Intermittent Preventive Therapy Post-Discharge: an innovative approach in the prevention of rebound severe malaria anaemia and mortality in young children

ISRCTN ISRCTN89727873
DOI https://doi.org/10.1186/ISRCTN89727873
Secondary identifying numbers N/A
Submission date
18/05/2006
Registration date
19/06/2006
Last edited
10/04/2012
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 Feiko ter Kuile
Scientific

Liverpool School of Tropical Medicine
Pembroke Place
Liverpool
L3 5QA
United Kingdom

Phone +44 (0)151 7053287
Email terkuile@liverpool.ac.uk

Study information

Study designRandomised, double-blind, placebo-controlled, multicentre study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Not specified
Study typePrevention
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleIntermittent Preventive Therapy Post-Discharge: an innovative approach in the prevention of rebound severe malaria anaemia and mortality in young children - a randomised double-blind placebo controlled multicentre study
Study acronymIPTpd
Study objectivesTo compare the efficacy of a single treatment course with lumefantrine-artemether (Coartem®) at discharge to three treatment courses with Coartem® given at discharge, 1 and 2 months (intermittent preventive therapy post-discharge [IPTpd]), to standard antimalarial therapy of oral sulfadoxine-pyrimethamine (SP) in Malawi, in the post-discharge management of children, aged 4-59 months, who have recovered from severe malarial anaemia by assessing mean haemoglobin concentration, and the incidence of rebound severe anaemia, clinical malaria and death by 3 and 6 months.

As of 22/04/2010 this record was updated; all changes can be found in the relevant fields with the above update date. At this time, the anticipated end date of this trial was also updated; the initial anticipated end date at the time of registration was 01/12/2008.
Ethics approval(s)Approved by College of Medicine Research and Ethics Committee on 25/02/05, reference number: P.03/04/287 and by Liverpool Research and Ethics Committee on 09/02/05, reference number: 05.01
Health condition(s) or problem(s) studiedSevere malarial anaemia
InterventionPatients are randomised into one of the following groups:
Group A - lumefantrine-artemether, single 3-day course at enrolment
Group B - lumefantrine-artemether, three 3-day courses (at enrolment, at 1 month, and at 2 months)
Group C - sulfadoxine-pyrimethamine (SP), single dose at enrolment (added 22/04/2010: group C dropped out following amendments to protocol)
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Specified
Drug / device / biological / vaccine name(s)lumefantrine-artemether (Coartem®), sulfadoxine-pyrimethamine
Primary outcome measureCurrent information as of 22/04/2010:
The incidence of rebound severe anaemia (Hb less than 5 g/L), severe malaria (hospital admissions requiring quinine) or death (a composite endpoint) between 1 and 6 months after enrolment.

Initial information at time of registration:
Mean haemoglobin at three months
Secondary outcome measuresCurrent information as of 22/04/2010:
1. The incidence of sick-child's clinic visits due to clinical malaria by 3 and 6 months
2. The incidence of all-cause sick-child's clinic visits by 3 and 6 months
3. The incidence of all cause re-hospitalisation between 1 - 3 and 1 - 6 months after enrolment
4. The incidence of the three individual components of the composite endpoint (severe anaemia, severe malaria, death) between 1 - 3 and 1 - 6 months after enrolment
5. Mean haemoglobin at 6 months
6. Incidence of adverse events by 3 and 6 months
7. Mean corrected heart rate (QTc) prolongation by 3 days

Initial information at time of registration:
1. The incidence of sick-child's clinic visits due to clinical malaria by 3 and 6 months
2. The incidence of rebound severe anaemia (Hb <5 g/l)
3. The incidence of death by 3 and 6 months
4. Mean haemoglobin at 6 months
5. Incidence of adverse events by 3 and 6 months
6. Mean corrected heart rate (QTc) prolongation by 3 days
Overall study start date22/05/2006
Completion date01/12/2010

Eligibility

Participant type(s)Patient
Age groupChild
Lower age limit4 Months
Upper age limit59 Months
SexBoth
Target number of participants1280 (initial). As of 22/04/2010: 1650 participants or 126 events
Key inclusion criteria1. Haemoglobin <5.0 g/dl or packed cell volume (PCV) <15% on admission to the hospital
2. Plasmodium falciparum malaria (any documented parasitaemia) at the time of admission to the hospital or within 24 hours prior to admission
3. Aged between 4 months (inclusive) and 59 months (inclusive) at the time of randomization
4. Bodyweight >5 kg at the time of randomization
5. Subject completed blood transfusion(s) in accordance with routine hospital practice
6. Subject completed intravenous (IV) quinine in accordance with routine hospital practice
7. Able to feed (for breastfed children) or eat (for older children)
8. Able to sit unaided
9. Provision of informed consent by parent or guardian
Key exclusion criteria1. Recognised, specific other cause of severe anaemia at the time of admission to the hospital (e.g. trauma, haematological malignancy, known bleeding disorder, known sickle cell disease)
2. Previous enrolment in the present study
3. Severe anaemia (haemoglobin <5.0 g/dl ) at the time of randomization
4. Known hypersensitivity to any of the study drugs
5. Documented intake of Coartem® (≥4 doses) or SP within 1 week prior to admission
6. Child resides outside of catchment area during the course of the study (6 months)
7. Known need at the time of randomization for concomitant prohibited medication during the 2 months randomized treatment period
8. Ongoing participation into another clinical trial involving ongoing or scheduled treatment with medicinal products during the course of the study (6 months)
9. Known need, or scheduled surgery during the course of the study (6 months)
10. Suspected non-compliance with the follow-up schedule
Date of first enrolment22/05/2006
Date of final enrolment01/12/2010

Locations

Countries of recruitment

  • England
  • Malawi
  • United Kingdom

Study participating centre

Liverpool School of Tropical Medicine
Liverpool
L3 5QA
United Kingdom

Sponsor information

Liverpool School of Tropical Medicine (UK)
University/education

Pembroke Place
Liverpool
L3 5QA
England
United Kingdom

Phone +44 (0)151 7053281
Email hemingway@liverpool.ac.uk
Website http://www.liverpool.ac.uk/lstm
ROR logo "ROR" https://ror.org/03svjbs84

Funders

Funder type

Research organisation

The Netherlands-African partnership for capacity development and clinical interventions against poverty-related diseases (NACCAP) (Netherlands) (ref: W 07.05.202.00)

No information available

UBS Optimus Foundation (Switzerland)

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 01/03/2012 Yes No