Evaluate impact of rectal artesunate on resolution of severe malaria and mortality (Bangladesh)

ISRCTN ISRCTN83979018
DOI https://doi.org/10.1186/ISRCTN83979018
Secondary identifying numbers N/A
Submission date
01/02/2006
Registration date
01/02/2006
Last edited
23/02/2009
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

Dr Melba Gomes
Scientific

20, Avenue Appia
Geneva-27
CH 1211
Switzerland

Phone +41 (0)22 791 3813
Email gomesm@who.int

Study information

Study designRandomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Not specified
Study typeTreatment
Scientific title
Study objectivesThe objective has been to establish whether, in patients with acute malaria who cannot take medication by mouth, rectal artesunate plus referral differs from rectal placebo plus referral in terms of death or permanent disability.
Ethics approval(s)Ethics approval received on the 8th July 1998.
Health condition(s) or problem(s) studiedMalaria
InterventionThe sample size determination in the protocol specified that a total of 10,000 non per os patients would need to be randomised in order to detect a reduction of mortality from 5% to 3%.

Individual patients will be randomised to receive either AS suppository (intervention group) or placebo (comparator group). Patients in both groups will then be referred immediately to the nearest hospital/health centre where all supportive treatment will be provided.
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Specified
Drug / device / biological / vaccine name(s)Artesunate (AS)
Primary outcome measure1. Number of relevant deaths in the intervention and control arm assessed 7 - 30 days after enrolment (relevant defined as malaria positive patients in whom the death was probably/definitely preventable by the intervention)
2. Number of individuals with serious neurological disability in the intervention and control arms assessed at 7 - 30 days following enrolment in the study. Neurological disability defined as the development of new problems with feeding, walking, talking, sitting, sight, hearing, playing, balance and behaviour
Secondary outcome measures1. Number of deaths in the intervention and control arm assessed 7 - 30 days following enrolment in the study
2. Number of cases of neurological disability in the intervention and control arms assessed at 7 - 30 days following enrolment in the study
3. Number of cases of neurological disability in malaria smear positive patients in the intervention and control arms assessed at 7 - 30 days following enrolment in the study
4. Number of cases of neurological disability in children in the intervention and control arms assessed at 7 - 30 days following enrolment in the study
5. Number of cases of neurological disability in pregnant women in the intervention and control arms assessed at 7 - 30 days following enrolment in the study
6. Number of deaths and neurological sequelae in the intervention and control arm in malaria smear positive patients who survived at least 8 hours but died before 7 days after enrolment in the study
Overall study start date08/07/1998
Completion date08/07/2000

Eligibility

Participant type(s)Patient
Age groupNot Specified
SexNot Specified
Target number of participantsIn this trial, it is not the number of patients recruited but the number of deaths that determine the statistical power of such a trial.
Key inclusion criteria1. Children above crawling age and adults of any age group
2. Clinical diagnosis of probable P. falciparum malaria (fever, or history of fever without any other obvious cause of fever). Clinical features must include fever or history of fever and at least one of the following:
2.1. Unable to take food, drink or suck
2.2. Prostration: inability to sit, stand or walk unaided
2.3. Any abnormal level of consciousness i.e. from abnormal behavior, obtunded (limited response to painful stimulus), to coma (unconsciousness with absent verbal response and non-specific or absent motor response)
2.4. Fits or history of fits (defined as more than one fit in the previous 24 hours)
3. Consent by patient or parent/guardian if patient is less than 18
4. Community informed consent - at the start of the study in that area, community consent to the project would have been obtained
Key exclusion criteria1. Afebrile (history/examination)
2. Unwillingness to sign (or parental signature) informed consent for study participation
3. Ability to take oral medication
4. Diarrhoea (at least two loose bowel movements in the previous two hours)
N.B. Pregnant or breast-feeding women will not be excluded from the study. Status of pregnancy in female will be noted in the Case Record Form (CRF).
Date of first enrolment08/07/1998
Date of final enrolment08/07/2000

Locations

Countries of recruitment

  • Bangladesh
  • Switzerland

Study participating centre

20, Avenue Appia
Geneva-27
CH 1211
Switzerland

Sponsor information

UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR)
Research organisation

20, Avenue Appia
Geneva-27
CH 1211
Switzerland

Website http://www.who.int/
ROR logo "ROR" https://ror.org/01f80g185

Funders

Funder type

Research organisation

Sources of funding:

No information available

United Nations Children's Fund (UNICEF)/United Nations Development Programme (UNDP)/World Bank/World Health Organization (WHO) - Special Programme for Research and Training in Tropical Diseases (TDR)

No information available

European Commission (Belgium)
Government organisation / National government
Alternative name(s)
European Union, Comisión Europea, Europäische Kommission, EU-Kommissionen, Euroopa Komisjoni, Ευρωπαϊκής Επιτροπής, Европейската комисия, Evropské komise, Commission européenne, Choimisiúin Eorpaigh, Europskoj komisiji, Commissione europea, La Commissione europea, Eiropas Komisiju, Europos Komisijos, Európai Bizottságról, Europese Commissie, Komisja Europejska, Comissão Europeia, Comisia Europeană, Európskej komisii, Evropski komisiji, Euroopan komission, Europeiska kommissionen, EC, EU
WHO Global Malaria Programme

No information available

US Agency for International Development (USAID) (USA)

No information available

Irish Aid (Ireland)

No information available

Karolinska Institutet (Sweden)
Government organisation / Local government
Alternative name(s)
Karolinska Institute, KI
Location
Sweden
Sall Family Foundation (USA)
Private sector organisation / Trusts, charities, foundations (both public and private)
Location
United States of America
University of Oxford Clinical Trial Service Unit (UK)

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 14/02/2009 Yes No