Chloroquine Alone or in Combination for Malaria in Children in Malawi

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier:
NCT00379821
First received: September 21, 2006
Last updated: March 28, 2013
Last verified: August 2012
Results First Received: June 30, 2011  
Study Type: Interventional
Study Design: Allocation: Randomized;   Endpoint Classification: Efficacy Study;   Intervention Model: Parallel Assignment;   Masking: Open Label;   Primary Purpose: Treatment
Condition: Plasmodium Falciparum Malaria
Interventions: Drug: Chloroquine
Drug: Atovaquone-proguanil
Drug: Artesunate
Drug: Azithromycin

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
Children who were brought to the Ndirande Health Centre with symptoms suggestive of malaria were recruited from February 19, 2007 to August 13, 2008.

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
No text entered.

Reporting Groups
  Description
Chloroquine Plus Artesunate Participants receive chloroquine (CQ) at 10 mg/kg on days 0 and 1, and 5 mg/kg/day on day 2; plus Artesunate at a dose of 4 mg/kg once a day for 3 days.
Chloroquine Plus Atovaquone-Proguanil Participants receive CQ at 10 mg/kg on days 0 and 1, and 5 mg/kg/day on day 2; plus Atovaquone-Proguanil (AP) once a day for 3 days dosed as follows: 5-8 kg, 2 pediatric tablet (PT, 62.5 mg/25mg); 9-10 kg, 3 PT; 11-20 kg, 1 full strength tablet (FST, 250mg/100 mg); 21-30 kg 2 FST; >30 kg, 3 FST.
CQ Plus Azithromycin Participants receive CQ at 10 mg/kg on days 0 and 1, and 5 mg/kg/day on day 2; plus Azithromycin 30 mg/kg once a day for 3 days.
CQ Monotherapy Participants receive CQ at 10 mg/kg on days 0 and 1, and 5 mg/kg/day on day 2.

Participant Flow:   Overall Study
    Chloroquine Plus Artesunate     Chloroquine Plus Atovaquone-Proguanil     CQ Plus Azithromycin     CQ Monotherapy  
STARTED     160     160     160     160  
COMPLETED     87     71     93     81  
NOT COMPLETED     73     89     67     79  



  Baseline Characteristics
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Reporting Groups
  Description
Chloroquine Plus Artesunate Participants receive chloroquine (CQ) at 10 mg/kg on days 0 and 1, and 5 mg/kg/day on day 2; plus Artesunate at a dose of 4 mg/kg once a day for 3 days.
Chloroquine Plus Atovaquone-Proguanil Participants receive CQ at 10 mg/kg on days 0 and 1, and 5 mg/kg/day on day 2; plus Atovaquone-Proguanil (AP) once a day for 3 days dosed as follows: 5-8 kg, 2 pediatric tablet (PT, 62.5 mg/25mg); 9-10 kg, 3 PT; 11-20 kg, 1 full strength tablet (FST, 250mg/100 mg); 21-30 kg 2 FST; >30 kg, 3 FST.
CQ Plus Azithromycin Participants receive CQ at 10 mg/kg on days 0 and 1, and 5 mg/kg/day on day 2; plus Azithromycin 30 mg/kg once a day for 3 days.
CQ Monotherapy Participants receive CQ at 10 mg/kg on days 0 and 1, and 5 mg/kg/day on day 2.
Total Total of all reporting groups

Baseline Measures
    Chloroquine Plus Artesunate     Chloroquine Plus Atovaquone-Proguanil     CQ Plus Azithromycin     CQ Monotherapy     Total  
Number of Participants  
[units: participants]
  160     160     160     160     640  
Age  
[units: participants]
         
<=18 years     160     160     160     160     640  
Between 18 and 65 years     0     0     0     0     0  
>=65 years     0     0     0     0     0  
Age  
[units: years]
Mean ± Standard Deviation
  2.7  ± 1.2     2.7  ± 1.2     2.8  ± 1.1     2.7  ± 1.2     2.7  ± 1.2  
Gender  
[units: participants]
         
Female     70     82     73     77     302  
Male     90     78     87     83     338  
Region of Enrollment  
[units: participants]
         
Malawi     160     160     160     160     640  



  Outcome Measures
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1.  Primary:   Number of Clinical Malaria Episodes Per Year of Follow-up   [ Time Frame: 1 year ]

2.  Secondary:   Number of Participants With Day 28 Adequate Clinical and Parasitologic Response in Each Treatment Arm   [ Time Frame: Day 28 of initial malaria episode (Episode 0) ]

3.  Secondary:   Number of Participants With Day 28 Adequate Clinical and Parasitologic Response in Each Treatment Arm   [ Time Frame: Day 28 of first subsequent malaria episode (Episode 1) ]

4.  Secondary:   Number of Participants With Day 28 Adequate Clinical and Parasitologic Response in Each Treatment Arm   [ Time Frame: Day 28 of second subsequent malaria episode (Episode 2) ]

5.  Secondary:   Number of Participants With Day 28 Adequate Clinical and Parasitologic Response in Each Treatment Arm   [ Time Frame: Day 28 of third subsequent malaria episode (Episode 3) ]

6.  Secondary:   Number of Participants With Day 28 Adequate Clinical and Parasitologic Response in Each Treatment Arm   [ Time Frame: Day 28 of fourth subsequent malaria episode (Episode 4) ]

7.  Secondary:   Number of Cases of Severe Malaria in Each Treatment Arm   [ Time Frame: 1 Year ]

8.  Secondary:   Mean Hemoglobin at the Last Study Visit in Each Treatment Arm for the Age Group of Participants 3 Years of Age or Younger.   [ Time Frame: 1 year ]

9.  Secondary:   Mean Hemoglobin at the Last Study Visit in Each Treatment Arm for the Age Group of Participants Greater Than 3 Years to 5 Years of Age.   [ Time Frame: 1 year ]

10.  Secondary:   Mean Creatinine in Each Treatment Arm (Renal Function)   [ Time Frame: Day 0 of initial malaria episode (Episode 0) ]

11.  Secondary:   Mean Creatinine in Each Treatment Arm (Renal Function)   [ Time Frame: Day 14 of initial malaria episode (Episode 0) ]

12.  Secondary:   Mean Creatinine in Each Treatment Arm (Renal Function)   [ Time Frame: Day 0 of first subsequent malaria episode (Episode 1) ]

13.  Secondary:   Mean Creatinine in Each Treatment Arm (Renal Function)   [ Time Frame: Day 14 of first subsequent malaria episode (Episode 1) ]

14.  Secondary:   Mean Creatinine in Each Treatment Arm (Renal Function)   [ Time Frame: Day 0 of second subsequent malaria episode (Episode 2) ]

15.  Secondary:   Mean Creatinine in Each Treatment Arm (Renal Function)   [ Time Frame: Day 14 of second subsequent malaria episode (Episode 2) ]

16.  Secondary:   Mean Creatinine in Each Treatment Arm (Renal Function)   [ Time Frame: Day 0 of third subsequent malaria episode (Episode 3) ]

17.  Secondary:   Mean Creatinine in Each Treatment Arm (Renal Function)   [ Time Frame: Day 14 of third subsequent malaria episode (Episode 3) ]

18.  Secondary:   Mean Creatinine in Each Treatment Arm (Renal Function)   [ Time Frame: Day 0 of fourth subsequent malaria episode (Episode 4) ]

19.  Secondary:   Mean Creatinine in Each Treatment Arm (Renal Function)   [ Time Frame: Day 14 of fourth subsequent malaria episode (Episode 4) ]

20.  Secondary:   Mean Alanine Transaminase (ALT) in Each Treatment Arm (Hepatic Function)   [ Time Frame: Day 0 of initial malaria episode (Episode 0) ]

21.  Secondary:   Mean Alanine Transaminase (ALT) in Each Treatment Arm (Hepatic Function)   [ Time Frame: Day 14 of initial malaria episode (Episode 0) ]

22.  Secondary:   Mean Alanine Transaminase (ALT) in Each Treatment Arm (Hepatic Function)   [ Time Frame: Day 0 of first subsequent malaria episode (Episode 1) ]

23.  Secondary:   Mean Alanine Transaminase (ALT) in Each Treatment Arm (Hepatic Function)   [ Time Frame: Day 14 of first subsequent malaria episode (Episode 1) ]

24.  Secondary:   Mean Alanine Transaminase (ALT) in Each Treatment Arm (Hepatic Function)   [ Time Frame: Day 0 of second subsequent malaria episode (Episode 2) ]

25.  Secondary:   Mean Alanine Transaminase (ALT) in Each Treatment Arm (Hepatic Function)   [ Time Frame: Day 14 of second subsequent malaria episode (Episode 2) ]

26.  Secondary:   Mean Alanine Transaminase (ALT) in Each Treatment Arm (Hepatic Function)   [ Time Frame: Day 0 of third subsequent malaria episode (Episode 3) ]

27.  Secondary:   Mean Alanine Transaminase (ALT) in Each Treatment Arm (Hepatic Function)   [ Time Frame: Day 14 of third subsequent malaria episode (Episode 3) ]

28.  Secondary:   Mean Alanine Transaminase (ALT) in Each Treatment Arm (Hepatic Function)   [ Time Frame: Day 0 of fourth subsequent malaria episode (Episode 4) ]

29.  Secondary:   Mean Alanine Transaminase (ALT) in Each Treatment Arm (Hepatic Function)   [ Time Frame: Day 14 of fourth subsequent malaria episode (Episode 4) ]

30.  Secondary:   Number of Participants in Each Treatment Arm Who Change From “Normal” to “Abnormal” on Any Questions of the Neurological Examination   [ Time Frame: 1 Year ]

31.  Secondary:   Prevalence of Chloroquine Resistant Parasites, by Treatment Arm: Prevalence of Parasites With the Mutation Pfcrt 76T on Day 0 of Each Episode of Malaria, and in Cases of Recurrent Parasitemia After Therapy.   [ Time Frame: 1 year ]
Results not yet posted.   Anticipated Posting Date:   02/2012   Safety Issue:   No

32.  Secondary:   Incidence of Infections and Recrudescent Infections After Initial Treatment Per Treatment Arm.   [ Time Frame: 28 days to 1 year ]
Results not yet posted.   Anticipated Posting Date:   02/2012   Safety Issue:   No

33.  Secondary:   Incidence of New and Recrudescent Infections After Subsequent New Episodes   [ Time Frame: 1 year ]
Results not yet posted.   Anticipated Posting Date:   02/2012   Safety Issue:   No

34.  Secondary:   Effect of Population Movements on the Risk of Malaria Infection - Risk of Malaria in Children Who Travelled Outside the City vs Those That Did Not.   [ Time Frame: 1 year ]
Results not yet posted.   Anticipated Posting Date:   02/2012   Safety Issue:   No

35.  Secondary:   Spatial Patterns and the Environmental Determinants of Malaria Infection: Distribution of Malaria Cases in Relation to Environmental Factors in Ndirande.   [ Time Frame: 1 year ]
Results not yet posted.   Anticipated Posting Date:   02/2012   Safety Issue:   No

36.  Secondary:   Chloroquine Blood Levels at Which Chloroquine Sensitive and Resistant Parasites Are Able to Cause Infection: Chloroquine Pharmacokinetic Curve for the Population, and Drug Concentration at the Time of Parasitemia.   [ Time Frame: 1 year ]
Results not yet posted.   Anticipated Posting Date:   02/2012   Safety Issue:   No


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