Evidence map›Paper›PMID 34670598›Full record

ArticleTrials2021

Efficacy and safety of dual intravenous artesunate plus quinine compared to intravenous artesunate for cerebral malaria in a triple blinded parallel multisite randomized controlled trial in Nigerian children: DUAL PAQ TRIAL Protocol.

Michael Abel Alao, Adebola Emmanuel Orimadegun, Olayinka Rasheed Ibrahim, Abayomi O Oyenuga, Adanze Onyenonachi Asinobi, Daniel Adedosu Gbadero, Ifeoma Joy Okoye, Emmanuel Okechukwu Nna

Open access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Michael Abel AlaoDepartment of Paediatric, University College Hospital, University of Ibadan, Ibadan, Nigeria. mikevikefountains@gmail.com.ORCID http://orcid.org/0000-0003-0109-4435
Adebola Emmanuel OrimadegunInstitute of Child Health, University of Ibadan, Ibadan, Nigeria.
Olayinka Rasheed IbrahimDepartment of Paediatrics, Federal Medical Centre, Lagos, Katsina, Nigeria.
Abayomi O OyenugaUniversity of Minnesota, Minneapolis, MN, USA.
Adanze Onyenonachi AsinobiDepartment of Paediatric, University College Hospital, University of Ibadan, Ibadan, Nigeria.
Daniel Adedosu GbaderoCollege of Medicine, University of Ibadan, Ibadan, Nigeria.
Ifeoma Joy OkoyeDepartment of Radiation Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
Emmanuel Okechukwu NnaThe Molecular Pathology Institute, 44 Rangers Avenue, Independence Layout, Enugu, Nigeria.
University of Ibadan · NGFederal Medical Centre · NGUniversity of Minnesota · USUniversity of Nigeria Teaching Hospital · NG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEvidence exists as to the criticality of the first 24 h in the management of cerebral malaria. The morbidity and the mortality rate (35%) with the current intravenous monotherapy for the initial treatment of cerebral malaria are unacceptably high. Combination therapy and a shorter course of effective medication have been shown to improve outcomes in human participants in the treatment of other diseases. This study outlines a protocol to conduct a triple blinded parallel randomized controlled trial on cerebral malaria using dual intravenous medications compared to the current standard of monotherapy.

methodsThis is a parallel multi-site randomized controlled superiority triple blinded trial consisting of intravenous artesunate plus quinine and a control arm of intravenous artesunate only. Eligible and assenting children aged 6 months to 17 years will be recruited from 4 tertiary hospitals by random selection from the list of tertiary hospitals in Nigeria. Participants will be randomized and assigned in parallel into two arms using random numbers generated from GraphPad Prism (version 9) by a clinical pharmacologist who has no link with the investigators, the patients, or the statistician. The primary measurable outcome is survival at 12, 24, and 48 h post-randomization. A composite secondary outcome consists of the number of children that regained consciousness, parasitaemia and defervescence at 12 and 24 h post-randomization and haematological and inflammatory markers at 24 and 48 h post-randomization. Adverse events both solicited and unsolicited are recorded all through the study post-randomization. The study is approved by the State Research Ethics Review Committee. Data analysis will be performed in GraphPad Prism version 9. DISCUSSION: The outcome of this analysis will give insight into the efficacy and safety of dual intravenous antimalaria in the treatment of cerebral malaria among Nigerian children compared with the standard of care. The safety profile of this intervention will also be highlighted. This may help inform physicians on the optimal treatment for cerebral malaria to improve outcomes and reduce recrudescence and treatment failure.

trial registrationPan Africa Clinical Trial Registry PACTR202102893629864 . 23/02/2021.

Indexed as

AntimalarialsArtemisininsMalaria, CerebralArtesunateChildEquivalence Trials as TopicHumansNeoplasm Recurrence, LocalNigeriaQuinineRandomized Controlled Trials as TopicAntimalarialsArtemisininsArtesunateQuinineArtesunateBlindingCerebral malariaQuinineRandomized controlled trial

Identifiers

PMID34670598
PMCPMC8527777
OpenAlexW3205137448

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.