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Combination Antimalarials in Uncomplicated Malaria

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00203801
Recruitment Status : Completed
First Posted : September 20, 2005
Last Update Posted : October 19, 2018
World Health Organization
Medical Research Council, South Africa
Global Fund
Information provided by (Responsible Party):
Professor Karen I Barnes, University of Cape Town

Brief Summary:
The purpose of this study is to study the efficacy of sulfadoxine-pyrimethamine on its own and compare this with efficacy of a new combination antimalarial therapy, either sulphadoxine-pyrimethamine plus artesunate or artemether-lumefantrine.

Condition or disease Intervention/treatment Phase
Malaria Drug: Sulfadoxine-pyrimethamine Drug: Artesunate plus sulfadoxine-pyrimethamine Drug: Artemether-lumefantrine Not Applicable

Detailed Description:
The resistance of Plasmodium falciparum to anti-malarial drugs is a serious impediment to the control of malaria. In the South East African Combination Anti-malarial Therapy (SEACAT) evaluation, there will be a comprehensive evaluation of phased introduction of combination anti-malarials (CAT) in Mozambique, Swaziland and South Africa. In order to facilitate formulation of an effective regional drug policy and provide a database for decision-making on the implementation of combination therapy, it is essential that the in vivo response to CAT in all three countries be investigated. An SP therapeutic efficacy study will be conducted according to this modified World Health Organization (WHO) protocol to guide the selection of CAT. After CAT is introduced an in vivo CAT efficacy study will then be conducted to evaluate the efficacy of artesunate plus SP (or artemether-lumefantrine in KwaZulu Natal and Limpopo). In areas of low intensity malaria transmission the CAT in vivo study results will be compared across sites and with those found at baseline with monotherapy, for each site.

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Study Type : Interventional  (Clinical Trial)
Enrollment : 700 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Open Label Study to Evaluate Combination Anti-malarial Therapy,in Terms of Efficacy, Prevalence of Gametocyte Carriage and Molecular Markers Associated With Sulfadoxine Pyrimethamine Resistance in Uncomplicated Plasmodium Falciparum
Study Start Date : January 2002
Actual Primary Completion Date : July 2005
Actual Study Completion Date : July 2005

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Malaria

Primary Outcome Measures :
  1. Therapeutic efficacy defined as:
  2. Adequate Clinical and Parasitological Response (ACPR), Early Treatment Failure (ETF), Late Treatment Failure (LTF), defined as Late Clinical Failure (LCF) and Late Parasitological Failure (LPF);
  3. Sensitive or parasitological failure (RI, early and late, RII, RIII)
  4. Parasitological failures will be classified as recrudescence or re-infection (or indeterminate) using glutamate-rich protein (GLURP) and merozoite surface protein (MSP) I & II markers;
  5. Parasite clearance time;
  6. Fever clearance time.

Secondary Outcome Measures :
  1. Association between study treatment and gametocyte carriage
  2. Pharmacokinetics by measurement of whole blood levels of Sulfadoxine and Pyrimethamine, and lumefantrine should a reliable assay become available
  3. Correlation of frequency of dihydropteroate synthase (DHFR) and dihydrofolate reductase (DHPS) mutations with parasitological outcome
  4. Tolerability by describing adverse events and changes in haematological parameters
  5. Capacity by describing the training and development of study teams and their subsequent skills attained

Information from the National Library of Medicine

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Ages Eligible for Study:   12 Months and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Male or female, older than 12 months.
  • Weight > 10 kg.
  • Diagnoses of uncomplicated acute P. falciparum malaria parasitaemia of up to 250 000 asexual parasite/mcl blood with axillary temperature of greater than and equal to 37.5 or history of fever
  • Documented informed consent
  • Lives close enough to the health centre for reliable follow up

Exclusion Criteria:

  • Has received anti-malarial treatment in the past 7 days.
  • Severely ill (based on WHO Criteria for severe malaria ) or if patient is considered, in the opinion of the investigator or designee, to have moderately severe malaria (e.g. prostrate, repeated vomiting, dehydrated).
  • Has received cotrimoxazole or chloramphenicol in the past 7 days.
  • History of Glucose-6-phosphate dehydrogenase (G6PD) deficiency (not a contra-indication for artemether-lumefantrine).
  • Is pregnant or breastfeeding.
  • Has a history of allergy to any of the study drugs (including other sulphonamides e.g. cotrimoxazole, other artemisinin derivatives e.g. artemether-lumefantrine).

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00203801

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Bela Vista Clinic
Bela Vista, Matutuine, Mozambique
Namaacha Clinic
Namaacha, Mozambique
South Africa
Ndumo Clinic
Ndumo, KwaZulu Natal, South Africa
Lulekani Clinic
Lulekani, Limpopo, South Africa
Naas Clinic
Naas, Mpumalanga, South Africa
Ndzevane Clinic
Ndzevane, Swaziland
Vuvulane Clinic
Vuvulane, Swaziland
Sponsors and Collaborators
University of Cape Town
World Health Organization
Medical Research Council, South Africa
Global Fund
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Principal Investigator: Karen Barnes, MBChB University of Cape Town
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Responsible Party: Professor Karen I Barnes, University of Cape Town Identifier: NCT00203801    
Other Study ID Numbers: SEACAT 01 Mono (Am 1,2,3,5,6)
First Posted: September 20, 2005    Key Record Dates
Last Update Posted: October 19, 2018
Last Verified: October 2018
Keywords provided by Professor Karen I Barnes, University of Cape Town:
Molecular markers
Additional relevant MeSH terms:
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Protozoan Infections
Parasitic Diseases
Vector Borne Diseases
Artemether, Lumefantrine Drug Combination
Fanasil, pyrimethamine drug combination
Antiprotozoal Agents
Antiparasitic Agents
Anti-Infective Agents
Antineoplastic Agents
Antiviral Agents
Antiplatyhelmintic Agents
Folic Acid Antagonists
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Anti-Infective Agents, Urinary
Renal Agents