ClinicalTrials.gg
CompletedNCT03534245Updated Oct 16, 2026

Investigating Vector-Borne Determinants of Aedes Transmitted Arboviral Infections in Cambodia: An Observational Longitudinal Cohort Study in Children

An observational study in Dengue Fever, sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Completed at 1 site in Cambodia. Open to participants aged 2 Years to 9 Years. Per ClinicalTrials.gov, last updated 2026-10-16.

Sponsored by National Institute of Allergy and Infectious Diseases (NIAID) · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
775
Ages
2 Years to 9 Years
Sex
All
01

Study summary

Background:

Some mosquitos carry viruses that can cause disease. Some examples are dengue and Zika. The mosquitos spread disease by biting people and infecting them with the virus. Children, elderly people, and people who are already sick are especially likely to get infected. Researchers want to learn more to help make new medicines to treat these viral infections.

Objective:

To learn more about how mosquitos infect people, and why young children are more likely to get sick than other people.

Eligibility:

Healthy children 2-9 years old who live near the study site. This is Kampong Speu District Referral Hospital in Chbar Mon, Cambodia.

Design:

At visit 1, participants will have a physical exam. A small amount of blood will be taken from their arm or finger. Parents will answer questions about the participant s general health and medical history.

Participants will come back to the study site every wet season and every dry season for the next 3 years. The visits will be the same as visit 1 and take about 1 hour.

If at any time during the study the participant gets a fever and has other symptoms that could be caused by these viral diseases, they should be brought to the study site. These symptoms might include headache, pain behind the eyes, muscle pain, or joint pain. They can also include a rash that lasts longer than 12 hours.

Participation ends after the final study visit in late 2021.

Read the detailed description

Mosquito-borne viruses continue to cause significant global morbidity and mortality, particularly in Southeast Asia. When mosquitoes deliver the virus into the skin of humans while probing for a blood meal, they deposit also saliva, which contains a myriad of pharmacologically active compounds that modulate the host immune system. Most vaccines against vector-borne diseases under development ignore the importance of the complex infectious inoculum delivered by the mosquito vector and the subsequent host immune response to mosquito salivary proteins. Many studies of vector-borne disease do not evaluate what role vector-derived factors play in the host immune response of these infections. A cumulative body of evidence from animal models and limited retrospective human data demonstrates that a variety of vector-derived components, including salivary components, are codelivered with the pathogen and may play an important role in the establishment and dissemination of arboviral infection. Knowledge of the effect of these vector-derived factors on the development of arboviruses in the human is limited. Here, we will establish and follow a longitudinal pediatric cohort study to describe the burden of dengue virus and to carefully examine the immune response to exposure of the salivary proteins of Aedes aegypti, the mosquito vector of dengue, Zika and chikungunya viruses. This study will serve as a foundation so that future studies may contribute to further understanding how saliva immunity impacts arboviral disease development i Cambodia, a country endemic to these viruses.

02

Conditions studied

  • Dengue Fever

Keywords

  • Mosquito Salivary Protein
  • Dengue Fever
  • Zika
  • Chikungunya
  • Kampong Speu
  • Natural History
03

In context

Dengue

283 studies on the registry are indexed under Dengue; 44 are open to participants now.

This study's enrollment of 775 is above the median of 595 across 80 observational studies indexed under Dengue.

Browse Dengue studies →

Lead sponsor

National Institute of Allergy and Infectious Diseases (NIAID) is the lead sponsor of 2,446 studies on the registry; 179 are open to participants now.

Of its 405 completed or terminated interventional studies of FDA-regulated products, 302 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
2 Years to 9 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Community-based cohort of children from the town of Chbar Mon in Kampong Speu, Cambodia, who live within 5.5 km to the Kampong Speu District Referral Hospital.@@@

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

In order to be eligible to participate in this study, an individual must meet all of the following criteria:

  1. Provision of signed and dated form
  2. Stated willingness to comply with all study procedures and availability for the duration of the study
  3. Male or female, aged 2-9 years
  4. Live within approximately 5.5 km of study site
  5. In good general health as evidenced by medical history
  6. Willing to allow biological samples to be stored for future research.

Exclusion criteria

EXCLUSION CRITERIA:

  1. Current or prior use within last 6 months of any (e.g. intravenous immunoglobulin, , interferon therapy)
  2. Treatment with another drug, vaccine, or other intervention within six months of screening
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
775 participants (actual)

Groups and cohorts

  • 1

    Healthy children aged 2 - 9 years

06

What researchers measure

Primary outcomes

  1. Prevalence of symptomatic and inapparent dengue infection (serotypes 1-4) as detected semiannually via ELISA assay (binary outcome present/absent) over a three-year period in Kampong Speu in children aged 2-9 years old

    Detailed knowledge of dengue seroprevalence and transmission season variability will help establish an epidemiological foundation to prepare for larger future studies such as disease incidence studies or vector interventional trials.

    Time frame: Semi-Annual visits and sick/convalescent visits throughout study enrollment

  2. Prevalence of Aedes aegypti salivary gland homogenate reactivity as detected by ELISA assay (binary outcome present/absent) during wet and dry seasons over a three-year period in Kampong Speu in children aged 2-9 years old

    Characterizing the Ae. aegypti salivary protein reactivity profile in Cambodians is the first step prior to assessing how Ae. aegypti saliva exposure modulates disease in humans.

    Time frame: Semi-annual visits and sick/convalescent visits throughout study enrollment

Secondary outcomes

  1. Western blot analysis of sera from participants with strongest ELISA positivity to Ae. aegypti whole salivary gland homogenate compared to Anopheles and Culex to assess cross-reactive immunogenicity to mosquito saliva versus specific Aedes marke...

    This next layer of analysis to identify specific immune dominant molecules, from a whole-protein approach, will provide the highestprobability of identifying novel proteins, irrespective of immune-modulatory function, that can then be characterized. It is essentialto assess reactivity to the saliva of Anopheles and Culex in order to exclude crossreactive antigens and select for Aedes-specific markers.

    Time frame: Semi-annual visits and sick/convalescent visits throughout study enrollment

  2. Positive RT-PCR result for diagnosis of dengue, chikungunya, and Zika viruses (or IgM capture ELISAs for dengue as needed)

    Dengue is the predominant flavivirus, but other circulating arbovirusescomplicate the serologic diagnosis of prior immunity and it will be important to characterize this burden given the ease and little costadded to run the multiplex RT-PCR compared to a DENV RT-PCR alone. Depending upon local transmission patterns, this could informwhether additional serological assays (e.g. plaque reduction neutralization assays \[PRNTs\]) may be needed to assess ZIKV, CHIKV, and Culex-transmitted JEV seroprevalence. The study is not powered to detect incidence of these symptomatic Aedestransmitted disease because it would require thousands and thousands of children.

    Time frame: Semi-annual visits and sick/convalescent visits throughout study enrollment

  3. Geographic information system with all data components (mosquito catch sites, houses, schools) referenced by latitude and longitude in addition to a series of map layers (point maps, smoothed maps) to evaluate relationships between IgG intensity...

    These data and analyses will allow for detailed spatiotemporal analysis of the data at individual, house and community levels. Similar published methods (except different entomological indices) were used for assessment of Anopheles salivary protein exposure at the Thai-Burma border for risk of malaria transmission.

    Time frame: Semi-annual visits and sick/convalescent visits throughout study enrollment

  4. Seroconversion to Ae. aegypti salivary homogenate in relationship to season (wet versus dry) and collected time-dependent variables defined as mean and maximum rainfall, temperature and humidity inaddition to monthly fingerpricks to evaluate ...

    Assessing the persistence of anti-saliva antibody response in the dry season is critical to a biomonitoring strategy to inform future vector control programs in the area. The natural time course of salivary protein exposure, particularly in confirmed arboviral disease settings,has not been wellcharacterized. Retrospective repeat analyses of nondiseased samples have suggested that salivary IgG antibodies may last 30-40 days. 10 Seasonal variation and climate factors are implicated in both disease transmission and vector abundance.

    Time frame: Semi-annual visits and sick/convalescent visits throughout study enrollment

  5. Capture a minimum of 25 female Aedes aegypti mosquitoes for transcriptional comparison to LMVR-reared Aedes aegypti mosquitoes

    Wild-caught Ae. aegypti may harbor considerable difference to inbred mosquito strains maintained in insectaries. Differences in salivary and midgut composition may help explain unique vector competence aspects and immunogenicity of the strains of Ae. aegypti in Cambodia.

    Time frame: Duration of study enrollment

07

Study locations

1 site
  • Kampong Speu Referral Hospital
    Chbar Mon, Kampong Speu, Cambodia
08

References and documents

Publications

  • Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, Drake JM, Brownstein JS, Hoen AG, Sankoh O, Myers MF, George DB, Jaenisch T, Wint GR, Simmons CP, Scott TW, Farrar JJ, Hay SI. The global distribution and burden of dengue. Nature. 2013 Apr 25;496(7446):504-7. doi: 10.1038/nature12060. Epub 2013 Apr 7. PubMed 23563266 ↗
  • Pingen M, Bryden SR, Pondeville E, Schnettler E, Kohl A, Merits A, Fazakerley JK, Graham GJ, McKimmie CS. Host Inflammatory Response to Mosquito Bites Enhances the Severity of Arbovirus Infection. Immunity. 2016 Jun 21;44(6):1455-69. doi: 10.1016/j.immuni.2016.06.002. PubMed 27332734 ↗
  • Machain-Williams C, Mammen MP Jr, Zeidner NS, Beaty BJ, Prenni JE, Nisalak A, Blair CD. Association of human immune response to Aedes aegypti salivary proteins with dengue disease severity. Parasite Immunol. 2012 Jan;34(1):15-22. doi: 10.1111/j.1365-3024.2011.01339.x. PubMed 21995849 ↗
  • Odio CD, Yek C, Hasund CM, Man S, Ly P, Nhek S, Chea S, Lon C, Voirin C, Huy R, Leang R, Huch C, Lamirande EW, Whitehead SS, Oliveira F, Manning JE, Katzelnick LC. Immunity to Non-Dengue Flaviviruses Impacts Dengue Virus Immunoglobulin G Enzyme-Linked Immunosorbent Assay Specificity in Cambodia. J Infect Dis. 2025 Feb 20;231(2):e337-e344. doi: 10.1093/infdis/jiae422. PubMed 39297691 ↗
  • Manning JE, Chea S, Parker DM, Bohl JA, Lay S, Mateja A, Man S, Nhek S, Ponce A, Sreng S, Kong D, Kimsan S, Meneses C, Fay MP, Suon S, Huy R, Lon C, Leang R, Oliveira F. Development of Inapparent Dengue Associated With Increased Antibody Levels to Aedes aegypti Salivary Proteins: A Longitudinal Dengue Cohort in Cambodia. J Infect Dis. 2022 Oct 17;226(8):1327-1337. doi: 10.1093/infdis/jiab541. PubMed 34718636 ↗
  • Manning JE, Oliveira F, Parker DM, Amaratunga C, Kong D, Man S, Sreng S, Lay S, Nang K, Kimsan S, Sokha L, Kamhawi S, Fay MP, Suon S, Ruhl P, Ackerman H, Huy R, Wellems TE, Valenzuela JG, Leang R. The PAGODAS protocol: pediatric assessment group of dengue and Aedes saliva protocol to investigate vector-borne determinants of Aedes-transmitted arboviral infections in Cambodia. Parasit Vectors. 2018 Dec 20;11(1):664. doi: 10.1186/s13071-018-3224-7. PubMed 30572920 ↗
09

Timeline

4 registry updates since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Jul 2018 to primary completion in Jan 2022, 42 months.

Of 36 observational studies under Dengue, half reached primary completion within 47 months of starting (the median), counting those still running; a quarter within 31 and three quarters within 71. This study's 42 months is below that.

How these figures are worked out, and which studies are left out of them.

Registered
May 22, 2018
First posted
May 23, 2018
StartActual
Jul 1, 2018
Primary completionActual
Jan 25, 2022
CompletionActual
Jan 25, 2022
Last update
Oct 16, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Minor edits
Nothing that changes what the study is or who can join. Edited: description
4 updates, last Oct 16, 2026
Show all 4 updates
  1. Oct 16, 2026
    Minor edits only
    + 1 other change: description
  2. Oct 13, 2026
    Minor edits only
    + 1 other change: description
  3. Oct 8, 2026
    Minor edits only
    + 1 other change: description
  4. Oct 2, 2026
    Minor edits only
    + 1 other change: description

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT03534245
Responsible party
Sponsor
First posted
May 23, 2018
Start date
Jul 1, 2018
Primary completion
Jan 25, 2022
Completion
Jan 25, 2022
Last update
Oct 16, 2026

Study contacts

Luiz F Oliveira, M.D.
principal investigator · National Institute of Allergy and Infectious Diseases (NIAID)

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.

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