Driving Reduced AIDS-associated Meningo-encephalitis Mortality
DREAMM
Integrating the Diagnosis and Management of HIV-associated Central Nervous System (CNS) Infections Into Routine Health Services in Low and Middle Income Countries (LMICs)
1 other identifier
interventional
495
3 countries
5
Brief Summary
The DREAMM project is investigating whether the DREAMM interventions (1) Health system strengthening, 2) Co-designed education programs tailored to frontline healthcare workers, 3) Implementation of a diagnostic and treatment algorithm and, 4) Communities of practice in infectious diseases and laboratory capacity building) when combined reduce two week all-cause mortality of HIV-associated meningo-encephalitis in African LMICs.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Apr 2016
Longer than P75 for not_applicable
5 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
Study Start
First participant enrolled
April 23, 2016
CompletedFirst Submitted
Initial submission to the registry
May 31, 2017
CompletedFirst Posted
Study publicly available on registry
July 21, 2017
CompletedPrimary Completion
Last participant's last visit for primary outcome
April 1, 2021
CompletedStudy Completion
Last participant's last visit for all outcomes
September 1, 2021
CompletedMay 4, 2022
April 1, 2022
4.9 years
May 31, 2017
May 3, 2022
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
2-week all-cause mortality
2-week all-cause mortality from enrolment
2 weeks from enrolment
Secondary Outcomes (8)
10-week all-cause mortality
10 weeks from enrolment
4-week all-cause mortality
4 weeks from enrolment
10-week and 6-month rate of death
10 weeks and 6 months from enrolment
Time to appropriate investigation: lumbar puncture, brain imaging
10 weeks from enrolment
Time to appropriate, microbiologically guided treatment
10 weeks from enrolment
- +3 more secondary outcomes
Study Arms (1)
DREAMM
OTHER4 DREAMM interventions to reduce HIV-related meningoencephalitis mortality once access to essential diagnostic tests and medicines: 1. Health system strengthening 2. Delivery of a co-designed education program tailored to frontline healthcare workers 3. Implementation of an algorithm for HIV-related meningoencephalitis 4. Infectious diseases/AHD mentorship and laboratory capacity building
Interventions
4 DREAMM interventions to reduce HIV-related meningoencephalitis mortality once access to essential diagnostic tests and medicines: 1. Health system strengthening 2. Delivery of a co-designed education program tailored to frontline healthcare workers 3. Implementation of an algorithm for HIV-related meningoencephalitis 4. Infectious diseases/AHD mentorship and laboratory capacity building
Eligibility Criteria
You may qualify if:
- Consecutive patients \> 18 years with 1st episode of suspected meningo- encephalitis
- Known to be HIV positive or willing to undertake an HIV test
- Willing to agree to participate in the study
You may not qualify if:
- Patients presenting with suspected relapse of HIV-associated meningo-encephalitis
- HIV negative patients
- Pregnant or lactating patients
- Patients presenting with a known diagnosis of primary CNS Lymphoma or cerebral malaria
- COVID-19 infected patients
- Patients who are HIV negative or are diagnosed with cerebral malaria on hospital admission or after initial investigation will be excluded or withdrawn from the DREAMM study.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- St George's, University of Londonlead
- European and Developing Countries Clinical Trials Partnership (EDCTP)collaborator
- National Agency for Research on AIDS and Viral Hepatitis (ANRS)collaborator
- Institut Pasteurcollaborator
- National Institute for Medical Research, Tanzaniacollaborator
- Amana Hospital, Dar es Salaam, Tanzaniacollaborator
- University of North Carolina Project-Malawi (UNC Project), Lilongwe, Malawicollaborator
- Kamuzu Central Hospitalcollaborator
- Yaounde Central Hospitalcollaborator
- Zomba Central Hospital, Zomba, Malawicollaborator
- Lighthouse Trustcollaborator
- Mwananyamala Hospital, Dar es Salaam, Tanzaniacollaborator
Study Sites (5)
Hôpital Central Yaoundé
Yaoundé, Cameroon
Kamuzu Central Hospital
Lilongwe, Malawi
Zomba Central Hospital
Zomba, Malawi
Amana Hospital
Dar es Salaam, Tanzania
Mwananyamala Hospital
Dar es Salaam, Tanzania
Related Publications (1)
Mfinanga S, Kanyama C, Kouanfack C, Nyirenda S, Kivuyo SL, Boyer-Chammard T, Phiri S, Ngoma J, Shimwela M, Nkungu D, Fomete LN, Simbauranga R, Chawinga C, Ngakam N, Heller T, Lontsi SS, Aghakishiyeva E, Jalava K, Fuller S, Reid AM, Rajasingham R, Lawrence DS, Hosseinipour MC, Beaumont E, Bradley J, Jaffar S, Lortholary O, Harrison T, Molloy SF, Sturny-Leclere A, Loyse A; DREAMM Consortium. Reduction in mortality from HIV-related CNS infections in routine care in Africa (DREAMM): a before-and-after, implementation study. Lancet HIV. 2023 Oct;10(10):e663-e673. doi: 10.1016/S2352-3018(23)00182-0.
PMID: 37802567DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Angela Loyse, MD
St George's, University of London
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- NA
- Masking
- NONE
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- SEQUENTIAL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
May 31, 2017
First Posted
July 21, 2017
Study Start
April 23, 2016
Primary Completion
April 1, 2021
Study Completion
September 1, 2021
Last Updated
May 4, 2022
Record last verified: 2022-04