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MalariaPhase 4NCT06225297

Evaluation of Vector and Chemoprevention-based Interventions to Reduce Malaria Burden in Urban Daaras of Touba, Senegal

A Phase 4 study testing Intervention package in people with Malaria, run by PATH at 1 site in Senegal.

Suspended

Paused. Enrolment is on hold for now and may resume.

Official record
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Trial summary

This study aims to evaluate the effectiveness of the use of adapted insecticide-treated mosquito nets combined with extended DHA-PQ-based seasonal chemoprevention for all ages and behavior change communication in reducing the burden of malaria in relation to standards of protection and care among students (taalibés)… Read more about this study

Who is it for?
Ages 3 months and olderHealthy volunteers can take part
Conditions the study is for
Malaria
What is being tested?
Intervention package
Could I receive a placebo?
No, everyone receives an active treatment
How many people
4,600 participants
Where
1 siteSenegal
Study dates
19 Jan 2024to Feb 2025
Phase
Phase 4
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 3 months and older
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Located within the catchment area of Touba Health District
  • Located within the catchment area of a health facility with an annual malaria incidence of ≥ 25 cases per 1000 population
  • Daara is registered in the health system and the Serigne daara (i.e., daara leader) can provide caregiver consent for taalibé.
  • Taalibé population between 29 to 120
  • PECAdaara model has been integrated and fully operational
  • Willingness of daara leader to participate in the study
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  • Age ≥ 3 months
  • Taalibé of study daara
  • Willingness to comply with study procedures
  • Provision of informed consent/assent
  • Additional inclusion criteria for receiving meganets:
  • Sleeping in a superimposed area with ≥ 2 people

Who cannot join

  • Age < 3 months
  • Refusal of informed consent
  • Concomitant or recent use of antimalarials within the past two weeks
  • Known allergy or hypersensitivity to DHA-PQ
  • Confirmed diagnosis of clinical malaria
  • Currently taking anti-worm or anti-infection drugs, including cotrimoxazole (BACTRIM), mebendazole, quinolones, sulfonamides (FANSIDAR, MALOXINE), dapsone, colchicine
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  • Currently taking medications that influence cardiac function or prolong the QTc interval
  • Serious or chronic illness, including known HIV infection, heart disease, or severe malnutrition (weight-for-age or mid-upper arm circumference (MUAC) < 3 SD)
  • Pregnancy (assessed by history or urine pregnancy test)

Trial locations and contacts

1 site in 1 country.

Senegal1 site
  • Daaras in Touba

    Touba

Other trials in Senegal

About this study

This study aims to evaluate the effectiveness of the use of adapted insecticide-treated mosquito nets combined with extended DHA-PQ-based seasonal chemoprevention for all ages and behavior change communication in reducing the burden of malaria in relation to standards of protection and care among students (taalibés) in the daaras (Koranic schools) of Touba, Senegal.

Read the detailed description

In Senegal, young children (mostly boys) may be sent to religious schools (daaras) to learn about the Koran and moral and cultural values. The students (talibés) often live and sleep in crowded conditions and as a result, insecticide-treated net (ITN) use is consistently low due to challenges faced in hanging ITNs as well as difficulty covering multiple children sleeping together. This study will consist of a two-arm cluster-randomized controlled trial to evaluate the effectiveness of an intervention package in urban daaras in Touba City, Diourbel region, Senegal.

The intervention package will include vector control through meganets (multiple insecticide-treated mosquito nets sewn together and adapted based on the needs and sleeping situation of the daara), seasonal malaria chemoprevention (SMC) extended to all ages using DHA-PQ, and behavior change communication.

Prior to evaluating an intervention, there will be 1) a mapping of the daaras in Touba City, Diourbel Region of Senegal to observe the various structures and types of daaras in order to select typical daaras for the entomological component, and to inform randomization, 2) human behavior observation (HBO) of students (talibes) and teachers (marabouts) in 2-3 daaras selected through the mapping to help tailor the intervention package, and 3) analysis of mosquito behavior observed through human landing catches.

Two cross-sectional surveys will be conducted, before and after the intervention, which will include an electronic questionnaire to be sent to the taalibés themselves or to their guardians, a temperature reading, an RDT for participants with a fever at the time of the survey, and a fingertip blood sample to assess parasite prevalence (microscopy and PCR). Qualitative surveys will be carried out using a mixed-method design, consisting of a literature review, in-depth individual interviews, focus groups, and on-site observations. Meganet monitoring surveys will be carried out after meganet distribution to assess the attrition and physical integrity of the nets.

Malaria incidence will be determined from records of community health workers assigned to the daaras who have been trained by the Ministry of Health to identify febrile students, test them for malaria using a rapid diagnostic test and treat confirmed cases with an antimalarial medicine. Additional data on students who seek care from health centers in their neighborhood will supplement the data obtained from community health workers.

Conditions
Malaria
Being tested
Intervention package
Medical subject headings
Malaria

What participants receive

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

  • Intervention packageCombination product

    Intervention package will include vector control through meganets (multiple insecticide-treated mosquito nets sewn together), seasonal malaria chemoprevention (SMC) extended to all ages using DHA-PQ, and behavior change communication.

Study groups in NCT06225297
Study groupRoleWhat they receive
Intervention clustersExperimentalwill receive the following interventions: 1. Distribution of meganets, defined as conventional insecticide-treated nets (ITNs) sewn together to adapt to taalibés sleeping conditions 2. Three monthly cycles of targeted chemoprevention with dihydroartemisinin-piperaquine (DHA-PQ) for all daara residents, regardless of resident age 3. Social behavior change (SBC) to promote intervention uptake
Receives: Combination Product: Intervention package
Control clustersNo interventionwill receive standard-of-care malaria interventions, which include: 1. Distribution of conventional ITNs 2. Three monthly cycles of SMC with sulfadoxine-pyrimethamine- amodiaquine (SP-AQ) given to children 3-120 months

What is being measured

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

  1. Difference in cumulative incidence of clinical malaria confirmed by rapid diagnostic test (RDT) between arms

    Cumulative incidence will be defined as the number of RDT-confirmed malaria cases per 1000 population in each daara. Cases will be identified from both PECAdaara and health facility registries

    Measured: monthly basis over 12 months

  2. Difference in change in prevalence of microscopy-confirmed infection between arms

    Prevalence will be defined as the proportion of individuals with microscopy-confirmed infection assessed during the endline survey

    Measured: 12 months

  3. Difference in pre-post change in prevalence of PCR-confirmed infection between arms

    Prevalence will be defined as the proportion of individuals with PCR-confirmed infection, assessed during cross-sectional surveys

    Measured: 12 months

Secondary outcomes (10)
  1. Difference in cumulative incidence of grade 3+ adverse events after drug administration between arms

    Defined as the number of grade 3+ AEs divided by the participant population who received at least one dose of drug.

    Measured: 12 months

  2. Difference in the cumulative incidence of serious adverse events (SAE) after SMC administration between arms

    Adverse events will be classified as serious or non-serious based on standardized AE grading scale

    Measured: 12 months

  3. Difference in human behavior on net use before and after ITN/meganet distribution

    ITN use (e.g., sleeping under net in the previous night, sleeping indoors versus outdoors) will be assessed during cross-sectional surveys

    Measured: 12 months

  4. Difference in indoor and outdoor adjusted human biting rates between arms

    The human landing rate will be used as a proxy for the human biting rate (HBR). The HBR data will be integrated with the human behavior observation (HBO) data on net use and sleep patterns data by calculating the hourly adjusted HBR.

    Measured: 12 months

  5. Difference in Anopheles biting trends between arms

    Anopheles biting trends will be examined by measuring the Anopheles biting times (including peak biting time), biting locations (indoors and outdoors), and vector density (defined as mean number of bites received by one person in one night) during human landing catches

    Measured: 12 months

  6. Acceptability of intervention package

    Perceptions of intervention package and reasons for participation assessed through qualitative studies conducted throughout the study period

    Measured: 12 months

  7. Difference in proportion of refusals between arms

    Refusals will be defined as the number of those who refused a specific intervention divided by the number of participants who were targeted and eligible to receive the specific intervention (i.e., chemoprevention and meganets).

    Measured: 12 months

  8. Difference in distribution coverage of chemoprevention strategies between arms

    Distribution coverage will be defined as the number of persons who received intervention divided by number of those targeted and eligible

    Measured: 12 months

  9. Difference in crude coverage of chemoprevention strategies between arms

    Crude coverage will be defined using WHO criteria as number of persons who received the intervention divided by number of those who were targeted (regardless of eligibility)

    Measured: 12 months

  10. Cost per malaria case averted

    Total intervention costs will be calculated in both arms and compared with efficacy measures of malaria incidence to generate the incremental cost effectiveness ratio.

    Measured: 12 months

Timeline

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

  1. First posted25 Jan 2024
  2. Study start19 Jan 2024
  3. Primary completion23 Dec 2024
  4. Study completionFeb 2025 (estimated)

Why it stopped: Executive order signed on January 20th 20254 to "reevaluate and realign US foreign aid", resulting in USAID funding freeze

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 4
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
4,600 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06225297
Sponsor's protocol ID
RES-00634
Status last verified
Feb 2025
First submitted
8 Jan 2024
Last updated
17 Feb 2025
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Intervention package in people with Malaria, run by PATH at 1 site in Senegal.

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 12 inclusion and 9 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: paused, as of the sponsor's last update on 17 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Senegal. 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.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

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?

Difference in cumulative incidence of clinical malaria confirmed by rapid diagnostic test (RDT) between arms (time frame: monthly basis over 12 months). 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?
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 17 Feb 2025.

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