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Controlled Human Malaria Infection in Semi-Immune Kenyan Adults. (CHMI-SIKA) (CHMI-SIKA)

Primary Purpose

Malaria

Status
Unknown status
Phase
Phase 1
Locations
Kenya
Study Type
Interventional
Intervention
Plasmodium falciparum sporozoite (PfSPZ)
Sponsored by
University of Oxford
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Malaria focused on measuring PfSPZ, Semi-immune adults, Kenya, challenge, CHMI, malaria

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Healthy adults aged 18 to 45 years.
  • Able and willing (in the Investigator's opinion) to comply with all study requirements.
  • Informed consent.
  • Use of effective method of contraception for duration of study (women only). The investigators will ask the female volunteers to come with their family planning records to verify. Effective contraception is defined as a contraceptive method with failure rate of less than 1% per year when used consistently and correctly, in accordance with the product label. Examples of these include: combined oral contraceptives; injectable progestogen; implants of etenogestrel or levonorgestrel; intrauterine device or intrauterine system; male partner sterilisation at least 6 months prior to the female subject's entry into the study, and the relationship is monogamous; male condom combined with a vaginal spermicide (foam, gel, film, cream or suppository); and male condom combined with a female diaphragm, either with or without a vaginal spermicide (foam, gel, film, cream, or suppository).

Exclusion Criteria:

  • Use of systemic antibiotics with known antimalarial activity within 30 days of administration of PfSPZ Challenge (e.g. trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones and azithromycin).
  • Receipt of an investigational product in the 30 days preceding enrolment, or planned receipt during the study period.
  • Current participation in another clinical trial or recent participation within 12 weeks of enrolment.
  • Prior receipt of an investigational malaria vaccine.
  • Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed).
  • Use of immunoglobulins or blood products within 3 months prior to enrolment.
  • Any serious medical condition reported or identified during screening that increases the risk of CHMI.
  • Any clinically significant abnormal finding on biochemistry or haematology blood tests, urinalysis or clinical examination.
  • Women only; pregnancy, or an intention to become pregnant during the duration of the study.
  • Confirmed parasite positive by PCR a day before challenge i.e. at C-1.

Exclusion Criterion on Day of Challenge:

• Acute disease, defined as moderate or severe illness with or without fever (temperature >37.5°C).

Sites / Locations

  • KEMRI Wellcome Trust Research ProgrammeRecruiting
  • KEMRI Centre for Clinical Research

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Plasmodium falciparum sprozoite (PfSPZ) challenge

Arm Description

Challenge agent

Outcomes

Primary Outcome Measures

Infectivity of PfSPZ (malaria infection) as determined by quantitative PCR

Secondary Outcome Measures

Safety profile of PfSPZ challenge via direct venous injection
Parasite growth rates with respect to antibody responses to over 100 falciparum antigens

Full Information

First Posted
April 13, 2016
Last Updated
May 27, 2016
Sponsor
University of Oxford
Collaborators
KEMRI-Wellcome Trust Collaborative Research Program, Sanaria Inc., KEMRI Centre for Clinical Research, Pwani University, University of Cambridge, Wellcome Trust Sanger Institute
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1. Study Identification

Unique Protocol Identification Number
NCT02739763
Brief Title
Controlled Human Malaria Infection in Semi-Immune Kenyan Adults. (CHMI-SIKA)
Acronym
CHMI-SIKA
Official Title
Controlled Human Malaria Infection (CHMI) to Assess Human Immunity to P. Falciparum Using Sporozoites Administered by Direct Venous Inoculation
Study Type
Interventional

2. Study Status

Record Verification Date
May 2016
Overall Recruitment Status
Unknown status
Study Start Date
May 2016 (undefined)
Primary Completion Date
January 2020 (Anticipated)
Study Completion Date
November 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Oxford
Collaborators
KEMRI-Wellcome Trust Collaborative Research Program, Sanaria Inc., KEMRI Centre for Clinical Research, Pwani University, University of Cambridge, Wellcome Trust Sanger Institute

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The investigators wish to understand how resistance to malaria develops and how this affects the growth rate of malaria in individuals who have past exposure to malaria.
Detailed Description
Malaria remains a major public health threat despite regulatory approval of a partially effective pre-erythrocytic malaria vaccine. There is an urgent need to accelerate the development of a more effective multi-stage vaccine. Controlled human malaria infection (CHMI) has been shown to be an important tool for the assessment of the efficacy of novel malaria vaccines and drugs prior to field trials. CHMI also allows for the evaluation of immunity to malaria and parasite growth rates in vivo. This is particularly useful in individuals from endemic areas with a level of exposure and immunity to malaria. Thus CHMI in individuals with prior exposure to malaria could be a valuable tool to accelerate malaria vaccine development. In this study, the investigators aim to use CHMI in semi-immune adults to provide a comprehensive prioritization of antigens associated with blood-stage immunity for vaccine development. The investigators will comprehensively characterize immunity to malaria using >100 antigens in up to 2,000 semi-immune adults, from known areas of malaria endemicity in Kenya, then select 200 individuals with a range of different immunological profiles, and conduct CHMI studies with serial quantitative polymerase chain reaction (PCR) to measure the parasite growth rate in vivo and relate this to host immunity. This will also involve analysing the relationship with functional immunity assessed by laboratory assays.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malaria
Keywords
PfSPZ, Semi-immune adults, Kenya, challenge, CHMI, malaria

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
200 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Plasmodium falciparum sprozoite (PfSPZ) challenge
Arm Type
Experimental
Arm Description
Challenge agent
Intervention Type
Biological
Intervention Name(s)
Plasmodium falciparum sporozoite (PfSPZ)
Intervention Description
Plasmodium falciparum sporozoites
Primary Outcome Measure Information:
Title
Infectivity of PfSPZ (malaria infection) as determined by quantitative PCR
Time Frame
day 7 to day 21
Secondary Outcome Measure Information:
Title
Safety profile of PfSPZ challenge via direct venous injection
Time Frame
day 0 to day 21
Title
Parasite growth rates with respect to antibody responses to over 100 falciparum antigens
Time Frame
day 7 to day 21

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy adults aged 18 to 45 years. Able and willing (in the Investigator's opinion) to comply with all study requirements. Informed consent. Use of effective method of contraception for duration of study (women only). The investigators will ask the female volunteers to come with their family planning records to verify. Effective contraception is defined as a contraceptive method with failure rate of less than 1% per year when used consistently and correctly, in accordance with the product label. Examples of these include: combined oral contraceptives; injectable progestogen; implants of etenogestrel or levonorgestrel; intrauterine device or intrauterine system; male partner sterilisation at least 6 months prior to the female subject's entry into the study, and the relationship is monogamous; male condom combined with a vaginal spermicide (foam, gel, film, cream or suppository); and male condom combined with a female diaphragm, either with or without a vaginal spermicide (foam, gel, film, cream, or suppository). Exclusion Criteria: Use of systemic antibiotics with known antimalarial activity within 30 days of administration of PfSPZ Challenge (e.g. trimethoprim-sulfamethoxazole, doxycycline, tetracycline, clindamycin, erythromycin, fluoroquinolones and azithromycin). Receipt of an investigational product in the 30 days preceding enrolment, or planned receipt during the study period. Current participation in another clinical trial or recent participation within 12 weeks of enrolment. Prior receipt of an investigational malaria vaccine. Any confirmed or suspected immunosuppressive or immunodeficient state, including HIV infection; asplenia; recurrent, severe infections and chronic (more than 14 days) immunosuppressant medication within the past 6 months (inhaled and topical steroids are allowed). Use of immunoglobulins or blood products within 3 months prior to enrolment. Any serious medical condition reported or identified during screening that increases the risk of CHMI. Any clinically significant abnormal finding on biochemistry or haematology blood tests, urinalysis or clinical examination. Women only; pregnancy, or an intention to become pregnant during the duration of the study. Confirmed parasite positive by PCR a day before challenge i.e. at C-1. Exclusion Criterion on Day of Challenge: • Acute disease, defined as moderate or severe illness with or without fever (temperature >37.5°C).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Melissa Kapulu, DPhil
Phone
+254709983463
Email
MKapulu@kemri-wellcome.org
First Name & Middle Initial & Last Name or Official Title & Degree
Patricia Njuguna, MMed, MSc
Phone
+254709983534
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Philip Bejon, MD,PhD
Organizational Affiliation
KEMRI Wellcome Trust Research Programme and University of Oxford
Official's Role
Principal Investigator
Facility Information:
Facility Name
KEMRI Wellcome Trust Research Programme
City
Kilifi
State/Province
Coast
ZIP/Postal Code
80108
Country
Kenya
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Melissa Kapulu, DPhil
Phone
+254709983463
Email
MKapulu@kemri-wellcome.org
First Name & Middle Initial & Last Name & Degree
Patricia Njuguna, MMed, MSc
Phone
+254709983534
Email
PNjuguna@kemri-wellcome.org
First Name & Middle Initial & Last Name & Degree
Philip Bejon, MD, PhD
Facility Name
KEMRI Centre for Clinical Research
City
Nairobi
Country
Kenya
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Elizabeth Juma, MMed, MPH
Email
jumaelizabeth@yahoo.com
First Name & Middle Initial & Last Name & Degree
Bernhards Ogutu, MBChB, PhD

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Study information will be made available through an open repository. The information to be made available will be anonymized so that there is no link to participants and will include data on antibody responses, parasite growth rates and any other data generated from samples obtained in this study, both generated from this current protocol or any future studies which will require additional ethical approval.
Citations:
PubMed Identifier
35835738
Citation
Musasia FK, Nkumama IN, Frank R, Kipkemboi V, Schneider M, Mwai K, Odera DO, Rosenkranz M, Furle K, Kimani D, Tuju J, Njuguna P, Hamaluba M, Kapulu MC, Wardemann H; CHMI-SIKA Study Team; Osier FHA. Phagocytosis of Plasmodium falciparum ring-stage parasites predicts protection against malaria. Nat Commun. 2022 Jul 14;13(1):4098. doi: 10.1038/s41467-022-31640-6.
Results Reference
derived
PubMed Identifier
35073864
Citation
Kapulu MC, Kimani D, Njuguna P, Hamaluba M, Otieno E, Kimathi R, Tuju J, Sim BKL; CHMI-SIKA Study Team. Controlled human malaria infection (CHMI) outcomes in Kenyan adults is associated with prior history of malaria exposure and anti-schizont antibody response. BMC Infect Dis. 2022 Jan 24;22(1):86. doi: 10.1186/s12879-022-07044-8.
Results Reference
derived
PubMed Identifier
34264864
Citation
Kapulu MC, Njuguna P, Hamaluba M, Kimani D, Ngoi JM, Musembi J, Ngoto O, Otieno E, Billingsley PF; Controlled Human Malaria Infection in Semi-Immune Kenyan Adults (CHMI-SIKA) Study Team. Safety and PCR monitoring in 161 semi-immune Kenyan adults following controlled human malaria infection. JCI Insight. 2021 Sep 8;6(17):e146443. doi: 10.1172/jci.insight.146443.
Results Reference
derived
PubMed Identifier
31803847
Citation
Kapulu MC, Njuguna P, Hamaluba MM; CHMI-SIKA Study Team. Controlled Human Malaria Infection in Semi-Immune Kenyan Adults (CHMI-SIKA): a study protocol to investigate in vivo Plasmodium falciparum malaria parasite growth in the context of pre-existing immunity. Wellcome Open Res. 2019 Nov 14;3:155. doi: 10.12688/wellcomeopenres.14909.2. eCollection 2018.
Results Reference
derived

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Controlled Human Malaria Infection in Semi-Immune Kenyan Adults. (CHMI-SIKA)

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