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Completed

NCT Number: NCT04666350

Clinical Investigation Study to Evaluate the Consistency and Reproducibility of Two Consecutive Mosquito Feeding Assays

The proposed trial design has been developed to assess the consistency and reproducibility of two consecutive direct skin feeding assays (DSFA) at 24-hour interval.

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Key information

Age range

18 year–55 year

Sex eligibility

All sexes

Study type

Observational

Primary location

KEMRI

Kombewa, Kenya

About this study

The proposed trial design has been developed to assess the consistency and reproducibility of two consecutive direct skin feeding assays (DSFA) at 24-hour interval. The results will determine the type of pivotal trial design for a follow-on Phase 2b trial whose objective is to bridge the standard membrane feeding assay (SMFA) to the direct skin feeding assay (DSFA) and direct membrane feeding assay (DMFA) using a monoclonal antibody intervention, TB31F monoclonal antibody (mAb), which interrupts transmission from human to mosquito. The results from this experimental medicine study will inform whether the preferred "Before-After" trial design in which each human volunteer serves as their own internal control can be utilized for a follow-on Phase 2b trial.

Who can participate

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Provision of signed or thumb printed and dated informed consent form
  • Stated willingness to comply with all study procedures and availability for the duration of the study
  • Male or female aged between 18 years and 55 years inclusive.
  • Resident within the study area
  • In good general health as evidenced by medical history and clinical examination before entering the study Ability to take oral Coartem and low-dose primaquine anti-malarials upon conclusion of day 2 (2nd direct skin feed) and be willing to adhere to the medication regimen
  • For females, she must be of non-childbearing potential or use appropriate measures to prevent pregnancy for 30 days after receiving Coartem and primaquine. Non-childbearing potential means she is surgically sterilized or at least one year post-menopausal. Appropriate measures to prevent pregnancy include abstinence or adequate contraceptive precautions (i.e. intrauterine contraceptive device; oral contraceptives; diaphragm or condom in combination with contraceptive jelly, cream or foam; Norplant or Depo-Provera).
  • For males, he must be willing to ensure that he does not get his partner(s) pregnant for at least 3 months after treatment with primaquine. Appropriate measures to prevent pregnancy include abstinence or adequate contraceptive precautions in either the participant or the partner.
  • Positive for P. falciparum gametocytes as measured by polymerase chain reaction (PCR) with cycle threshold (cT) value < 31.

Exclusion criteria

Presence of any signs or symptoms of malaria

  • Presence of contraindications to administration of Coartem and primaquine as indicated in the respective drug package inserts
  • History of severe allergic reactions to mosquito bites (other than pruritus and local swelling)
  • Pregnant (i.e. a positive pregnancy test)
  • Current or recent (within the preceding 2 weeks) use of antimalarial treatment
  • Current participation in a malaria vaccine study
  • Any other findings that the investigator feels would increase the risk of having an adverse outcome from participation in the trial.

Treatment and study plan

Direct Skin Feeding Assay (DSFA)

Other

In the direct feeding assay a cup with 60 unfed, sterile insectary-reared Anopheles gambiae mosquitoes will be allowed to feed on a participant's calf or arm for 15 minutes.

Primaquine

Drug

Participants will receive one dose of primaquine 26.3 mg tablet on Day 2 after completion of the direct feeding assay.

artemether/lumefantrine

Drug

Participants will receive artemether (80 mg) and lumefantrine (480 mg) combination tablets twice a day for 3 days, starting after completion of the direct feeding assay on Day 2.

Other names: Coartem®

Primary outcomes

  1. Oocyst Prevalence

    Time frame: Feeding assays were performed on Day 1 and Day 2; Oocyst prevalence in surviving mosquitoes was assessed 9 days after feeding (Days 9 and 10).

    Participants underwent feeding assays on two days, 24 hours apart (day 1 and Day 2). After feeding, mosquitoes were maintained in locked environmental chambers for 9 days to allow oocyst development.

    An oocyst is a structure that develops on the outer wall of the infected mosquito's stomach that contains developing sporozoites.

    Nine days after feeding mosquito midguts were dissected, stained with 1% mercurochrome and examined by optical microscopy. The number of oocysts in each midgut were recorded.

    Oocyst prevalence is defined as the percentage of mosquitoes in a cup with at least one oocyst detected in the mid-gut among the surviving mosquitoes (in the same cup) that underwent the feeding assays.

Secondary outcomes

  1. Oocyst Density

    Time frame: Feeding assays were performed on Day 1 and Day 2; Oocyst density in surviving mosquitos was assessed 9 days after feeding (Days 9 and 10).

    Participants underwent feeding assays on two days, 24 hours apart (Day 1 and Day 2). After feeding, mosquitoes were maintained in locked environmental chambers for 9 days to allow oocyst development.

    An oocyst is a structure that develops on the outer wall of the infected mosquito's stomach that contains developing sporozoites.

    Nine days after feeding mosquito midguts were dissected, stained with 1% mercurochrome and examined by optical microscopy. The number of oocysts in each midgut were recorded.

    Oocyst density is defined as the mean number of oocysts detected in infected mosquitoes that underwent feeding assays on the same participant.

  2. Sporozoite Prevalence

    Time frame: Feeding assays were performed on Day 1 and Day 2; Sporozoite prevalence in surviving mosquitoes was assessed 14 days after feeding (Days 14 and 15).

    Participants underwent feeding assays on two days, 24 hours apart (day 1 and Day 2). After feeding, mosquitoes were maintained in locked environmental chambers for 14 days to allow sporozoite development.

    Sporozoites are the forms of the plasmodium that are liberated from the oocysts in the mosquito, accumulate in the salivary glands of the mosquito, and are transferred to humans when the mosquito feeds.

    Fourteen days after feeding, salivary glands were dissected from live mosquitoes submerged in phosphate-buffered saline (PBS) in order to visualize motile sporozoites by microscopy. Sporozoite prevalence was recorded.

    Sporozoite prevalence is defined as the percentage of mosquitoes in a cup with at least one sporozoite detected in the salivary glands among the mosquitoes (in the same cup) that underwent feeding assays.

  3. Sporozoite Density

    Time frame: Day 1 and Day 2

    Sporozoite density is defined as the mean number of sporozoites detected in infected mosquitoes that underwent feeding assays.

    Due to limitation on the state of the art, it was not possible to estimate the sporozoite density using the Optical Microscopy technique.

Sponsors and collaborators

Lead sponsor

PATH

Other

Collaborators

  • Kenya Medical Research Institute
  • Walter Reed Army Institute of Research (WRAIR)

Registry information

Official study title

Clinical Investigation Study to Evaluate the Consistency and Reproducibility of Two Consecutive Mosquito Feeding Assays in Adults With Varying Plasmodium Falciparum Gametocyte Densities

Important dates

Study start
2021
Primary completion
2021
Study completion
2021
First posted
Dec 14, 2020
Registry last updated
Apr 29, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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