Ignite Creation Date:
2024-05-05 @ 4:56 PM
Last Modification Date:
2024-10-26 @ 9:25 AM
Study NCT ID:
NCT00341003
Status:
COMPLETED
Last Update Posted:
2017-07-02
First Post:
2006-06-19
Brief Title:
Severe Malaria and Anti-malarial Drug Resistance in Cambodia
Sponsor:
National Institute of Allergy and Infectious Diseases NIAID
Organization:
National Institutes of Health Clinical Center CC
Study Overview
Official Title:
Multidisciplinary Studies of Severe Malaria and Antimalarial Drug Resistance in Cambodia
Status:
COMPLETED
Status Verified Date:
2011-01-14
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
This study conducted by the National Center for Malaria Control of Cambodias Ministry of Health the Guangzhou University of Traditional Chinese Medicine in the Peoples Republic of China and the US National Institutes of Health will explore why some people with mild malaria progress to a severe form of the disease and why some malaria parasites are resistant to treatment
Malaria is caused by a parasite that is transmitted to humans through a mosquito bite It can cause fever aches and weakness Left untreated it can cause severe illness and even death Malaria can be cured when it is treated with effective medicine but some malaria parasites are resistant to medicine
Children and adults with malaria symptoms and parasites in their blood will be recruited for this study from the Pursat Regional Health Center in Cambodia and the Thai-Cambodian border area within Pursat Province
Participants are hospitalized for 4 to 6 days at the Pursat Regional Health Center A small blood sample is collected for genetic study and to look for substances in the blood such as certain proteins that may help protect against severe malaria Patients are then treated with two doses of ArtequickRegistered Trademark artemisinin-piperaquine the first dose upon arrival at the hospital and the second the next day Participants who are pregnant will be treated with either quinine or artesunate-mefloquine instead of Artequick
Patients undergo fingersticks several times during their hospital stay to collect a small drop of blood to monitor parasite counts They are discharged from the hospital when their symptoms resolve and parasites can no longer be detected in their blood After discharge patients return to the clinic once a week for 3 weeks for a blood test to monitor for parasites as some parasites may be slightly resistant to the medication Patients in whom symptoms or parasites reappear undergo treatment with artesunate and mefloquine
Malaria is caused by a parasite that is transmitted to humans through a mosquito bite It can cause fever aches and weakness Left untreated it can cause severe illness and even death Malaria can be cured when it is treated with effective medicine but some malaria parasites are resistant to medicine
Children and adults with malaria symptoms and parasites in their blood will be recruited for this study from the Pursat Regional Health Center in Cambodia and the Thai-Cambodian border area within Pursat Province
Participants are hospitalized for 4 to 6 days at the Pursat Regional Health Center A small blood sample is collected for genetic study and to look for substances in the blood such as certain proteins that may help protect against severe malaria Patients are then treated with two doses of ArtequickRegistered Trademark artemisinin-piperaquine the first dose upon arrival at the hospital and the second the next day Participants who are pregnant will be treated with either quinine or artesunate-mefloquine instead of Artequick
Patients undergo fingersticks several times during their hospital stay to collect a small drop of blood to monitor parasite counts They are discharged from the hospital when their symptoms resolve and parasites can no longer be detected in their blood After discharge patients return to the clinic once a week for 3 weeks for a blood test to monitor for parasites as some parasites may be slightly resistant to the medication Patients in whom symptoms or parasites reappear undergo treatment with artesunate and mefloquine
Detailed Description:
Hemoglobin E HbE is distinguished from normal HbA by a single amino acid mutation beta26 Glu to Lys High allele frequencies in some areas of Cambodia are believed to have been naturally selected by life-threatening manifestations of malaria Few epidemiological studies support this hypothesis however and in vitro studies have not clearly defined a mechanism of protection The prevalence of drug-resistant malaria is alarmingly high along the Thai-Cambodian border such that chloroquine quinine or mefloquine can no longer effect acceptable cure rates Recently prolonged parasite clearance times after artemisinin treatment have been documented in Battambang and Pailin provinces in Cambodia Combinations of artemisinins and other drugs eg mefioquine piperaquine are now used as standard first-line treatments for P falciparum malaria in Southeast Asia Further decreases in the effectiveness of these drugs would constitute a disaster making some cases of malaria essentially untreatable The molecular basis for parasite resistance to these antimalarials has not been firmly established The main aims of this study are to 1 determine whether HbE protects against severe P falciparum malaria 2 identify genetic determinants associated with parasite resistance to antimalarial drugs and 3 determine whether HbE and other erythrocyte polymorphisms influence parasite clearance times after artemisinin treatment To meet these aims we are conducting an unmatched case-control study comparing the prevalence of HbE in patients with severe and uncomplicated P falciparum malaria Cambodians who complain of fever andor symptoms of malaria are recruited from Pursat Regional Health Center and surrounding districts within Pursat Province Patients with uncomplicated malaria are treated with weight-based doses of artesunate given orally each day for 3 days followed by weight-based doses of mefloquine given orally each day for 2 days Patients with severe malaria will be treated with artemisinin compounds given parenterally for 5 consecutive days followed by artesunate plus mefioquine treatment as above We will also collect parasitized blood samples from malaria patients prior to antimalarial drug administration These parasites will be tested in short-term in vitro culture experiments to determine their susceptibility to antimalarial drugs Genome-wide typing of drug-sensitive and drug-resistant P falciparum isolates using microsatellite and single nucleotide polymorphism markers and genetic association studies will be used to identify genes that determine parasite responses to various antimalarial drugs
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| 05-I-N210 | None | None | None |