Rehabilitation for cognitive deficits after central nervous system malaria in Ugandan children

ISRCTN ISRCTN53183087
DOI https://doi.org/10.1186/ISRCTN53183087
ClinicalTrials.gov number NCT00658450
Secondary identifying numbers 2006/HD11/4748U
Submission date
10/04/2008
Registration date
03/07/2008
Last edited
28/02/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Infections and Infestations
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Mr Paul Bangirana
Scientific

Department of Psychiatry
Makerere University Medical School
Kampala
7072
Uganda

Phone +256 (0)772 673 831
Email pbangirana@yahoo.com

Study information

Study designRandomised controlled single centre trial (multicentre as of 05/02/2009)
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleA randomised trial to investigate the effect of a rehabilitation program for cognitive deficits in Ugandan children after central nervous system malaria
Study objectivesCurrent hypothesis as of 05/02/2009:
Malaria with central nervous system (CNS) involvement affects several children in sub-Saharan Africa leaving some survivors with cognitive problems especially in attention and memory. There are currently no tested interventions for such deficits resulting from infectious diseases like malaria or other causes. Providing such interventions will go a long way in helping these children achieve their full potential.

The purpose of this study is to determine whether computerised cognitive rehabilitation training improves cognition in children who have had CNS malaria.

Initial hypothesis at time of registration:
Children receiving cognitive rehabilitation will have better cognitive outcomes than those not receiving cognitive rehabilitation.
Ethics approval(s)1. Makerere University Faculty of Medicine Research and Ethics Committee on the 31st October 2007
2. Uganda National Council of Science and Technology on the 11th December 2007

In addition to the proposal being reviewed on the above two dates, another approval for the new changes was given on the 14th Nov 2008.
Health condition(s) or problem(s) studiedMalaria with CNS involvement
InterventionA computerised cognitive training package (named Captain's Log) will be the main intervention. Children assigned to the intervention will be given cognitive training for 45 minutes, twice a week for 8 weeks (16 sessions in all). The hope is that continued use of certain cognitive functions during the training will strengthen them leading to improvement in these areas.

Duration of the treatment in the intervention arm is 16 sessions each lasting 45 minutes bi-weekly for 8 weeks (2 months). This intervention will start at 3 months post-discharge.

The control group will receive the standard post-discharge care for cerebral malaria at Mulago Hospital, the study site (treatment as usual). This includes follow up visits at the Paediatric neurology clinic if child had neurological complications at discharge. No cognitive rehabilitation takes place at this clinic.
Intervention typeOther
Primary outcome measureAttention measured by the Test of Variables of Attention (TOVA).

Primary and secondary outcomes will be measured at 3 months post-discharge (just before intervention starts) and at 6 months post-discharge (a month after intervention).
Secondary outcome measuresAmended as of 20/10/2010:
1. Memory, visual spatial ability, learning and reasoning measured by the Kaufmann Assessment Battery for children second edition
2. Parental rating of behaviour measured by the child behaviour checklist
3. Academic functioning measured by the wide range achievement test, third edition

Primary and secondary outcomes will be measured at 3 months post-discharge (just before intervention starts) and at 6 months post-discharge (a month after intervention).

Initial information at time of registration:
1. Memory, planning and reasoning measured by the Kaufmann Assessment Battery for children second edition
2. Parental rating of behaviour measured by the child behaviour checklist
3. Academic functioning measured by the wide range achievement test, third edition

Primary and secondary outcomes will be measured at 3 months post-discharge (just before intervention starts) and at 6 months post-discharge (a month after intervention).
Overall study start date01/02/2008
Completion date01/10/2010

Eligibility

Participant type(s)Patient
Age groupChild
Lower age limit5 Years
Upper age limit15 Years
SexBoth
Target number of participants124
Key inclusion criteriaCurrent information as of 05/02/2009:
Study will recruit children with central nervous system malaria (CNS) and healthy controls (HC).

Inclusion criteria for CNS group:
1. Aged five to 15 years, either sex
2. Presenting with asexual forms of P. falciparum malaria on a peripheral blood smear
3. Unarousable coma (not able to localise a painful stimulus) and no other cause for coma (normal cerebrospinal fluid [CSF])
4. A history of seizures for the present illness
5. Impaired consciousness

Inclusion criteria for HC group:
1. Aged five to 15 years, either sex
2. No other illness at present
3. Within two years of the CNS child (for CNS children aged 5 and 6 years, the HC's age won't go below 5 and for CNS children aged 14 and 15, the HC's age won't go above 15 years)

Initial information at the time of registration:
Study will recruit children with cerebral malaria (CM) and healthy controls (HC).

Inclusion criteria for CM group:
1. Aged five to 15 years, either sex
2. Presenting with asexual forms of P. falciparum malaria on a peripheral blood smear
3. Unarousable coma (not able to localise a painful stimulus) and no other cause for coma (normal cerebrospinal fluid [CSF])

Inclusion criteria for HC group:
1. Aged five to 15 years, either sex
2. No other illness at present
3. Within two years of the CM child (for CM children aged 5 and 6 years, the HC’s age won't go below 5 and for CM children aged 14 and 15, the HC’s age won't go above 15 years)
Key exclusion criteriaAmended as of 20/10/2010:
Please note that the exclusion of HIV children has been removed as of 20/10/2010, meaning that children infected with HIV will now be allowed to participate in this trial.

Initial information at time of registration:
Exclusion criteria for CNS* group:
1. History of or present meningitis, encephalitis, prior CNS*, sickle cell disease (SCD), human immunodeficiency virus (HIV) infection, epilepsy, multiple seizures
2. Developmental delay
3. History of hospitalisation for malnutrition

Exclusion criteria for HC group:
1. History of or present bacterial meningitis, encephalitis, CNS, SCD, HIV infection
2. History of hospitalisation for malnutrition
3. Any chronic illness for which the patient is currently taking medication

* Please note that this changed from CM to CNS on 05/02/09 in response to updates from the Principal Investigator)
Date of first enrolment01/02/2008
Date of final enrolment01/10/2010

Locations

Countries of recruitment

  • Uganda

Study participating centre

Makerere University Medical School
Kampala
7072
Uganda

Sponsor information

Swedish International Development Cooperation Agency (SIDA) (Sweden)
Government

Valhallavägen 199
Stockholm
105 25
Sweden

Phone +46 (0)8 698 50 00
Email sida@sida.se
Website http://www.sida.se
ROR logo "ROR" https://ror.org/01fn7me06

Funders

Funder type

Government

Department for Research Cooperation (SAREC) of the Swedish International Development Cooperation Agency (SIDA) (Sweden)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 04/08/2011 28/02/2019 Yes No

Editorial Notes

28/02/2019: Publication reference added.
Please note that as of 05/02/2009 this record has been updated to include information on the revised protocol - the disease was changed from cerebral malaria to central nervous system malaria after a drop in the number of cerebral malaria cases in the study population. All updates can be found in the relevant field under the above update date. Please note that the public and scientific titles have also been updated; the initial titles were as follows:
Public title: Rehabilitation for cognitive deficits after cerebral malaria in Ugandan children
Scientific title: A randomised trial to investigate the effect of a rehabilitation program for cognitive deficits in Ugandan children after cerebral malaria
Please also note that the anticipated end date has also been extended; the initial anticipated end date was: 30/03/2009.