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The main purpose of this study is to compare artesunate-mefloquine combination therapy given for 2 and 3 days at the same total dose for the treatment of uncomplicated falciparum malaria.
This will be a randomized, open-label comparison of two versus three days artesunate-mefloquine treatment in patients with uncomplicated falciparum malaria. Primary endpoints will be 63-day parasitological cure rates in the 2 treatment groups. Secondary endpoints will be parasitological failure rates at each of the weekly follow-up visits to Day 56, occurence of treatment-emergent adverse events on days 0, 1 and 2, mefloquine blood concentrations on days 7, 14 and 28, and in vitro drug sensitivity profiles for parasite isolates as measured by inhibitory concentrations. Genotyping of parasites for known markers of drug resistence will be performed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | Active Comparator | 2-day oral treatment with: Artesunate 6mg/kg at 0 and 24 hours Mefloquine 25 mg/kg total dose split into 2 doses of 15 mg/kg at 0 hours and and 10 mg/kg given 6-24 hours later Primaquine 0.5 mg/kg single dose at 24 hours |
|
| 2 | Active Comparator | 3 days oral treatment with: Artesunate 4 mg/kg/day for 3 days Mefloquine 8 mg/kg/day for 3 days Primaquine 0.5 mg/kg single dose at 24 hours |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Artesunate | Drug | 6 mg/kg/day for 2 days (total dose 12 mg/kg) |
| |
| Artesunate |
| Measure | Description | Time Frame |
|---|---|---|
| Determination of parasitological cure rate of directly observed antimalarial therapy | 63 days from initiation of treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Parasitological cure rates | Weekly to Day 56 | |
| Occurence of treatment-emergent adverse events | 3 days | |
| In vitro drug sensitivity profile for individual parasite isolates |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Wichai - Satimai, M.D., D.T.M. & H. | Bureau of Vector-Borne Disease, Department of Disease Control, Ministry of Public Health | Principal Investigator |
| Mark M. Fukuda, M.D. | Dept. of Immunology and Medicine, AFRIMS | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Vector Borne Diseases Control Units (VBDC, malaria clinics) | Borai, Khaosaming and Muang Districts | Changwat Trat | 23000 | Thailand |
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| ID | Term |
|---|---|
| D016778 | Malaria, Falciparum |
| ID | Term |
|---|---|
| D008288 | Malaria |
| D011528 | Protozoan Infections |
| D010272 | Parasitic Diseases |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D000077332 | Artesunate |
| D015767 | Mefloquine |
| ID | Term |
|---|---|
| D037621 | Artemisinins |
| D017382 | Reactive Oxygen Species |
| D005609 | Free Radicals |
| D007287 | Inorganic Chemicals |
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| Drug |
4 mg/kg/day for 3 days |
|
| Mefloquine | Drug | 15mg/kg at T=0 and 10 mg/kg 6-24 hours later |
|
| Mefloquine | Drug | 8 mg/kg daily for 3 days |
|
| Baseline |
| Mefloquine whole blood concentrations | 28 days |
| D000096724 |
| Mosquito-Borne Diseases |
| D000079426 | Vector Borne Diseases |
| D009930 |
| Organic Chemicals |
| D012717 | Sesquiterpenes |
| D013729 | Terpenes |
| D006838 | Hydrocarbons |
| D011804 | Quinolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |