DeTACT-Asia

Funder
UKAid, Foreign & Commonwealth Development Office

Principal Investigators
Professor A.M. Dondorp
Dr Erni Juwita Nelwan

Locations
Bangladesh
Cambodia
Jayapura City, Indonesia

Duration
June 2021 – March 2023

Trial Registration

A multi-centre randomised controlled non-inferiority trial to compare the efficacy, safety and tolerability of Triple Artemisinin-based Combination Therapies versus first-line ACTs + placebo for the treatment of uncomplicated Plasmodium falciparum malaria in Asia.

Background

Loss of efficacy of first-line Artemisinin combination therapies (ACTs) jeopardises current malaria control and elimination efforts and will accelerate the spread of drug resistance. New antimalarial drugs are not expected to come to the market within the next five years.

There is an urgent need to evaluate alternative treatments using combinations of existing drugs which will not fall rapidly to resistance and can be deployed immediately. The deployment of Triple Artemisinin Combination Treatments (TACT) could be part of such a strategy.

Aims

This project aims to compare the efficacy, safety and tolerability of the TACTs artemether-lumefantrine+amodiaquine and artesunate-mefloquine+piperaquine and the standard ACTs artemether-lumefantrine+placebo, and artesunate-mefloquine+placebo.

From left to right: OUCRU ID Clinical Trial Coordinator, OUCRU ID Laboratory and Field Support, OUCRU ID Clinical Trial Laboratory Manager, Co-Investigator, Director of RSUD Ramela Muara Tami, Indonesia Site PI

Outputs to date

In Indonesia, recruitment has not started yet. The trial documents are currently under submission to the Indonesian FDA and have been approved by The Ethics Committee of the Faculty of Medicine, University of Indonesia – Cipto Mangunkusumo Hospital on August 12th, 2022.

We anticipate fully enrolling this site with 235 P. falciparum patient subjects commencing in December 2022 before May 2023.

 

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Related

Dr Erni Nelwan

Dr Erni Nelwan

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Koya Barat Health Clinic

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Mahidol Oxford Tropical Medicine Research Unit (MORU)

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Papua Provincial Health Office

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RSUD Ramela Muara Tami

Forum Theatre Simulation

Analyse Tam’s choices. Step inside the story as an interactive spectator to break the chain of medical mishaps before it’s too late.

STORY TIMELINE PROGRESSION

progress step 6

The Ultimate Prevention: Vaccine Status

What if the volunteer leader had checked everyone’s Tetanus vaccination status before leaving for the field trip?

Vaccination Changes Everything

  • 100% Preventable: As you can see from our play, Tetanus cannot be cured easily once symptoms start and can be costly. But it is almost completely preventable with regular vaccination.
  • 10-Year Rule: Adults need a Tetanus booster shot every 10 years to maintain immunity.
  • Early booster shot: If you receive a deep or dirty cut (such as in the play, one from a rusty tool), you may need a booster if your last shot was more than 5 years ago.

When was your last Tetanus shot? Check your records today — a simple booster is the ultimate protection against unexpected accidents.

Forum Theatre Simulation

Analyse Tam’s choices. Step inside the story as an interactive spectator to break the chain of medical mishaps before it’s too late.

STORY TIMELINE PROGRESSION

progress step 5

Scenario Solved at Step 5!

Life-saving intervention! Jaw stiffness (lockjaw) is a classic symptom of active Tetanus toxin. Immediate hospital admission is required to secure the airway and control muscle spasms.

What if Tam had an ultimate shield against tetanus—protecting him from rusty tools before the trip even started?

Forum Theatre Simulation

Analyse Tam’s choices. Step inside the story as an interactive spectator to break the chain of medical mishaps before it’s too late.

STORY TIMELINE PROGRESSION

progress step 4

Scenario Solved at Step 4!

Good call! Healthcare providers depend on the full context. Clearly stating that an injury involved rusted metal alerts the nurse to assess Tetanus exposure immediately.

What if Tam had an ultimate shield against tetanus—protecting him from rusty tools before the trip even started?

Forum Theatre Simulation

Analyse Tam’s choices. Step inside the story as an interactive spectator to break the chain of medical mishaps before it’s too late.

STORY TIMELINE PROGRESSION

progress step 3

Scenario Solved at Step 3!

Spot on! Social media content often promotes unverified advice that delays crucial medical intervention. Deep, dirty cuts always require professional evaluation within hours.

What if Tam had an ultimate shield against tetanus—protecting him from rusty tools before the trip even started?

Forum Theatre Simulation

Analyse Tam’s choices. Step inside the story as an interactive spectator to break the chain of medical mishaps before it’s too late.

STORY TIMELINE PROGRESSION

progress step 2

Scenario Solved at Step 2!

Smart choice! Clostridium tetani bacteria thrive in organic material like dirt and leaves. Keeping raw plants out of deep cuts prevents pushing bacterial spores deeper into tissue.

What if Tam had an ultimate shield against tetanus—protecting him from rusty tools before the trip even started?

Forum Theatre Simulation

Analyse Tam’s choices. Step inside the story as an interactive spectator to break the chain of medical mishaps before it’s too late.

STORY TIMELINE PROGRESSION

progress 1 of 6

Scenario Solved at Step 1!

Great call! By stopping work with high-risk, corroded tools, you removed the physical source of Tetanus exposure entirely before an injury could even happen.

What if Tam had an ultimate shield against tetanus—protecting him from rusty tools before the trip even started?

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