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Vivax MalariaSCOPENCT05879224

Short Course Primaquine for the Radical Cure of P. Vivax Malaria - Indonesia

A study testing Revised case management package in people with Vivax Malaria and G6PD Deficiency, run by Menzies School of Health Research at 6 sites in Indonesia.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The proportion of malaria that is the Plasmodium vivax species is increasing in Indonesia. Reducing vivax malaria will require innovative solutions to cure both the blood and liver stages of the disease. Read more about this study

Who is it for?
Ages 6 months and older
Conditions the study is for
Vivax Malaria, G6PD Deficiency
What is being tested?
Revised case management package
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,999 participants
Where
6 sitesIndonesia
Study dates
7 Aug 2023to 17 Dec 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 months and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Patients with vivax malaria

Who cannot join

  • Patients who are pregnant
  • Patients who are breastfeeding
  • Patients with a Hb <8g/dL
  • Patients with a previous adverse reaction to primaquine
  • Patient with severe malaria

Trial locations and contacts

6 sites in 1 country.

6 sites in 1 country

Indonesia6 sites
  • Puskesmas Hanura

    Hanura, Lampung

  • Puskesmas Tanjung Leidong

    Labuhanbatu, North Sumatra

  • Puskesmas Bhintuka

    Mimika, Special Region of Papua

  • Puskesmas Pasar Sentral

    Mimika, Special Region of Papua

  • Puskesmas Timika

    Mimika, Special Region of Papua

  • Puskesmas Wania

    Mimika, Special Region of Papua

Other trials in Indonesia

About this study

Official title: Feasibility of High Daily Dose Short Course Primaquine After G6PD Testing for the Radical Cure of Plasmodium Vivax Malaria

The proportion of malaria that is the Plasmodium vivax species is increasing in Indonesia. Reducing vivax malaria will require innovative solutions to cure both the blood and liver stages of the disease. This study will evaluate of the feasibility of implementing point-of-care glucose-6-phosphate dehydrogenase deficiency (G6PD) testing. This will be followed by high dose, short course primaquine treatment regimens for patients with vivax malaria, and combined with patient education, surveillance, and pharmacovigilance. We plan to implement the study at 6 health facilities across Indonesia using a staged before-and-after study, with a mixed method evaluation.

Read the detailed description

Significant gains have been made in reducing the overall burden of malaria worldwide, however these have been far greater for Plasmodium falciparum than P. vivax. P. vivax remains a major obstacle to malaria control and elimination efforts, largely due to its ability to form dormant liver stages (hypnozoites) that allow it to escape detection and treatment. Importantly, they are susceptible only to 8 aminoquinolines such as primaquine however, primaquine is associated with risk of haemolysis in individuals with a genetic condition, called glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Additionally, the recommended 14-day prolonged treatment regimen is associated with poor treatment adherence hence ineffective primaquine treatment. Innovative solutions to the radical cure of both the blood and liver stages of P. vivax are urgently required.

The Indonesian Ministry of Health has requested a pragmatic study of the feasibility and cost-effectiveness of implementing point-of-care G6PD testing followed by high-dose, short-course primaquine treatment regimens for patients with vivax malaria. These interventions are to be combined with practicable enhancements to patient education, supervision, malariometric surveillance and pharmacovigilance.

This will be a before-after longitudinal health facility-based study implemented at six sites in Indonesia; four in Papua, one in North Sumatra and one in Lampung. We will use a staged approach for the implementation of the revised case management strategy, including patient education and counselling,community-based clinical review, with mixed methods evaluation.

Being tested
Revised case management package
Keywords
Primaquine
Medical subject headings
Malaria, Vivax, Glucosephosphate Dehydrogenase Deficiency

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Revised case management packageCombination product

    1. Point-of-care quantitative G6PD testing using G6PDSTANDARD (SD Biosensor) prior to use of primaquine (Day 0)
    2. Prescription of short course primaquine (7 mg/kg total)(Day 0):
    • PQ7 (1 mg/kg/day for 7 days) if G6PD activity greater than 70 percent
    • PQ14 (0.5 mg/kg/day for 14 days) if G6PDactivity is 30-70 percent
    • PQ8w (0.75 mg/kg/week for 8 weeks) if G6DPactivity less than 30 percent
    1. Participant counselling at the health facility (Day 0):
    • Supervision of first dose of primaquine
    • Education regarding the importance and risks of primaquine therapy and necessity to take primaquine with food
    1. Community based clinical review on Day 3 (and Day 7 for the first 300 participants) to detect and manage gastrointestinal or haemolytic adverse effects of treatment and encourage adherence to full treatment regime
    2. Improved malariometric surveillance and pharmacovigilance to support wider scale use of the revised case management
Study groups in NCT05879224
Study groupRoleWhat they receive
Revised case management packageExperimentalNot described
Receives: Combination Product: Revised case management package

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of patients experiencing at least one Serious Adverse Event (SAE) during treatment

    SAEs are collected during clinical review using a study-specific questionnaire

    Measured: During treatment (up to 8 weeks) ]

  2. Proportion of patients experiencing at least one Adverse Event of Special Interest(AESI) during treatment

    AESIs (haemolysis, methaemoglobinaemia and gastrointestinal discomfort) are collected during clinical review using a study-specific questionnaire

    Measured: During treatment (up to 8 weeks)

  3. Proportion of patients with P. vivax malaria who correctly receive all components of the revised case management package

    Measured by completion of G6PD testing and the correct prescription of primaquine based on G6PD activity, completion of patients counselling and community based follow up on Day 3

    Measured: 3 days

Secondary outcomes (35)
  1. The proportion of patients with any AESI during treatment

    AESIs are collected during clinical review using a study-specific questionnaire

    Measured: During treatment (up to 8 weeks)

  2. The proportion of patients with a gastrointestinal (GI) AESI during treatment

    AESIs are collected during clinical review using a study-specific questionnaire

    Measured: During treatment (up to 8 weeks)

  3. The proportion of patients with an AESI related to haemolysis during treatment

    AESIs are collected during clinical review using a study-specific questionnaire

    Measured: During treatment (up to 8 weeks) ]

  4. The proportion of patients an AESI related to methaemoglobinaemia

    AESIs are collected during clinical review using a study-specific questionnaire

    Measured: During treatment (up to 8 weeks)

  5. Proportion of patients permanently stopping PQ before end of treatment

    Discontinuation of PQ will be assessed using a study-specific questionnaire

    Measured: During treatment (up to 8 weeks)

  6. The proportion of patients receiving correct treatment based on G6PD activity

    This will be assessed by linking patients G6PD activity results measured during study enrolment with primaquine dose prescribed on the same day

    Measured: 1 day

  7. Proportion of patients who were reviewed on Day 3 and Day 7

    This will be assessed by linking patients enrolment data with Day 3 and Day 7clinical review data

    Measured: 1 week

  8. Perception of and experience with new radical cure tools among health care providers and community members

    This will be assessed using stakeholder interviews

    Measured: 6 months

  9. Proportion of health care practitioners who comply with the revised radical cure treatment algorithm

    The outcome will be assessed from patients' enrolment data

    Measured: 1 day

  10. Proportion of patients receiving a SD Biosensor G6PD test

    The outcome will be assessed from patients' enrolment data

    Measured: 1 day

  11. Proportion of eligible P. vivax malaria patients receiving the correct dose of primaquine based on the result of the G6PD test

    The outcome will be assessed from patients' enrolment data

    Measured: 1 day

  12. Proportion of P. vivax malaria patients who are ineligible for daily primaquine and are incorrectly given primaquine (including infants, pregnant females and G6PD deficient patients

    The outcome will be assessed from patients' enrolment data

    Measured: 1 day

  13. Proportion of P. vivax malaria patients that are reviewed on Day 3

    This will be assessed by linking patients' enrolment data with clinical review data

    Measured: 3 days

  14. Proportion of P. vivax malaria patients that adhere to their prescribed primaquine regimen

    This will be assessed by linking patients' enrolment data with clinical review data

    Measured: 3 days

  15. Factors influencing acceptability and feasibility of the new radical cure tools among health care providers are identified

    This will be assessed using stakeholder interviews, observations and focus groups

    Measured: 3 days

  16. Barriers and enablers of uptake and implementation at the sub-national levels are identified

    This will be assessed using stakeholder interviews and focus groups

    Measured: 18 months

  17. Factors influencing compliance with G6PD testing and perceptions of new drug regimens and serious adverse events among health care providers are identified

    This will be assessed using stakeholder interviews and focus groups

    Measured: 18 months

  18. Required knowledge, skills, and training to administer the revised case management and patient-counselling identified

    This will be assessed using stakeholder interviews and focus groups

    Measured: 18 months

  19. Factors influencing the barriers and facilitators to patient adherence to primaquine after the rollout of the revised case management identified

    This will be assessed using stakeholder interviews and focus groups

    Measured: 18 months

  20. Factors influencing the acceptability and feasibility of community-based clinical review at Day 3 of primaquine treatment identified

    This will be assessed using stakeholder interviews and focus groups

    Measured: 18 months

  21. Perceptions of the new radical cure tools and serious adverse events at the community level identified

    This will be assessed using stakeholder interviews and focus groups

    Measured: 18 months

  22. Local acceptability of the revised case management algorithms among patients, their families, and healthcare workers established

    This will be assessed using stakeholder interviews and focus groups

    Measured: Day 3

  23. The monthly incidence of confirmed symptomatic P. vivax malaria episodes (mono-infection or mixed) before implementation versus after implementation

    This will be assessed by comparing facility surveillance data before implementation with facility surveillance data after implementation

    Measured: 18 months

  24. The prevalence of P. vivax parasitaemia in patients presenting with fever before implementation versus after implementation

    This will be assessed by comparing cross-sectional data on n=200 patients (per facility) collected before implementation to the prevalence collected in n=200patients (per facility) after implementation

    Measured: 18 months

  25. Cumulative risk of representation to the same clinic with symptomatic P. vivax malaria within 6 months

    This will be assessed by linking patients' enrolment data

    Measured: 18 months

  26. Costs of implementing policy from a healthcare provider perspective, including health systems strengthening processes

    This will be assessed from health system data collected throughout the study

    Measured: 18 months

  27. Household costs per P. vivax episode

    This will be assessed from a household cost survey on a subset of patients

    Measured: 3 days

  28. Overall cost-effectiveness of changing policy if revised case management is effective

    This will be assessed from health system data collected throughout the study

    Measured: 18 months

  29. Cost per episode of P. vivax malaria from the healthcare provider and societal perspectives

    This will be assessed from health system data collected throughout the study

    Measured: 18 months

  30. Cost per component of the revised case management package

    This will be assessed from health system data collected throughout the study

    Measured: 18 months

  31. If revised case management package is effective (significantly reduces the incidence of malaria), then the cost-effectiveness of implementing the revised case management as compared with usual care

    This will be assessed from health system data collected throughout the study

    Measured: 18 months

  32. Proportion of CHWs who correctly act on early signs of haemolytic anaemia and GI events (i.e. refer patients for further medical review, instruct patient to discontinue treatment)

    This will be assessed from clinical review data and study-specific questionnaire

    Measured: 3 days

  33. Number of patients with an SAE who are identified by community or clinic staff follow-up and referred to hospital for further management

    This will be assessed by linking clinical review data, study specific questionnaire and SAE form

    Measured: During treatment (up to 8 weeks)

  34. The proportion of patients eligible to receive PQ who had a SAE during treatment

    This will be assessed by linking enrolment data, clinical review, study specific questionnaire and SAE form

    Measured: During treatment (up to 8 weeks)

  35. Prevalence of severe anaemia in patients presenting with fever before and after implementation

    This will be assessed by comparing the facility surveillance data before implementation with facility surveillance data after implementation

    Measured: 18 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 May 2023
  2. Study start7 Aug 2023
  3. Primary completion1 Nov 2025
  4. Study completion17 Dec 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Model description
Combination Product: Revised case management package
Masking
None (open label)
Enrolment
2,999 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05879224
Sponsor's protocol ID
MMV_PQ_21_01 U1111-1291-3218
Acronym
SCOPE
Status last verified
Jan 2026
First submitted
18 May 2023
Last updated
15 Jan 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Study Protocol and Statistical Analysis Plan will be made available to others. The results will be published in peer-reviewed open access journals and disseminated to stakeholders. De-identified quantitative data for the purposes of confirming risk of adverse events will be available to researchers who provide a methodological sound proposal that is in line with the aims of the approved protocol.

Publications

  • SCOPE Study Group. High daily dose Short COurse PrimaquinE after G6PD testing for the radical cure of Plasmodium vivax malaria in Indonesia and Papua New Guinea: the SCOPE implementation study protocol. BMC Infect Dis. 2025 Jul 16;25(1):922. doi: 10.1186/s12879-025-11109-9.

    PubMed 40670924

Questions about this trial

What is this clinical trial studying?

A study testing Revised case management package in people with Vivax Malaria and G6PD Deficiency, run by Menzies School of Health Research at 6 sites in Indonesia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in Indonesia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of patients experiencing at least one Serious Adverse Event (SAE) during treatment (time frame: During treatment (up to 8 weeks) ]). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05879224, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jan 2026.

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