- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06575647
Vivax Elimination With Tafenoquine (VET) Study (VET)
Mass Drug Administration of Tafenoquine for P. Vivax Radical Cure: Safety and Feasibility Study
Theoretically, so long as there is a sink-source for malaria, transmission could be sustained at very low level (even at sub-microscopic oscillation) and reintroduce malaria either as sporadic cases or as resurgent outbreak. Uncertainty or shortage in financing has typically limited the malaria control or elimination projects to go further beyond the "Pre-elimination phase". Since malaria is no longer a top scoring mortality in national statistics in South East Asia, the governments/stakeholders are less willing to allocate from the austerity budget. There are proven evidence of resurgences after cessation of intervention programs where over 90% of all resurgence events were attributed to the interruption of malaria control programmes. In Karen state Myanmar-Thailand border, multiple factors including a cascade of political, financial, and logistical fiascos have compounded on the ongoing malaria elimination activities. Deleterious impacts after military coup since 2021 February including cessation of foreign investment, humanitarian aids, Civil Dis-obedience Movement of government staff and resuming armed-conflicts have strained the nearly failed health infrastructure of the country to a collapse stage. Interruption of the National Malaria Control activities due to the health system failure and accelerating combats countrywide could inevitably lead to the overturn in recently achieved malaria pre-elimination status especially in Karen state.
The disruption in health services within Myanmar is already resulting in an increase in malaria. Supply of the first line antimalarial drug artemether-lumefantrine, and other essential malaria control interventions, has been interrupted. The study is proposed to evaluate the impact of Mass Drug Administration (MDA) in 3 villages in Karen state with consistently high incidence of P. vivax and spatially clustered within 5 km radius. This proposal outlines a study to assess the feasibility and the safety of tafenoquine MDA.
Study Overview
Status
Intervention / Treatment
Detailed Description
Malaria remains a major health concern in Myanmar, particularly in Karen State along the Myanmar-Thailand border, where disruptions in health services have led to a significant increase in cases. To address this, a study is proposed to assess the feasibility and safety of Mass Drug Administration (MDA) using tafenoquine, a single-dose treatment for P. vivax malaria, which has been approved in several countries, including Thailand. The study will focus on three high-incidence villages in Karen State, Myanmar, with a total population of around 1,000.
In this study, the entire village population will be screened for malaria using Rapid Diagnostic Tests (RDT) and PCR, a highly sensitive method that detects parasites by copying and identifying their unique genetic material in blood samples. Participants who test positive for malaria by RDT will receive standard treatment. Additionally, all participants will be screened for their G6PD enzyme status and will receive tafenoquine if G6PD levels are above 6.0 units, or chloroquine prophylaxis if their enzyme levels are lower or if they are pregnant. Impact of MDA on reduction in malaria incidence by RDT and prevalence by PCR will also be evaluated as a secondary outcome of the study.
Participation is voluntary, and participants can withdraw at any time. They will receive full information about the study's risks and benefits before deciding whether to participate.
Risks:
According to previous research conducted both in this context and in other regions, tafenoquine and chloroquine are generally safe, with side effects usually being mild. The most common side effects are nausea and mild to moderate abdominal pain. A research team led by a medical doctor will be on hand to manage any side effects, and a referral system will be established in case of any serious adverse events.
Benefits:
If successful, the study could significantly reduce malaria cases in these villages. Additionally, it could provide valuable insights for implementing Tafenoquine MDA on a larger scale.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Changwat Tak
-
Mae Sot, Changwat Tak, Thailand
- Shoklo Malaria Research Unit (SMRU)
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- All village residence, aged >6 months who agrees to participate in the research.
Exclusion Criteria:
- People who refuse to participate
- People who are hypersensitive to Tafenoquine or Chloroquine
- Critically ill patient
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Tafenoquine
Tafenoquine KODATEF® 100 mg film-coated tablets will be purchased from Biocelect (Suite 5.02, Level 5, 139 Macquarie Street, Sydney NSW, 2000 Australia). Tafenoquine will be given as follows, >10 kg to ≤ 20 kg - 150 mg (1 tab), >20 kg to ≤ 35 kg - 300 mg (2 tabs), > 35 kg - 450 mg (3 tabs) |
Tafenoquine KODATEF® 100 mg film-coated tablets will be purchased from Biocelect (Suite 5.02, Level 5, 139 Macquarie Street, Sydney NSW, 2000 Australia). Tafenoquine will be given as follows, >10 kg to ≤ 20 kg - 150 mg (1 tab), >20 kg to ≤ 35 kg - 300 mg (2 tabs), > 35 kg - 450 mg (3 tabs) |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of Serious Adverse Events (SAEs) to assess safety and tolerability of Tafenoquine MDA
Time Frame: Baseline survey to end of Month-1 survey
|
Number of (serious) adverse events reported
|
Baseline survey to end of Month-1 survey
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
To compare the incidence by Rapid Diagnostic Test (RDT) of P. vivax before and 1-3-6 months after providing the single round of MDA with Tafenoquine radical cure treatment
Time Frame: Month 1, 3 and 6
|
Malaria Incidence by RDT reported from malaria post at month 1, 3 and 6
|
Month 1, 3 and 6
|
|
To evaluate the adherence of healthcare workers to the SOP for implementing MDA of Tafenoquine.
Time Frame: Baseline survey and Month-1 survey
|
Proportion of village health workers adhere to the SOP for G6PD testing & documentation, tafenoquine administration and adverse event recording & reporting.
|
Baseline survey and Month-1 survey
|
|
To compare the prevalence by PCR of P. vivax before and a month after providing the single round of MDA.
Time Frame: Baseline survey and Month-1 survey
|
Difference in proportion positive to PCR positive before and a month after providing the single round of MDA.
|
Baseline survey and Month-1 survey
|
Collaborators and Investigators
Sponsor
Collaborators
Publications and helpful links
General Publications
- Cohen JM, Smith DL, Cotter C, Ward A, Yamey G, Sabot OJ, Moonen B. Malaria resurgence: a systematic review and assessment of its causes. Malar J. 2012 Apr 24;11:122. doi: 10.1186/1475-2875-11-122.
- Jaramillo-Ochoa R, Sippy R, Farrell DF, Cueva-Aponte C, Beltran-Ayala E, Gonzaga JL, Ordonez-Leon T, Quintana FA, Ryan SJ, Stewart-Ibarra AM. Effects of Political Instability in Venezuela on Malaria Resurgence at Ecuador-Peru Border, 2018. Emerg Infect Dis. 2019 Apr;25(4):834-836. doi: 10.3201/eid2504.181355. Epub 2019 Apr 17.
- Okell LC, Bousema T, Griffin JT, Ouedraogo AL, Ghani AC, Drakeley CJ. Factors determining the occurrence of submicroscopic malaria infections and their relevance for control. Nat Commun. 2012;3:1237. doi: 10.1038/ncomms2241.
- Poonkham, J. (2022). A Paradise Lost in the Indo-Pacific? Great Power Politics and International Relations of the Myanmar Tragedy. In: Yamahata, C., Anderson, B. (eds) Demystifying Myanmar's Transition and Political Crisis. Palgrave Macmillan, Singapore. https://doi.org/10.1007/978-981-16-6675-9_11
- Nguyen TN, von Seidlein L, Nguyen TV, Truong PN, Hung SD, Pham HT, Nguyen TU, Le TD, Dao VH, Mukaka M, Day NP, White NJ, Dondorp AM, Thwaites GE, Hien TT. The persistence and oscillations of submicroscopic Plasmodium falciparum and Plasmodium vivax infections over time in Vietnam: an open cohort study. Lancet Infect Dis. 2018 May;18(5):565-572. doi: 10.1016/S1473-3099(18)30046-X. Epub 2018 Feb 2.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- MAL24004
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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