NCT04160026

Brief Summary

This multi-centre study will compare the acceptability, feasibility, cost and incremental cost-effectiveness of intermittent preventive treatment (IPTp) with dihydroartemisinin-piperaquine (DP) with or without azithromycin to the current strategy of IPTp with sulphadoxine-pyrimethamine (SP) to prevent malaria, sexually transmitted and reproductive tract infections in HIV-uninfected pregnant women (IMPROVE).

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,600

participants targeted

Target at P75+ for phase_4

Timeline
Completed

Started Nov 2019

Shorter than P25 for phase_4

Geographic Reach
1 country

1 active site

Status
completed

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

First Submitted

Initial submission to the registry

November 7, 2019

Completed
4 days until next milestone

Study Start

First participant enrolled

November 11, 2019

Completed
1 day until next milestone

First Posted

Study publicly available on registry

November 12, 2019

Completed
9 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 31, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

July 31, 2020

Completed
Last Updated

April 15, 2021

Status Verified

April 1, 2021

Enrollment Period

9 months

First QC Date

November 7, 2019

Last Update Submit

April 12, 2021

Conditions

Outcome Measures

Primary Outcomes (1)

  • Adherence in pregnant women

    Proportion of pregnant women attending ANC who receive the drug course correctly and who have verified they completed the treatment at home during a home visit.

    Assessed 6-10 months after implementation commences

Secondary Outcomes (1)

  • Effectiveness of service delivery

    Assessed 6-10 months after implementation commences

Study Arms (3)

IPTp-SP

ACTIVE COMPARATOR

Arm 1. Standard single-day stat course of quality-assured SP (Fansidar ®) of 3 tablets (500 mg of sulphadoxine and 25 mg of pyrimethamine). SP given monthly

Drug: Monthly intermittent preventive treatment with sulfadoxine-pyrimethamine

IPTp-DP

EXPERIMENTAL

Arm 2. Standard 3-day course of 3 to 5 tablets (40/320mg) of DP per day based on bodyweight (Eurartesim®, AlfaSigma, Italy). DP given monthly

Drug: Monthly intermittent preventive treatment with dihydroartemisnin-piperaquine

IPTp-DP Plus

EXPERIMENTAL

Arm 3. Standard 3-day course of 3 to 5 tablets (40/320mg) of DP per day based on bodyweight (Eurartesim®, AlfaSigma, Italy) plus targeted information for health providers.

Drug: Monthly intermittent preventive treatment with dihydroartemisnin-piperaquine with targeted information transfer

Interventions

Feasibility study to assess adherence among health providers in antenatal clinics delivering the study interventions in a routine setting and uptake and adherence among pregnant women.

Also known as: Dihydroartemisnin- piperaquine -Eurartesim®
IPTp-DP

Feasibility study to assess adherence among health providers in antenatal clinics delivering the study interventions in a routine setting and uptake and adherence among pregnant women.

Also known as: Sulfadoxine-Pyrimethamine, Control Arm
IPTp-SP

Feasibility study to assess adherence to guidelines among health providers in antenatal clinics delivering the study interventions in a routine setting and uptake and adherence among pregnant women.

Also known as: Dihydroartemisnin- piperaquine -Eurartesim®, DP Plus
IPTp-DP Plus

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Kenya Government owned health facilities, Level 3 or 4 health facilities
  • Pregnant women attending ANC through non-trial health facilities for a scheduled antenatal care visit in the second or third trimester who receive one of the three study interventions depending on which arm is allocated to that health facility

You may not qualify if:

  • Mission or private health facilities, Kenya government owned Level 2 or level 5 health facilities, health facilities included in the trial
  • Pregnant women accessing private health facilities
  • Health facilities, or pregnant women, involved in other malaria or HIV in pregnancy intervention trials or studies.
  • Pregnant women in the first trimester, or pregnant women for who their last visit was less than one month ago

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Kenya Medical Research Institute

Kisumu, 40100, Kenya

Location

Related Publications (1)

  • Barsosio HC, Webster J, Omiti F, K'Oloo A, Odero IA, Ojuok MA, Odiwa D, Omondi B, Okello E, Dodd J, Taegtmeyer M, Kuile FOT, Lesosky M, Kariuki S, Hill J. Delivery effectiveness of and adherence to intermittent preventive treatment for malaria in pregnancy with dihydroartemisinin-piperaquine with or without targeted information transfer or sulfadoxine-pyrimethamine in western Kenya: a three-armed, pragmatic, open-label, cluster-randomised trial. Lancet Glob Health. 2024 Oct;12(10):e1660-e1672. doi: 10.1016/S2214-109X(24)00261-4.

MeSH Terms

Conditions

Treatment Adherence and Compliance

Interventions

fanasil, pyrimethamine drug combination

Condition Hierarchy (Ancestors)

Health BehaviorBehavior

Study Officials

  • Jenny Hill, PhD

    Liverpool School of Tropical Medicine

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
NONE
Masking Details
The feasibility study in the routine setting was not masked, this was a 3-arm study where interventions were delivered by ministry of health staff. The acceptability study was nested in the clinical trial which was a 3-arm placebo controlled multicentre trial (see NCT02909712) .
Purpose
PREVENTION
Intervention Model
PARALLEL
Model Details: The feasibility study is cluster randomised, where a health facility is a cluster. The acceptability studies are nested within the feasibility study and the IMPROVE clinical trial.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 7, 2019

First Posted

November 12, 2019

Study Start

November 11, 2019

Primary Completion

July 31, 2020

Study Completion

July 31, 2020

Last Updated

April 15, 2021

Record last verified: 2021-04

Data Sharing

IPD Sharing
Will not share

Locations