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IPT of Malaria With SP in Different Zones of Drug Resistance in Rwanda

12 september 2010 bijgewerkt door: Institute of Tropical Medicine, Belgium

Intermittent Preventive Treatment of Malaria With Sulfadoxine-Pyrimethamine in Different Zones of Drug Resistance in Rwanda

The present study will address the question whether the use of IPT using SP in pregnancy is efficacious in Rwanda, where it is going to be used for the first time, in areas with high levels of SP resistance. While the implementation of the new policy will take place in areas at low SP resistance level, where we expect pregnant women and newborns to benefit from it, it is of paramount importance to clarify which is the real impact of IPT/SPin areas of high SP drug resistance and at what level of SP resistance this strategy is still efficacious. As bed nets are a part of the actual control strategy of malaria in pregnancy all women will receive a bed net at enrolment

Studie Overzicht

Gedetailleerde beschrijving

The present study will address the question whether the use of IPT using SP in pregnancy is efficacious in Rwanda, where it is going to be used for the first time, in areas with high levels of SP resistance. While the implementation of the new policy will take place in areas at low SP resistance level, where we expect pregnant women and newborns to benefit from it, it is of paramount importance to clarify which is the real impact of IPT/SPin areas of high SP drug resistance and at what level of SP resistance this strategy is still efficacious. As bed nets are a part of the actual control strategy of malaria in pregnancy all women will receive a bed net at enrolment.

This will be a randomized blinded placebo controlled trial: women in the 16-28th week of gestation will be offered enrolment into the study and randomized to receive IPT/SP regimen or placebo once during the second and once in the third trimesters.

The study will be conducted in Mashesha (estimated SP drug resistance 20%, 12% in 2000), Kicukiro (40% SP resistance) and Rukara (60% SP resistance). In each of these sites there are about 1000 deliveries per year. According to DHMT data, over 75% of pregnant women attend antenatal clinics, usually booking between 15 and 25 weeks of gestation. Based on this study we expect to find placental malaria prevalence over 50% in all sites.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

1717

Fase

  • Fase 4

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

      • Kigali, Rwanda
        • Programme Nationale de Controle de Paludisms

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

21 jaar tot 50 jaar (Volwassen)

Accepteert gezonde vrijwilligers

Ja

Geslachten die in aanmerking komen voor studie

Vrouw

Beschrijving

Inclusion Criteria:

  1. Pregnant women between 16-28 weeks of gestation;
  2. Residence within the catchment's area of the health facility;
  3. Willing to deliver at the health facility;
  4. Willing to ; adhere to all requirements of the study;
  5. Willing to provide written informed consent;
  6. Aged 21 years and above

Exclusion Criteria:

  1. Severe anemia (Hb < 6 g/dL)
  2. History of allergic reactions to sulfa drugs;
  3. Taking other sulfa drugs as CTX;
  4. History of known pregnancy complications (e.g. breech presentation, severe pre-eclampsia, prior caesarian section);
  5. History or presence of major illnesses likely to influence pregnancy outcome including diabetes mellitus, severe renal or heart disease, or active tuberculosis, prior to randomization;
  6. Any significant illness that requires hospitalization;
  7. Intent to move out of the study catchment's area before delivery or deliver at relative's home out of the catchment's area;
  8. Prior enrollment in the study or concurrent enrollment in another study

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Verviervoudigen

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Placebo-vergelijker: placebo
The control group receives placebo similar in taste and appearance to to the experimental arm
Experimenteel: sulfadoxine-pyrimethamine
The intervention group receives 1500mg of sulfadoxine and 75mg of pyrimethamine at enrollment and in the third trimester.
Andere namen:
  • fans

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
malaria infection will be defined as the presence of asexual stage parasites on thick smears made with maternal side placental blood and Maternal peripheral blood
Tijdsspanne: maternal placental blood at delivery; maternal peripheral blood at monthly visits between 16 weeks of gestation and delivery
maternal placental blood at delivery; maternal peripheral blood at monthly visits between 16 weeks of gestation and delivery

Secundaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
LBW = birth weight <2,500 grams
Tijdsspanne: at delivery
at delivery
Premature delivery = delivery prior to 37 weeks gestation
Tijdsspanne: at delivery
at delivery
Spontaneous miscarriage = any spontaneous abortion before the end of gestation
Tijdsspanne: at delivery
at delivery
Stillbirth
Tijdsspanne: at delivery
at delivery
Cord blood parasitaemia = presence of asexual stage parasites in thick smears
Tijdsspanne: at delivery
at delivery
Neonatal death = infant death within the first 28 days of life
Tijdsspanne: 7days and 6 weeks after delivery
7days and 6 weeks after delivery
Maternal anemia = Hb <11.0 g/dL
Tijdsspanne: at monthly visits between 16 weeks of gestation and delivery
at monthly visits between 16 weeks of gestation and delivery
Maternal severe anemia = Hb <6 g/dL
Tijdsspanne: at monthly visits between 16 weeks of gestation and delivery
at monthly visits between 16 weeks of gestation and delivery
Symptomatic maternal malaria infection = axillary temperature 37.5°C and asexual parasitaemia
Tijdsspanne: at monthly visits between 16 weeks of gestation and delivery
at monthly visits between 16 weeks of gestation and delivery
Severe maternal adverse reactions to SP = severe cutaneous reactions (e.g., erythema multiform, Stevens-Johnson syndrome, or toxic epidermal necrolysis)
Tijdsspanne: at monthly visits between 16 weeks of gestation and delivery plus at day 7 and week 6 after delivery
at monthly visits between 16 weeks of gestation and delivery plus at day 7 and week 6 after delivery

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Onderzoekers

  • Studie directeur: Umberto D'Alessandro, MD,MSc, PHD, Institute of Tropical Medicine Antwerp

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 december 2005

Primaire voltooiing (Werkelijk)

1 april 2008

Studie voltooiing (Werkelijk)

1 april 2008

Studieregistratiedata

Eerst ingediend

5 september 2006

Eerst ingediend dat voldeed aan de QC-criteria

5 september 2006

Eerst geplaatst (Schatting)

7 september 2006

Updates van studierecords

Laatste update geplaatst (Schatting)

14 september 2010

Laatste update ingediend die voldeed aan QC-criteria

12 september 2010

Laatst geverifieerd

1 september 2010

Meer informatie

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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