Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: A Double Blind Randomized Controlled Trial to Assess the Efficacy and Safety of Low Dose Primaquine for Clearance of Gametocytes in Asymptomatic Individuals Infected With P. Falciparum in Burkina Faso
Brief Summary: Primaquine (PQ) is currently the only available drug that can clear mature transmission stages of P. falciparum parasites. PQ was previously shown to clear gametocytes that persist after artemisinin-combination therapy. However, there are safety concerns about the use of PQ at the currently recommended dose of 0.75mg/kg in individuals who are glucose-6-phosphate dehydrogenase (G6PD) deficient. PQ causes transient but significant haemolysis in G6PD deficient individuals; this side-effect is dose dependent. There are indications that a lower dosing of PQ may effectively reduce gametocyte carriage but the lowest efficacious dose for gametocyte clearance is currently unknown. Recently, the World Health Organization changed their recommendation to a low dose of primaquine, 0.25mg/kg. However, there is no direct evidence on the extent to which (low dose) PQ prevents malaria transmission to mosquitoes and what the lowest efficacious dose is.

In the current study we aim to identify the lowest efficacious dose of PQ in individuals with normal G6PD function. Children with asymptomatic malaria and normal G6PD enzyme function will be randomized to treatment with artemether-lumefantrine alone or in combination with low doses of PQ. All enrolled individuals will receive a full three-day course of AL, and will be randomized to receive a dose of primaquine or placebo with their fifth dose of AL. Efficacy will be determined based on gametocyte carriage during follow-up, measured by molecular methods. For a subset of participants with patent gametocytes, primaquine effect on infectivity to mosquitoes will be assessed by membrane feeding assays


Options:
A: Arm Label: Placebo; Type: PLACEBO_COMPARATOR; Interventions: Drug: Primaquine | Arm Label: Low dose primaquine (PQ1); Type: EXPERIMENTAL; Interventions: Drug: Primaquine | Arm Label: Intermediate dose primaquine (PQ2); Type: EXPERIMENTAL; Interventions: Drug: Primaquine | Arm Label: Reference dose primaquine (PQ-R); Type: ACTIVE_COMPARATOR; Interventions: Drug: Primaquine | Intervention Type: DRUG; Name: Primaquine; Assigned to Arm(s): Intermediate dose primaquine (PQ2), Low dose primaquine (PQ1), Placebo, Reference dose primaquine (PQ-R)
B: Arm Label: Artemether-Lumefantrine; Type: ACTIVE_COMPARATOR; Interventions: Drug: Artemether-lumefantrine combination | Arm Label: Artemether-Lumefantrine-Primaquine 0.25; Type: EXPERIMENTAL; Interventions: Drug: Artemether-Lumefantrine with a single dose of 0.25mg/kg primaquine | Arm Label: Artemether-Lumefantrine-Primaquine 0.4; Type: EXPERIMENTAL; Interventions: Drug: Artemether-Lumefantrine with a single dose of 0.4mg/kg primaquine | Intervention Type: DRUG; Name: Artemether-lumefantrine combination; Assigned to Arm(s): Artemether-Lumefantrine | Intervention Type: DRUG; Name: Artemether-Lumefantrine with a single dose of 0.25mg/kg primaquine; Assigned to Arm(s): Artemether-Lumefantrine-Primaquine 0.25 | Intervention Type: DRUG; Name: Artemether-Lumefantrine with a single dose of 0.4mg/kg primaquine; Assigned to Arm(s): Artemether-Lumefantrine-Primaquine 0.4
C: Arm Label: Arm 1; Type: EXPERIMENTAL; Interventions: Drug: chlorproguanil-dapsone-artesunate, Drug: chlorproguanil-dapsone | Intervention Type: DRUG; Name: chlorproguanil-dapsone-artesunate; Assigned to Arm(s): Arm 1 | Intervention Type: DRUG; Name: chlorproguanil-dapsone; Assigned to Arm(s): Arm 1
D: Arm Label: dihydroartemisinin-piperaquine; Type: ACTIVE_COMPARATOR; Interventions: Drug: dihydroartemisinin-piperaquine | Arm Label: Dihydroartemisininpiperaquine primaquine; Type: ACTIVE_COMPARATOR; Interventions: Drug: dihydroartemisinin-piperaquine + primaquine | Intervention Type: DRUG; Name: dihydroartemisinin-piperaquine; Assigned to Arm(s): dihydroartemisinin-piperaquine | Intervention Type: DRUG; Name: dihydroartemisinin-piperaquine + primaquine; Assigned to Arm(s): Dihydroartemisininpiperaquine primaquine

Answer: B