Innovative Treatments in Pneumonia (ITIP) 3

NCT02960919 | Completed

• 1 other identifier: ITIP3
• Study Type: observational
• Target: 1,001
• Locations: 1 country
• Sites: 2

Brief Summary

This is a prospective observational study assessing the clinical outcomes of children 2 to 59 months of age with both pneumonia and other co-morbidities presenting to a tertiary hospital outpatient setting in Malawi, Africa who are most at risk for mortality or have other complications and thus, are typically excluded from childhood pneumonia studies.

Conditions

Pneumonia

Outcome Measures

Primary Outcomes (1)

• Clinical outcomes: cured, not cured

  Clinically cured - absence of very fast-breathing, chest-indrawing, hypoxemia, severe respiratory distress (e.g., presence of grunting, nasal flaring, head nodding, or severe chest-indrawing), World Health Organization danger signs (i.e. lethargy or unconsciousness, convulsions, vomiting everything, or inability to drink or breastfeed), and fever: * Cured but failed initial antibiotic treatment regimen * Cured and did not fail initial antibiotic treatment regimen Not cured: * Deteriorating * Stable (not improving or deteriorating, prognosis unclear)

  14 days

Interventions

oral amoxicillin or parenteral ampicillin/ penicillin and gentamicin DRUG

parenteral ampicillin/ penicillin DRUG

gentamicin DRUG

Eligibility Criteria

• Age: 2 Months - 59 Months
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)
• Sampling Method: Non-Probability Sample

Study Population

Children 2 to 59 months of age who present to Kamuzu Central Hospital or Bwaila District Hospital with fast-breathing pneumonia or chest-indrawing pneumonia and other co-morbidities, or severe pneumonia AND are excluded from ITIP1 and ITIP2

You may qualify if:

• Male or female, 2 to 59 months of age.
• Excluded from enrollment in Innovative Treatment in Pneumonia (ITIP) 1 and ITIP2 clinical trials due to presence of any of the following:
• Hypoxia (SaO2 \< 90% on room air, as assessed by a pulse oximeter).
• Severe respiratory distress (e.g., presence of grunting, nasal flaring, head nodding, or severe chest-indrawing).
• Severe malaria, classified by World Health Organization (WHO) guidelines on hospital care for children, including a positive malaria rapid antibody test result.
• Severe anemia, classified by WHO Integrated Management of Childhood Illness (IMCI) guidelines (i.e., severe palmar pallor) only if a positive malaria rapid antibody test result.
• severe acute malnutrition (SAM) (i.e., weight for height/length \< -3 SD, mid-upper arm circumference (MUAC) \<115, or edema).
• HIV-1 seropositivity or HIV-1 exposure, assessed as follows: An HIV-positive result upon rapid antibody testing.
• If a child is less than 24 months of age and has an HIV-negative result upon rapid antibody test documented from the past three months, the child's biological mother's HIV status will need to be assessed. If the mother is HIV-positive, the child will be included. If the mother does not have documentation of an HIV-negative test result from the past 3 months, she will be tested via rapid antibody testing to determine the child's eligibility for this study.
• Ability and willingness of child's caregiver to provide informed consent and to be available for follow-up (in the inpatient ward, returning to KCH for a scheduled study follow-up visit, and by phone) for the planned duration of the study.

You may not qualify if:

• Possible tuberculosis (coughing for more than 14 days).
• Stridor when calm.
• Severe anemia, classified by WHO IMCI guidelines (i.e., severe palmar pallor) if a negative malaria rapid antibody test result.
• Known allergy to penicillin or amoxicillin.
• Receipt of an antibiotic treatment in the 48 hours prior to the study based on caregiver's self-report and/or documentation in child's medical record.
• Living outside Lilongwe urban area, the study catchment area.
• Any medical or psychosocial condition or circumstance that, in the opinion of the investigators, would interfere with the conduct of the study or for which study participation might jeopardize the child's health.
• Participation in a clinical study of an investigational product within 12 weeks prior to enrollment or planning to begin participation during this study.
• Prior participation in ITIP1, ITIP2 or ITIP3 during a previous pneumonia diagnosis.

Sponsors & Collaborators

• Save the Children: lead
• University of Washington: collaborator
• University of North Carolina: collaborator
• Kamuzu Central Hospital: collaborator
• Kamuzu University of Health Sciences: collaborator

Study Sites (2)

Bwaila District Hospital

Lilongwe, Malawi

Location

Kamuzu Central Hospital

Lilongwe, Malawi

Location

Related Publications (2)

• Mvalo T, McCollum ED, Fitzgerald E, Kamthunzi P, Schmicker RH, May S, Phiri M, Chirombo C, Phiri A, Ginsburg AS. Chest radiography in children aged 2-59 months enrolled in the Innovative Treatments in Pneumonia (ITIP) project in Lilongwe Malawi: a secondary analysis. BMC Pediatr. 2022 Jan 10;22(1):31. doi: 10.1186/s12887-021-03091-3.

  PMID: 35012490 DERIVED

• Ginsburg AS, Mvalo T, Hwang J, Phiri M, McCollum ED, Maliwichi M, Schmicker R, Phiri A, Lufesi N, May S. Malawian children with fast-breathing pneumonia with and without comorbidities. Pneumonia (Nathan). 2021 Feb 25;13(1):3. doi: 10.1186/s41479-021-00081-y.

  PMID: 33627192 DERIVED

MeSH Terms

Conditions

Pneumonia

Interventions

Amoxicillin; Penicillins; Gentamicins

Condition Hierarchy (Ancestors)

Respiratory Tract Infections; Infections; Lung Diseases; Respiratory Tract Diseases

Intervention Hierarchy (Ancestors)

Ampicillin; Penicillin G; beta-Lactams; Lactams; Amides; Organic Chemicals; Sulfur Compounds; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Heterocyclic Compounds; Aminoglycosides; Glycosides; Carbohydrates

Study Officials

• Amy Ginsburg, MD MPH

  Save the Children, Federation Inc

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 27, 2016
• First Posted: November 10, 2016
• Study Start: October 19, 2016
• Primary Completion: June 1, 2018
• Study Completion: July 1, 2018
• Last Updated: February 21, 2021

Record last verified: 2021-02

Locations

MA (2)