Research into the treatment of bubonic plague is currently being conducted on the Big Island.
« The Imasoy trial has now reached its minimum target sample size “. The first randomized controlled clinical trial to evaluate the effectiveness and safety of bubonic plague treatments in Madagascar is underway. Covered by more than 220 confirmed or probable cases, this first clinical trial intends to “ test the hypothesis that ciprofloxacin monotherapy is non-inferior to streptomycin followed by ciprofloxacin in the treatment of bubonic plague “. Carried out in 82 peripheral health centers (Basic Health Centers) and hospitals across the country, Imasoy is part of a collaboration between “ the Institut Pasteur Madagascar (IPM), ISARIC, based at the Pandemic Sciences Institute of the University of Oxford (Sponsor), the Joseph Befelatanana University Hospital, the Charles Mérieux Infectiology Center (CICM) and the London School of Hygiene & Medicine Tropical (LSHTM)”. According to the leaders of this project, reaching the sample size planned for this trial constitutes a “ monumental achievement “. A breakthrough made possible thanks to “ the commitment of the institutions involved and health personnel » peripheral health centers and target hospitals distributed throughout « 13 districts de Madagascar ».
Soon. The plague is endemic in Madagascar and continues to claim victims every year. According to studies, “ current treatments are based on weak evidence “. No clinical trials conclusive » would never have been carried out until today. This, to the extent that they (clinical trials on plague) would always have been difficult to carry out due to “ operational complexity » that this presented. In the context of Imasoy, it would be a question of evaluating a ten-day treatment with oral ciprofloxacin. This differs from the protocol currently carried out in the country and which consists of a three-day treatment of an injectable aminoglycoside followed by seven days of oral ciprofloxacin. The results of Imasoy should be known and shared “ in the fourth quarter of this year “. For now, the initiative would strengthen the evidence base regarding plague. The same ones that should serve as decision-making tools for political decision-makers.
José Belalahy
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