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Africa starts investigating best treatments for mild COVID-19 cases

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Kampala, Uganda |  THE INDEPENDENT |  Uganda and 12 other African countries have launched a new  clinical trial that aims to respond to the urgent need to identify treatments that can be used to treat mild and moderate cases of COVID-19 early and prevent spikes in hospitalization that could overwhelm fragile and already overburdened health systems on the continent.

The study dubbed ANTIVOC will be conducted at 19 sites across 13 countries where 2,000 to 3,000 patients with mild infection will be enrolled on various treatments to test their safety and efficacy in preventing the disease from progressing into severe state.  The countries involved are Burkina Faso, Cameroon, Côte d’Ivoire, the Democratic Republic of Congo (DRC), Equatorial Guinea, Ethiopia, Ghana, Guinea, Kenya, Mali, Mozambique, Sudan, and Uganda.

“There is a need for large clinical trials in Africa for COVID-19 to answer research questions that are specific to an African context,” said Dr. John Nkengasong, Director of the Africa Centres for Disease Control and Prevention in a statement.  “African countries have mounted an impressive response so far to COVID-19 and now is the time to prepare for future waves of the disease. We welcome the ANTICOV trial led by African doctors because it will help answer one of our most pressing questions: With limited intensive care facilities in Africa, can we treat people for COVID-19 earlier and stop our hospitals from being overwhelmed?”

The ANTICOV study falls under the category of adaptive platform trials where rapid decisions including adding, continuing or stopping treatment arms basing on an ongoing analysis of results can be quickly made. This approach was pioneered in studies for cancer drugs whereby testing for several treatments simultaneously was allowed.

In the new study, among the potential therapeutic options being explored are medicines currently used to treat malaria, HIV, hepatitis C, parasitic infections, and certain cancers.  Once the enrollment of participants phase that has just kicked off is complete, people will initially be given  the HIV antiretroviral combination lopinavir/ritonavir and the malaria drug hydroxychloroquine, which several studies done in the west have found not very helpful with COVID-19.

Back here in Uganda, the antimalarial was used to treat the initial mild cases recorded but has since been abandoned for Azithromycin, Zinc and Vitamin C.

Dr. Nathalie Strub- Wourgaft, the Director of the COVID-19 Response for DNDi, one of the organisations participating in the study says all the other drugs will be analysed as the study goes on but they chose hydroxy chloroquine because many countries still use it in treatment.

“Collaboration is the only way to provide robust scientific responses to these research questions,” said Dr Nathalie. “The trial was designed in a way that enables rapid and flexible decisions as we gather knowledge.”

In Uganda, the trial is taking place at Makerere University and Kabale University. Enrollment of participants is currently going on.

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