and STATA. An analytical plan was prepared and approved by the DSMB before the code was broken.
Trial oversight
The trial was monitored by a DSMB. It was conducted in line with the requirements of Good Clinical Practice.
Study Type
Enrollment
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
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Banjul, Gambia, PO Box 273
- Medical Research Council Laboratories
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Multigravid pregnancy.
- Residence in study area.
- Informed consent.
Exclusion Criteria:
- Allergy to sulfonamides.
- Chronic illness.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Single Group Assignment
- Masking: Double
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
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Hemoglobin concentration at delivery.
|
Birthweight.
|
Secondary Outcome Measures
Outcome Measure |
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Hemoglobin concentration six weeks after delivery.
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start
Study Completion
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Infections
- Vector Borne Diseases
- Parasitic Diseases
- Protozoan Infections
- Malaria
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Enzyme Inhibitors
- Antiprotozoal Agents
- Antiparasitic Agents
- Antimalarials
- Folic Acid Antagonists
- Anti-Infective Agents, Urinary
- Renal Agents
- Pyrimethamine
- Sulfadoxine
- Fanasil, pyrimethamine drug combination
Other Study ID Numbers
- ITCRVG27b
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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