ELVIS Kids is a parallel, open label, randomised controlled trial (RCT) of Hypertonic Saline (HS) nose drops (\~2.6% NaCl) vs. standard care in children \<7 years of age with symptoms of an Upper Respiratory Tract Infection (URTI).
The study will run over \~30 months. Children are recruited prior to, or within 48 hours of developing URTI symptoms by advertising in areas such as local schools, nurseries, health centres and workplaces as well as social media. For the purposes of this study an URTI is defined as: at least two respiratory symptoms (nasal stuffiness, runny nose, cough, sore throat, or sneezing) OR one respiratory symptoms and at least one systemic symptom (lethargy, muscle pain, headache, pyrexia ≥38°C). Willing parents/guardians, of children \<7 years of age, will be directed by the study advertising to contact the research team at their local research site if they are interested in participating. Children will be randomised to either a Control arm of standard symptomatic care, or an Intervention arm of 3 drops each nostril of HS at least 4 times a day until 24 hours after asymptomatic or maximum of 28 days. All participants will be requested to obtain a mid-turbinate nasal swab prior to first nasal HS drops (repeated daily for 5 days), a daily symptom diary (CARIFS, a valid illness measure in the UK), and an end of illness questionnaire (healthcare use, adverse events, acceptability, infection in household contacts, parental time taken off usual activities). Parent/guardian of the children allocated to the intervention arm will be taught how to prepare the HS. Parent/guardian of children who are asymptomatic at recruitment are requested to inform CCRF when the child develops an URTI (within 48 hours) and follow the instructions already provided to them when given the go-ahead to start the trial. On day 28, parents/guardians will be contacted to determine if their child suffered from wheeze either during the illness or at any point until day 28. Participation in the study will end on day 28.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
407
\~2.6% NaCl solution prepared from sea salt
Childrens' Clinical Research Facility
Edinburgh, United Kingdom
Time to the first report that the child is "not unwell".
Time until child not unwell
Time frame: Maximum of 28days
Severity of all symptoms
Recorded by parents from options: No Problem, Minor Problem,Moderate Problem,Major Problem or Unknown/Not Applicable
Time frame: 1-28 days (or until child is well)
The length of time for individual symptoms to resolve
Recorded as: No Problem, Minor Problem,Moderate Problem,Major Problem or Unknown/Not Applicable
Time frame: 1-28 days (or until child is well)
Severity of individual symptoms
Recorded by parents from options: No Problem, Minor Problem,Moderate Problem,Major Problem or Unknown/Not Applicable
Time frame: 1-28 days (or until child is well)
Contacting healthcare (NHS 24, OOH, GP) -Number of participants
Number of participants
Time frame: 1-28 days (or until child is well)
Contacting healthcare (NHS 24, OOH, GP) -Frequency of contacts
Number of contacts
Time frame: 1-28 days (or until child is well)
Participants needing GP appointments- Number of participants
Number of appointments
Time frame: 1-28 days (or until child is well)
Participants needing GP appointments- Frequency of contacts
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Number of appointments
Time frame: 1-28 days (or until child is well)
Number of participants attending hospital and diagnosis - Number of participants
Number of participants
Time frame: 1-28 days (or until child is well)
Number of participants attending hospital and diagnosis - Frequency of contacts
Number of attendances
Time frame: 1-28 days (or until child is well)
Length of stay in hospital if admitted
Length in Days
Time frame: 1-28 days (or until child is well)
Number of participants reporting wheeze during illness and between end of illness to 28 days
Number reporting wheeze
Time frame: Day 28
Number of participants reporting over the counter medication use
Number of participants
Time frame: 1-28 days (or until child is well)
Duration of viral shedding
Viral shedding duration in days
Time frame: Days 1-5
Reduction in viral shedding
Log conversion of each positive result will be done using the following formula: (40-CT of specimen)/3.3 to estimate change in shedding.
Time frame: Days 1-5
Rate of reduction in viral shedding
Rate of viral shedding duration in days
Time frame: Days 1-5
Reduction in transmission to household contacts
Questionnaire - reported number of adults and children catching URTI
Time frame: 1-28 days (or until child is well)
Number of participants reporting side effects of nasal drops
Side effects reported
Time frame: 1-28 days (or until child is well)
Types and severity of side effects reported
Side effects reported
Time frame: 1-28 days (or until child is well)
Number of days lost from school/nursery for child
Number of days
Time frame: 1-28 days (or until child is well)
Number of days lost from work for parent/guardian
Number of days
Time frame: 1-28 days (or until child is well)
Cost of over the counter medication used
Cost of medicine used.
Time frame: 1-28 days (or until child is well)