ClinicalTrials.gg
CompletedNCT03893097SchistoSAMUpdated Apr 5, 2021

Evaluation of Artesunate-mefloquine as a Novel Alternative Treatment for Schistosomiasis in African Children

A Phase 3 interventional study of Praziquantel and Artesunate + Mefloquine in Schistosoma Haematobium and Schistosoma Mansoni, sponsored by Institute of Tropical Medicine, Belgium. Completed at 1 site in Senegal. Open to participants aged 6 Years to 14 Years. Per ClinicalTrials.gov, last updated 2021-04-05.

Sponsored by Institute of Tropical Medicine, Belgium · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
726
Allocation
Randomized
Ages
6 Years to 14 Years
Sex
All
01

Study summary

The SchistoSAM study is an open label, two-arm, individually-randomized controlled trial with a non-inferiority design, conducted in northern Senegal.

The study aims at determining if the efficacy of one and of repeated courses of artesunate-mefloquine (AM) is respectively similar to or higher than that of a standard praziquantel (PZQ) treatment. Secondly, the study will assess if novel DNA- and antigen-based diagnostics are more accurate than microscopy in assessing antischistosomal treatment response.

Read the detailed description

The SchistoSAM study is an open label, two-arm, individually-randomized controlled trial with a non-inferiority design, conducted in northern Senegal.

The study aims at determining if the efficacy of one and of repeated courses of artesunate-mefloquine (AM) is respectively similar to or higher than that of a standard praziquantel (PZQ) treatment. Secondly, the study will assess if novel DNA- and antigen-based diagnostics are more accurate than microscopy in assessing antischistosomal treatment response.

For this purpose, 726 school children, aged 6-14 years old and infected with Schistosoma (as demonstrated by presence of eggs in stool and/or urine) will be randomized in one of the following arms:

  1. AM, available in fixed dose tablets of 25/50 mg and 100/200 mg will be administered once daily for three days in a dose closest to 4 mg/kg artesunate and 8 mg/kg mefloquine. This treatment course will be repeated 2 times at 6-week intervals.
  2. PZQ, available in tablets of 600 mg, will be administered as a single dose of 40 mg/kg.

Trial participants will be regularly followed-up:

  1. At each dose administration
  2. At day 7 after each dose for follow-up of safety
  3. At week 4, 10 and 16 for parasitological assessment and follow-up of safety
  4. At week 6 and 12 for clinical assessment before the second and third drug administration (only in the AM arm)
  5. At week 24 and 48 for assessment of Schistosoma spp. and malaria infection and associated morbidity (compared to baseline)
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Conditions studied

  • Schistosoma Haematobium
  • Schistosoma Mansoni

Keywords

  • Schistosoma
  • Schistosomiasis
  • Senegal
  • Praziquantel
  • Artesunate
  • Mefloquine
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In context

Schistosomiasis haematobia

21 studies on the registry are indexed under Schistosomiasis haematobia; 2 are open to participants now.

This study's enrollment of 726 is above the median of 200 across 13 interventional studies indexed under Schistosomiasis haematobia.

Browse Schistosomiasis haematobia studies →

Lead sponsor

Institute of Tropical Medicine, Belgium is the lead sponsor of 104 studies on the registry; 21 are open to participants now.

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

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Who can participate

Ages eligible
6 Years to 14 Years
Sexes eligible
All
Accepts healthy volunteers
No

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

  1. Children ≥6 and ≤14 years of age
  2. Enrolled in one of the selected primary schools in the region
  3. Infected with schistosomiasis (i.e. Schistosoma spp. eggs in urine and/or stool)
  4. from parents/guardians signed

Exclusion criteria

Exclusion Criteria:

  1. History of, or ongoing, epilepsy or psychiatric illness (I.e. recent history of depression, generalized anxiety disorder; history of psychosis, schizophrenia or other major psychiatric disorders) or known to one of the three study drugs
  2. Chronic medication for any reason
  3. Any severe underlying illness, including severe malnutrition or severe chronic schistosomiasis, based on clinical judgement
  4. Any febrile illness
  5. Exposure to PZQ or ACT within the three previous months.
Terms in these criteria, in plain language(2)

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.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
726 participants (actual)

Study arms

  • Active comparator
    Praziquantel

    Participants in this arm will receive one dose of PZQ at baseline at 40 mg/kg.

    Drug: Praziquantel

  • Experimental
    Artesunate-Mefloquine

    Participants in this arm will receive the Artesunate-Mefloquine (fixed-drug)combination at 4 mg/kg artesunate and 8 mg/kg mefloquine at 3 consecutive days. This will be repeated twice; at week 6 and week 12.

    Drug: Artesunate + Mefloquine

Interventions

  • 40 mg/kg at baseline

  • DrugArtesunate + Mefloquine

    Drug pages: Artesunate · Mefloquine

    4mg/kg artesunate and 8 mg/kg mefloquine at baseline (3 consecutive days) and repeated at Week 6 and Week 12

06

What researchers measure

Primary outcomes

  1. Evaluate the efficacy of a single course of artesunate-mefloquine for the treatment of schistosomiasis, compared to the standard PZQ regimen: Parasitological cure rate

    Parasitological cure rate, as assessed by microscopy, after administration of PZQ and after one AM course

    Time frame: Week 4

  2. Number of safety events of a single course of artesunate-mefloquine for the treatment of schistosomiasis, compared to the standard PZQ regimen

    Frequency of drug-related adverse events and serious adverse events

    Time frame: Week 4

  3. Number of safety events of a single course of artesunate-mefloquine for the treatment of schistosomiasis, compared to the standard PZQ regimen

    Pattern of drug-related adverse events and serious adverse events

    Time frame: Week 4

Secondary outcomes

  1. Evaluate the cumulative efficacy of two additional courses of AM (at 6-week intervals each) for the treatment of schistosomiasis, compared to a single course of AM, and compared to the standard regimen: Cure rate

    Cure rate, as assessed by microscopy, after the second and after the third AM administration

    Time frame: Week 48

  2. Number of safety events of two additional courses of AM (at 6-week intervals each) for the treatment of schistosomiasis, compared to a single course of AM, and compared to the standard regimen.

    Frequency of adverse events and serious adverse events up to 4 weeks after the second and third AM administration.

    Time frame: Week 16

  3. Determine the egg reduction rate obtained after single and repeated courses of AM compared to the standard PZQ regimen.

    Egg reduction rate after administration of PZQ and after each AM course

    Time frame: Week 48

  4. Determine the parasitological efficacy of single and repeated courses of AM by Schistosoma species and by infection intensity.

    Cure rate and egg reduction rate by Schistosoma species (S. haematobium and S. mansoni) and by initial Schistosoma infection intensity after PZQ administration and single and repeated courses of AM

    Time frame: Week 16

  5. Assess the impact of repeated AM courses on schistosomiasis-related morbidity

    Prevalence and severity of general and organ-specific schistosomiasis morbidity (as assessed by clinical evaluation, ultrasound, point-of-care morbidity markers and hemoglobin level) compared to baseline and compared to the control arm.

    Time frame: Week 48

  6. Determine the diagnostic accuracy of novel schistosomiasis antigen- and DNA-based diagnostic assays to monitor antischistosomal treatment response

    Diagnostic accuracy of the different conventional and novel diagnostic tests (antigen- and DNA-based) at baseline and at defined time points after treatment compared to conventional stool/urine microscopy, and to composite reference standards (any positive test would be considered as infection).

    Time frame: Week 48

  7. Determine the effect of repeated AM courses on prevalence of P. falciparum infection as well as on incidence and morbidity of clinical malaria in school-age children with schistosomiasis

    * Prevalence of malaria infection, as assessed by molecular testing of dried blood spots. * Incidence of clinical malaria, as assessed by the number of incident malaria cases diagnosed through passive case detection during the study period (by standard malaria rapid tests and molecular diagnostics on dried blood spots). * Frequency and severity of anemia, as assessed by determination of hemoglobin levels.

    Time frame: Week 48

  8. Monitor the prevalence of Pf molecular markers associated with mefloquine resistance and the potential emergence of reduced artesunate susceptibility

    Prevalence and patterns of mutations in the K13 gene (for artemisinin susceptibility) and increased copy number of the Pfmdr1 gene or other relevant mutations (for mefloquine resistance) observed in the molecular surveys Presence and patterns of mutations observed in incident malaria cases.

    Time frame: Week 48

  9. Number of safety events of two additional courses of AM (at 6-week intervals each) for the treatment of schistosomiasis, compared to a single course of AM, and compared to the standard regimen.

    Pattern of adverse events and serious adverse events up to 4 weeks after the second and third AM administration.

    Time frame: Week 16

07

Study locations

1 site
  • Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation (IRESSEF)
    Dakar, Senegal
08

References and documents

Publications

  • Roucher C, Brosius I, Mbow M, Faye BT, De Hondt A, Smekens B, Arango D, Burm C, Tsoumanis A, Paredis L, van Herrewege Y, Potters I, Cisse B, Mboup S, Polman K, Bottieau E. Evaluation of Artesunate-mefloquine as a Novel Alternative Treatment for Schistosomiasis in African Children (SchistoSAM): protocol of a proof-of-concept, open-label, two-arm, individually-randomised controlled trial. BMJ Open. 2021 Jun 24;11(6):e047147. doi: 10.1136/bmjopen-2020-047147. PubMed 34168029 ↗

Individual participant data

Plan to share: Yes — The proposed research will include data from 726 subjects, infected with Schistosomiasis and treated according to protocol in one of two arms. The final dataset will include phenotypic data such as demographics and medical history, results of the different diagnostic tests under investigation, clinical signs and symptoms, echography findings on Schistosomiasis induced morbidity, results of indirect morbidity markers under investigation, presence or absence of Plasmodium falciparum (Pf) and of Pf molecular resistance markers. All the individual participant data and additional supporting information will be deposited, after deidentification, at the IDDO - Schistosomiasis/STHs Data Platform. This is a platform specifically for Schistosomiasis/STHs data and is part of the IDDO project, an international collaboration hosted by the University of Oxford. The repository has data access policies and procedures consistent with ITM data sharing policies.

Supporting information: Study protocol, Informed consent form

Time frame: We anticipate to deposit the individual participant data into the IDDO repository as soon as possible after publication of both findings on treatment efficacy and diagnostic accuracy, but no later than within one year. No end date is established for availability and access to the submitted data.

Access criteria: For the first five years from submission of the data, decisions regarding data access for third parties will be taken by the authors in collaboration with the ITM Data Access Committee (DAC). After five years, all requests for access to the Data from third parties shall automatically be delegated to DAC of IDDO. The IDDO DAC will provide controlled access to third party researchers whose applications for Data held within the IDDO repository are approved by the DAC in accordance with specific Data Access Guidelines. All requests are reviewed for qualifications of the researchers, the design and objectives of the secondary research, analysis plan and publication plan, consistency with ITM data sharing policies, applicable laws and regulations, and required ethics approvals.

Data sharing details ↗ · www.itg.be

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 5, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03893097
Collaborators
Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation (IRESSEF)
Responsible party
Sponsor
First posted
Mar 28, 2019
Start date
Oct 14, 2019
Primary completion
Mar 4, 2021
Completion
Mar 4, 2021
Last update
Apr 5, 2021

Study contacts

Moustapha Mbow, MD
principal investigator · IRESSEF

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drugs tested here: Artesunate · Mefloquine

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