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London School of Hygiene & Tropical Medicine Malaria Centre

Malaria clinical trials and studies

Effects of restricting the use of artesunate plus amodiaquine combination therapy to malaria cases confirmed by a dipstick test: a cluster randomised control trial.

LSHTM investigators:
Daniel Chandramohan, Jayne Webster & Seth Owusu-Agyei.
External collaborators:
Frank Baiden (Kintampo Health Research Centre, Ghana).

WHO now recommends test-based management of malaria across all age groups and transmission settings.

The national malaria programs in sub-Saharan Africa are at various stages of implementing the revised guideline. However, there are concerns that restricting ACT to rapid diagnostic  test (RDT)-positive malaria could lead to increased frequency of malaria and as a result, anaemia in children who are denied ACT on account of negative RDT results. On the other hand, uncurtailed use of ACTs has the potential to accelerate the development of resistance to the ACTs. The Kintampo-ACT study is a cluster randomised controlled trial to evaluate the effect of restricting ACT to RDT-positive malaria in under-five children in rural Ghana. In June 2010, a cohort of 3061 under-five children from 32 clusters was randomly allocated to RDT-based malaria management or to presumptive malaria management groups. The  follow up of  the cohort and collection of data on study endpoints (smear-confirmed malaria, anaemia, overall sick visits and cost-effectiveness) will be completed in June 2012. Study results will be disseminated in the last quarter of 2012.