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| Name | Class |
|---|---|
| Centre national de recherche et de formation sur le paludisme | OTHER_GOV |
| Radboud University Medical Center | OTHER |
| Institute for Disease Modeling, Bellevue, US | UNKNOWN |
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In the current randomized trial, the investigators will test the ability of two experimental approaches to malaria infection management to reduce malaria transmission potential. Compounds in Saponé, Burkina Faso, will be randomized to 1 of 3 study arms: arm 1 - current standard of care with passively monitored malaria infections; arm 2 - standard of care plus enhanced community case management (CCM), comprising active weekly screening for fever, and detection and treatment of infections in fever positive individuals using conventional rapid diagnostic tests (RDTs); or arm 3 - standard of care and enhanced CCM, plus monthly screening and treatment (MSAT) using RDTs. The study will be conducted over approximately 18 months covering two high transmission seasons and the intervening dry season
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard of Care | No Intervention | Standard of care with passively monitored malaria incidence at health centers that receive appropriate diagnostic and clinical supplies and Seasonal Malaria Chemoprevention (SMC) for children less than 5 years of age | |
| CCM | Experimental | Standard of care supplemented with enhanced Community Case Management for malaria (CCM) involving weekly active screening for fever using a research-grade thermometer by a trained health worker. A measured temperature ≥37.5°C or reported fever in the last 24 hours will prompt screening with a conventional rapid diagnostic test (RDT). RDT positive individuals will be treated with artemether-lumefantrine (AL) according to national guidelines |
|
| CCM+MSAT | Experimental | Standard of Care supplemented with CCM and Monthly Screening and Treatment (MSAT) regardless of symptoms with a conventional RDT. Screening will be performed by research staff with 25-35 days between screening rounds; RDT positive individuals will be treated with AL according to national guidelines. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Enhanced Community Case Management (CCM) | Other | Enhanced Community Case Management for malaria (CCM) involving weekly active screening for fever using a research-grade thermometer by a trained health worker. A measured temperature ≥37.5°C or reported fever in the last 24 hours will prompt screening with a conventional rapid diagnostic test (RDT). RDT positive individuals will be treated with AL according to national guidelines |
| Measure | Description | Time Frame |
|---|---|---|
| Parasite prevalence and density by molecular detection at the end of study cross-sectional survey. | The primary outcome measure is parasite prevalence in the cross-sectional survey conducted at the end of the transmission season of year 2. If CCM and MSAT result in the early detection of infections, parasite prevalence at the end of the study will be lower in these arms compared to the control arm. | Month 18 (end of second transmission season; January-February 2020) |
| Measure | Description | Time Frame |
|---|---|---|
| Parasite prevalence and density by molecular detection at the end of year 1 cross-sectional survey. | Parasite prevalence and density in the cross-sectional survey conducted at the end of the transmission season of year 1. If CCM and MSAT result in the early detection of infections, parasite prevalence will be lower in these arms compared to the control arm. | Month 6 (end of first transmission season; January-February 2019) |
| Measure | Description | Time Frame |
|---|---|---|
| The detectability of infections by highly sensitive rapid diagnostic tests. | For a selection of samples, the detectability of infections is assessed by conventional rapid diagnostic test and by highly sensitive rapid diagnostic tests and related to i. histidine rich protein-2 (HRP2) concentrations; ii. duration of infection; iii. parasite density by molecular diagnostics. | Throughout study, an average of 18 months |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Chris Drakeley, PhD | London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, United Kingdom | Principal Investigator |
| Alfred Tiono, PhD, MD | Centre national de recherche et de formation sur le paludisme | Principal Investigator |
| Teun Bousema, PhD | Radboud university medical centre, Nijmegen, The Netherlands | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre National de Recherche et de Formation sur le Paludisme | Ouagadougou | Burkina Faso |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39068937 | Derived | Collins KA, Ouedraogo A, Guelbeogo WM, Soulama I, Ouattara MS, Sombie S, Ouedraogo N, Coulibaly AS, Nombre A, Lanke K, Ramjith J, Awandu SS, Serme SS, Henry N, Stone W, Ouedraogo IN, Diarra A, Holden TM, Sirima SB, Bradley J, Soremekun S, Selvaraj P, Gerardin J, Drakeley C, Bousema T, Tiono AB. Effect of weekly fever-screening and treatment and monthly RDT testing and treatment on the infectious reservoir of malaria parasites in Burkina Faso: a cluster-randomised trial. Lancet Microbe. 2024 Sep;5(9):100891. doi: 10.1016/S2666-5247(24)00114-9. Epub 2024 Jul 25. | |
| 31519680 |
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Anonymised individual participant data may be shared on a digital repository or upon reasonable request.
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| ID | Term |
|---|---|
| D008288 | Malaria |
| D004194 | Disease |
| ID | Term |
|---|---|
| D011528 | Protozoan Infections |
| D010272 | Parasitic Diseases |
| D007239 | Infections |
| D000096724 | Mosquito-Borne Diseases |
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| ID | Term |
|---|---|
| D013812 | Therapeutics |
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Cluster randomized trial
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|
| Monthly Screening and Treatment (MSAT) | Other | Monthly Screening and Treatment (MSAT) regardless of symptoms with a conventional RDT. Screening will be performed by research staff with 25-35 days between screening rounds; RDT positive individuals will be treated with AL according to national guidelines. |
|
| Parasite prevalence and density by molecular detection at the end of dry season cross-sectional survey. | Parasite prevalence and density in the cross-sectional survey conducted at the end of the dry season. If CCM and MSAT result in the early detection of infections, parasite prevalence will be lower in these arms compared to the control arm. | Month 12 (prior to second transmission season; June 2019) |
| Gametocyte prevalence and or density in P. falciparum infections at the end of study cross-sectional survey | Gametocyte prevalence in qPCR detected infections is assessed by molecular methods and compared between study arms. | Month 18 (end of second transmission season; January-February 2020) |
| Gametocyte prevalence and or density in P. falciparum infections at the end of year 1 cross-sectional survey | Gametocyte density of male and female gametocytes will be assessed by molecular methods and compared between study arms. | Month 6 (end of first transmission season; January-February 2019) |
| Gametocyte prevalence and or density in P. falciparum infections at the end of dry season cross-sectional survey | Gametocyte density of male and female gametocytes will be assessed by molecular methods and compared between study arms. | Month 12 (prior to second transmission season; June 2019) |
| Gametocyte prevalence and or density in P. falciparum during all study visits | Gametocyte density of male and female gametocytes will be assessed by molecular methods and compared between study arms. | Throughout study, an average of 18 months |
| The number of incident infections. | Regular visits by CCM and MSAT will result in the identification of malaria infections that are not detected during passive case detection. The numbers of infections that are detected in each arm are quantified and compared between arms. | Throughout study, an average of 18 months |
| Infectivity to mosquitoes of P. falciparum infections | For a selection of infections, infectiousness to mosquitoes is assessed by membrane feeding assays. | Throughout study, an average of 18 months |
| The relationship between the proportion of infected mosquitoes and gametocyte density. | Gametocyte density and sex ratio will be assessed by molecular methods and associated with the proportion of infected mosquitoes and the burden of infection in mosquitoes | Throughout study, an average of 18 months. |
| The impact of infection characteristics on the transmissibility of infections to mosquitoes | Under this outcome, we aim to determine the impact of gametocyte sex-ratio, other gametocyte characteristics, duration of infection and clonal complexity of malaria infections on the transmissibility of infections to mosquitoes | Throughout study, an average of 18 months. |
| The impact of human host characteristics on the transmissibility of infections to mosquitoes | Under this outcome, we aim to determine the impact of red blood cell haemoglobinopathies, haemoglobin concentration, inflammatory markers, naturally acquired antibody responses to gametocyte antigens and other host characteristics on the transmissibility of infections to mosquitoes | Throughout study, an average of 18 months |
| Association between total parasite density and gametocyte density | Under this outcome, we aim to evaluate the relationship between asexual parasite density and gametocyte density in P. falciparum infections | Throughout study, an average of 18 months |
| Malaria transmission potential based on measured gametocyte densities | Under this outcome, we aim to determine malaria transmission potential of infections based on the gametocyte density | Throughout study, an average of 18 months |
| Number of acquired clones based on genotyping | Under this outcome, we aim to examine the complexity of P. falciparum infection by measuring the number of clones present in infections | Throughout study, an average of 18 months |
| The duration of infections in the dry season | Under this outcome, we aim to evaluate the duration of P. falciparum carriage during the dry season | Month 6-12, between end of season survey January/February 2019 and end of dry season survey June 2019 |
| To quantify mosquito exposure in relation to incident infections | Under this outcome, we aim to quantify mosquito exposure and relate this to number of incident infections | Throughout study, an average of 18 months |
| Derived |
| Collins KA, Ouedraogo A, Guelbeogo WM, Awandu SS, Stone W, Soulama I, Ouattara MS, Nombre A, Diarra A, Bradley J, Selvaraj P, Gerardin J, Drakeley C, Bousema T, Tiono A. Investigating the impact of enhanced community case management and monthly screening and treatment on the transmissibility of malaria infections in Burkina Faso: study protocol for a cluster-randomised trial. BMJ Open. 2019 Sep 13;9(9):e030598. doi: 10.1136/bmjopen-2019-030598. |
| D000079426 |
| Vector Borne Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |