- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04245033
Evaluation of the Implementation and Effectiveness of Intermittent Preventive Treatment for Malaria Using Dihydroartemisinin-piperaquine on Reducing Malaria Burden in School Aged Children in Tanzania (IPTsc)
In Tanzania, according to the National Malaria Control Programme (NMCP), malaria prevalence has declined from an average of 18.1% in 2008 to 7% in 2017, marked as an epidemiological transition from meso-endemic to hypo-endemic levels with variation across and within regions and/or councils. Children of school-age have become increasingly more vulnerable as compared to those aged less than five years. In high-transmission settings, up to 70% of school-aged children harbour malaria parasites which is mostly asymptomatic, accounting for around 50% of the mortality, 13-50% of all school absenteeism. The NMCP developed a supplementary malaria midterm strategic plan (SMMSP 2018-2020) to customise malaria interventions by stratifying the burden of malaria in Tanzania mainland and recommended use of Dihydroartemisinin-Piperaquine (DP) for intermittent preventive treatment in school children (IPTsc) in high malaria strata. The investigators plan to evaluate the implementation of IPTsc using DP, given three times a year, for evidence on the operational feasibility and effectiveness of IPTsc on clinical malaria incidence at a high endemic area in Handeni District Council (DC), Handeni Town Council (TC) and Kilindi DC of Tanga region, Tanzania.
The study is an effectiveness-implementation hybrid trial to assess feasibility and effectiveness of IPTsc using DP against standard of care (control). Wards in the three study districts (Handeni DC, Handeni TC and Kilindi DC) will be the randomisation unit (clusters). Each ward will be randomised to implement IPTsc or not (control). In all wards in the IPTsc arm, the interventional drugs (DP) will be given at an interval of four months, three times a year. For study evaluation of the impact of intervention, in each district representative randomly selected wards, will provide randomly selected school per ward (24 in total) to formulate part of evaluable children per intervention. Mixed design methods will be used to assess the feasibility and acceptability of implementing IPTsc as part of a more comprehensive school children health package.
The study is expected to be operationally feasible given existing school health programme for Neglected Tropical Disease (NTD) control and the school net programme (SNP). IPTsc is expected to increase malaria case management effectiveness and to have additional effect in reducing the burden of disease on top of optimal access to malaria case management (MCM) and malaria vector control (MVC) initiatives e.g. early diagnosis and treatment, and insecticide-treated nets (ITNs) coverage, respectively.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
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-
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Tanga, Tanzania
- Handeni Town Council, Handeni and Kilindi Districts
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
The following eligibility criteria are used to enroll participants on for close monitoring follow ups assessing the effectiveness part of the study protocol.
Inclusion Criteria:
- Includes parental/guardian informed consent
- Assent by primary school children aged 11 years and above.
- Aged 5-15 years.
- Currently, lives within the pre-defined catchment area of study district; and
- Will remain within the same area throughout the study period (preferably class five and below).
Exclusion Criteria:
- Students at class 7
- Currently enrolled in another study or participated in another investigational drug study within the last 30 days.
- Known to have heart disease or a known cardiac ailment.
- Reports known hypersensitivity to the study drugs.
- Not willing to undergo all study procedures including physical examination and to provide blood samples as per this study protocol.
- Having clinical features of severe anaemia
- Febrile due to non-malaria illness at the time of recruitment.
- Has apparent severe infection or any condition that requires hospitalization
- Illness or conditions like hematologic, cardiac, renal, hepatic diseases which in the judgement of the investigator would place the subject at undue risk or interfere with the results of the study, including known G6PD deficiency and SS sickle cell.
- Body weight < 12 kg
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: IPTsc arm
Dihydroartemisinin-Piperaquine (DP) for intermittent preventive treatment in school children (IPTsc) will be given in all wards in the IPTsc arm at an interval of four months, three times a year.
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Dihydroartemisinin-Piperaquine (DP) for intermittent preventive treatment of malaria in school children (IPTsc).
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No Intervention: Control
No intervention will be given to wards randomised in this arm
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Efficiency of school health teachers to deliver antimalarial drugs to school children in high endemic regions
Time Frame: 1 year from start of intervention
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Efficiency in terms of percentage of children given a complete dose in each round.
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1 year from start of intervention
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Clinical malaria incidence
Time Frame: from month 0 till month 12 of follow up
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Malaria incidence will be collected in terms of number of episodes a child gets malaria.
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from month 0 till month 12 of follow up
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in malaria incidence per 1000 population at local health facility level
Time Frame: from month 0 till month 12 of follow up
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Number of malaria episodes before and after intervention in a respective ward
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from month 0 till month 12 of follow up
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Change from baseline in haemoglobin concentration
Time Frame: measured at month 12
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individual change in Haemoglobin before and after intervention
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measured at month 12
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Number of participants with treatment-related adverse events
Time Frame: through study completion, an average of 1 year"
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Number of participants with treatment-related adverse events encountered by subjects per study arm
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through study completion, an average of 1 year"
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Cardio safety profile by QTc prolongation from baseline
Time Frame: Day 1, 2,3 and 7 after before and after dosing
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measured by ECG
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Day 1, 2,3 and 7 after before and after dosing
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Acceptability of IPTsc in communities with high malaria endemicities
Time Frame: At month 8 of implementation
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Through in depth interview in a guided questionnaire
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At month 8 of implementation
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of school children with malnutrition
Time Frame: at month 0 (baseline) and at month 12.
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Weight and height will be combined to report BMI in kg/m^2, WHO's BMI z-score will be used to categorise nutrition status.
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at month 0 (baseline) and at month 12.
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Collaborators and Investigators
Collaborators
Investigators
- Study Director: John P.A Lusingu, MD, PhD, National Institute for Medical Research, Tanga, Tanzania
- Study Director: Ally Mohamed, MD, National Malaria Control Programme, Tanzania
- Principal Investigator: Geofrey Makenga, MD, Msc, PhD fellow, National Institute for Medical Research, Tanzania
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IPTsc version 1
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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