Study protocol: an open-label individually randomised controlled trial to assess the efficacy of artemether-lumefantrine prophylaxis for malaria among forest goers in Cambodia

Introduction In the Greater Mekong Subregion, adults are at highest risk for malaria. The most relevant disease vectors bite during daytime and outdoors which makes forest work a high-risk activity for malaria. The absence of effective vector control strategies and limited periods of exposure during...

Full description

Bibliographic Details
Main Authors: Maude, RJ, Tripura, R, Ean, M, Sokha, M, Peto, TJ, Callery, JJ, Imwong, M, Vongpromek, R, Tarning, J, Mukaka, M, Waithira, N, Soviet, O, von Seidlein, L, Sovannaroth, S
Format: Journal article
Language:English
Published: BMJ Publishing Group 2021
_version_ 1797073057788985344
author Maude, RJ
Tripura, R
Ean, M
Sokha, M
Peto, TJ
Callery, JJ
Imwong, M
Vongpromek, R
Tarning, J
Mukaka, M
Waithira, N
Soviet, O
von Seidlein, L
Sovannaroth, S
author_facet Maude, RJ
Tripura, R
Ean, M
Sokha, M
Peto, TJ
Callery, JJ
Imwong, M
Vongpromek, R
Tarning, J
Mukaka, M
Waithira, N
Soviet, O
von Seidlein, L
Sovannaroth, S
author_sort Maude, RJ
collection OXFORD
description Introduction In the Greater Mekong Subregion, adults are at highest risk for malaria. The most relevant disease vectors bite during daytime and outdoors which makes forest work a high-risk activity for malaria. The absence of effective vector control strategies and limited periods of exposure during forest visits suggest that chemoprophylaxis could be an appropriate strategy to protect forest goers against malaria. Methods and analysis The protocol describes an open-label randomised controlled trial of artemether-lumefantrine (AL) versus multivitamin as prophylaxis against malaria among forest goers aged 16–65 years in rural northeast Cambodia. The primary objective is to compare the efficacy of the artemisinin combination therapy AL versus a multivitamin preparation as defined by the 28-day PCR parasite positivity rate and incidence of confirmed clinical malaria of any species. The sample size is 2200 patient-episodes of duration 1 month in each arm. The duration of follow-up and prophylaxis for each participant is 1, 2 or 3 consecutive 28-day periods, followed by a further 28 days of post-exposure prophylaxis, depending on whether they continue to visit the forest. Analysis will be done both by intention to treat and per protocol. Ethics and dissemination All participants will provide written, informed consent. Ethical approval was obtained from the Oxford Tropical Research Ethics Committee and the Cambodia National Ethics Committee for Health Research. Results will be disseminated by peer-reviewed open access publication together with open data. Trial registration number NCT04041973; Pre-result.
first_indexed 2024-03-06T23:16:31Z
format Journal article
id oxford-uuid:6751c343-ab98-4ecb-8096-acb96828e1bb
institution University of Oxford
language English
last_indexed 2024-03-06T23:16:31Z
publishDate 2021
publisher BMJ Publishing Group
record_format dspace
spelling oxford-uuid:6751c343-ab98-4ecb-8096-acb96828e1bb2022-03-26T18:37:30ZStudy protocol: an open-label individually randomised controlled trial to assess the efficacy of artemether-lumefantrine prophylaxis for malaria among forest goers in CambodiaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6751c343-ab98-4ecb-8096-acb96828e1bbEnglishSymplectic ElementsBMJ Publishing Group2021Maude, RJTripura, REan, MSokha, MPeto, TJCallery, JJImwong, MVongpromek, RTarning, JMukaka, MWaithira, NSoviet, Ovon Seidlein, LSovannaroth, SIntroduction In the Greater Mekong Subregion, adults are at highest risk for malaria. The most relevant disease vectors bite during daytime and outdoors which makes forest work a high-risk activity for malaria. The absence of effective vector control strategies and limited periods of exposure during forest visits suggest that chemoprophylaxis could be an appropriate strategy to protect forest goers against malaria. Methods and analysis The protocol describes an open-label randomised controlled trial of artemether-lumefantrine (AL) versus multivitamin as prophylaxis against malaria among forest goers aged 16–65 years in rural northeast Cambodia. The primary objective is to compare the efficacy of the artemisinin combination therapy AL versus a multivitamin preparation as defined by the 28-day PCR parasite positivity rate and incidence of confirmed clinical malaria of any species. The sample size is 2200 patient-episodes of duration 1 month in each arm. The duration of follow-up and prophylaxis for each participant is 1, 2 or 3 consecutive 28-day periods, followed by a further 28 days of post-exposure prophylaxis, depending on whether they continue to visit the forest. Analysis will be done both by intention to treat and per protocol. Ethics and dissemination All participants will provide written, informed consent. Ethical approval was obtained from the Oxford Tropical Research Ethics Committee and the Cambodia National Ethics Committee for Health Research. Results will be disseminated by peer-reviewed open access publication together with open data. Trial registration number NCT04041973; Pre-result.
spellingShingle Maude, RJ
Tripura, R
Ean, M
Sokha, M
Peto, TJ
Callery, JJ
Imwong, M
Vongpromek, R
Tarning, J
Mukaka, M
Waithira, N
Soviet, O
von Seidlein, L
Sovannaroth, S
Study protocol: an open-label individually randomised controlled trial to assess the efficacy of artemether-lumefantrine prophylaxis for malaria among forest goers in Cambodia
title Study protocol: an open-label individually randomised controlled trial to assess the efficacy of artemether-lumefantrine prophylaxis for malaria among forest goers in Cambodia
title_full Study protocol: an open-label individually randomised controlled trial to assess the efficacy of artemether-lumefantrine prophylaxis for malaria among forest goers in Cambodia
title_fullStr Study protocol: an open-label individually randomised controlled trial to assess the efficacy of artemether-lumefantrine prophylaxis for malaria among forest goers in Cambodia
title_full_unstemmed Study protocol: an open-label individually randomised controlled trial to assess the efficacy of artemether-lumefantrine prophylaxis for malaria among forest goers in Cambodia
title_short Study protocol: an open-label individually randomised controlled trial to assess the efficacy of artemether-lumefantrine prophylaxis for malaria among forest goers in Cambodia
title_sort study protocol an open label individually randomised controlled trial to assess the efficacy of artemether lumefantrine prophylaxis for malaria among forest goers in cambodia
work_keys_str_mv AT mauderj studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT tripurar studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT eanm studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT sokham studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT petotj studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT calleryjj studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT imwongm studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT vongpromekr studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT tarningj studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT mukakam studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT waithiran studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT sovieto studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT vonseidleinl studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia
AT sovannaroths studyprotocolanopenlabelindividuallyrandomisedcontrolledtrialtoassesstheefficacyofartemetherlumefantrineprophylaxisformalariaamongforestgoersincambodia