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Parasite clearance and protection from Plasmodium falciparum infection (PCPI): a three-arm, parallel, double-blinded, placebo-controlled, randomised trial of presumptive sulfadoxine-pyrimethamine versus sulfadoxine-pyrimethamine plus amodiaquine versus artesunate monotherapy among asymptomatic children 3–5 years of age in Cameroon

Authors :
Rosario Martinez-Vega
Wilfred Fon Mbacham
Innocent Ali
Akindeh Nji
Andria Mousa
Khalid B. Beshir
Ana Chopo-Pizarro
Harparkash Kaur
Lucy Okell
Helle Hansson
Emma Filtenborg Hocke
Michael Alifrangis
Roland Gosling
Cally Roper
Colin Sutherland
R. Matthew Chico
Source :
BMC Infectious Diseases, Vol 24, Iss 1, Pp 1-12 (2024)
Publication Year :
2024
Publisher :
BMC, 2024.

Abstract

Abstract Background The World Health Organization 2022 malaria chemoprevention guidelines recommend providing a full course of antimalarial treatment at pre-defined intervals, regardless of malaria status to prevent illness among children resident in moderate to high perennial malaria transmission settings as perennial malaria chemoprevention (PMC) with sulfadoxine-pyrimethamine (SP). The dhps I431V mutation circulating in West Africa has unknown effect on SP protective efficacy. Methods This protocol is for a three-arm, parallel, double-blinded, placebo-controlled, randomised trial in Cameroon among children randomly assigned to one of three directly-observed treatment groups: (i) Group 1 (n = 450) receives daily artesunate (AS) placebo on days − 7 to -1, then active SP plus placebo amodiaquine (AQ) on day 0, and placebo AQ on days 1 and 2; (ii) Group 2 (n = 250) receives placebo AS on days − 7 to -1, then active SP and AQ on day 0, and active AQ on days 1 and 2; and (iii) Group 3 (n = 200) receives active AS on days − 7 to -1, then placebo SP on day 0 and placebo AQ on days 0 to 2. On days 0, 2, 5, 7, and thereafter weekly until day 28, children provide blood for thick smear slides. Dried blood spots are collected on the same days and weekly from day 28 to day 63 for quantitative polymerase chain reaction (qPCR) and genotype analyses. Discussion Our aim is to quantify the chemopreventive efficacy of SP, and SP plus AQ, and measure the effect of the parasite genotypes associated with SP resistance on parasite clearance and protection from infection when exposed to SP chemoprevention. We will report unblinded results including: (i) time-to-parasite clearance among SP and SP plus AQ recipients who were positive on day 0 by qPCR and followed to day 63; (ii) mean duration of SP and SP plus AQ protection against infection, and (iii) mean duration of symptom-free status among SP and SP plus AQ recipients who were parasite free on day 0 by qPCR. Our study is designed to compare the 28-day follow-up of the new WHO malaria chemoprevention efficacy study protocol with extended follow-up to day 63. Trial registration ClinicalTrials.gov NCT06173206; 15/12/2023.

Details

Language :
English
ISSN :
14712334
Volume :
24
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Infectious Diseases
Publication Type :
Academic Journal
Accession number :
edsdoj.010a3991247c4267a89a5e047d7d4a06
Document Type :
article
Full Text :
https://doi.org/10.1186/s12879-024-09868-y