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A child stands behind a mosquito net (picture alliance/dpa/E. Morrison)

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ASAAP leads the way in assessing the viability of a triple therapy antimalarial via a multicenter clinical trial. Triple therapy is expected to significantly slow down the rate at which resistance of malaria parasites to medication develops.
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Seven reputable institutions across Sub-Saharan Africa, Germany, and France have come together to run the project ASAAP - Clinical evaluation of ArteSunate+Amodiaquine+Atovaquone-Proguanil tri-therapy for malaria treatment in African children. ASAAP is a 48-month-long multicenter clinical trial, coordinated by the Kumasi Center for Collaborative Research in Tropical Medicine (KCCR).

ASAAP’s main objective is to test a new combination of three drugs for how well they work for children and how safe and child-friendly they are. It is hoped that ASAAP will lead to the development of one of the first fixed-dose antimalarial tri-therapies aimed at slowing down resistance to malaria medicines, as well as the risk of mosquitoes passing malaria from one person to another. Over the next 4 years, ASAAP will use its network to develop a platform for clinical trials, entomology and molecular biology in Benin, Ghana, Mali, Gabon and Burkina Faso.

Malaria is preventable and curable. Its control currently relies on three major tools: long lasting insecticide treated nets to prevent mosquito bites; rapid and accurate diagnostic tests to identify parasite carriers; and efficacious, safe and well-tolerated antimalarial drugs to prevent the infection and cure the disease. Thanks to these tools and increased international funding over the past almost two decades, it is estimated that the prevalence of malaria parasite infection and the incidence of clinical disease fell by 50% and 40% respectively in Sub-Saharan Africa between 2000 and 2015. However, the malaria burden has remained stable since 2016. Most malaria cases in 2017 were in the WHO African Region (200 million or 92%). Ten countries in sub- Saharan Africa -- including Burkina Faso, Ghana, and Mali--, and India carried almost 80% of the global malaria burden. The WHO Global Technical Strategy for Malaria 2016–2030 has set ambitious goals, including the reduction of malaria incidence and mortality rates globally by at least 90% by 2030. The Strategy calls for continued research and development into new malaria control tools toward its elimination. Currently, the available tools to control malaria are under enormous pressure, due to the resistance of the malaria parasite to medication.

ASAAP in Africa learning about how to avoid the emergence of resistance to multiple previously effective antimalarials from Southeast Asia, where resistance is widespread, and robust strategies now need to be implemented to secure progress made in malaria control.

ASAAP’s strategy is therefore to develop new antimalarial regimens by combining antimalarial drugs having different modes of action – such as Artesunate + Amodiaquine (highly efficacious in Africa) with Atovaquone-Proguanil (so far only prescribed for travelers coming from non-endemic regions). This combined use of three antimalarials can reduce the incidence of and delay parasite resistance to the drugs, thereby prolonging their effectiveness. This strategy will maximize the possibility of a transition to next-generation antimalarials without a lapse in gains made in malaria control.

Through the support of EDCTP/EU funding and BMBF, the project is being led and coordinated by Dr. Oumou Maiga-Ascofaré of the BNITM in Germany and the KCCR in Kumasi, Ghana under the authority of the Kwame Nkrumah University of Science and Technology (KNUST), in collaboration with:

Dr. Jerome Clain and Dr. Michel Cot at MERIT (Paris); and Dr. Anna Cohuet at MIVEGEC (Montpellier) from the Institut de Recherche pour le Développement (IRD) in France

Prof.  Abdoulaye   Djimde   from   the   Université   des   Sciences, des   Techniques   et   des Technologies de Bamako (USTTB) in Bamako in Mali

Prof. Achille Massougbodji from the Institut de Recherche Clinique du Bénin (IRCB) in Abomey-Calavi, Benin

Dr.  Ghyslain  Mombo  Ngoma  from  the  Center  de  Recherches  Médicales  de  Lambaréné (CERMEL) in Lambaréné, Gabon

Dr.  Serge Yerbanga from the Institut des Sciences et Techniques (INSTech) in Bobo- Dioulasso, Burkina Faso

Prof.  Jürgen May and Prof.  Michael Ramharter from the Bernhard-Nocht-Institut  für Tropenmedizin (BNITM) in Hamburg, Germany

Dr. John Amuasi from KCCR and the department of Global Health at the KNUST School of Public Health in Kumasi, Ghana.

The Kumasi Center for Collaborative Research in Tropical Medicine (KCCR) is an international platform for biomedical research. KCCR’s modus operandi is based on the close collaboration between KNUST School of Medical Sciences in Ghana, the Ministry of Health and the Bernhard-Nocht Institute for Tropical Medicine (BNITM) in Germany. The main objective of the center is to develop a series of world standard research programs through the acquisition of research grants to carry out biomedical research in communicable diseases such as neglected tropical diseases, antimicrobial resistance, tuberculosis, malaria, and emerging and re-emerging infectious diseases; but also, in non-communicable diseases. KCCR houses one of the few level 3 laboratories established in West Africa. The Center is based on the campus of the Kwame Nkrumah University of Science and Technology (KNUST) in Kumasi, Ghana.

 

Source: ASAAP Malaria Project

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