Optimal dosing of dihydroartemisinin-piperaquine for seasonal malaria chemoprevention in young children

Palang Chotsiri, Issaka Zongo, Paul Milligan, Yves Daniel Compaore, Anyirékun Fabrice Somé, Daniel Chandramohan, Warunee Hanpithakpong, François Nosten, Brian Greenwood, Philip J. Rosenthal, Nicholas J. White, Jean-Bosco Ouédraogo and Joel Tarning ()
Additional contact information
Palang Chotsiri: Mahidol University
Issaka Zongo: Institut de Recherche en Sciences de la Santé
Paul Milligan: London School of Hygiene and Tropical Medicine
Yves Daniel Compaore: Institut de Recherche en Sciences de la Santé
Anyirékun Fabrice Somé: Institut de Recherche en Sciences de la Santé
Daniel Chandramohan: London School of Hygiene and Tropical Medicine
Warunee Hanpithakpong: Mahidol University
François Nosten: University of Oxford
Brian Greenwood: London School of Hygiene and Tropical Medicine
Philip J. Rosenthal: University of California
Nicholas J. White: Mahidol University
Jean-Bosco Ouédraogo: Institut de Recherche en Sciences de la Santé
Joel Tarning: Mahidol University

Nature Communications, 2019, vol. 10, issue 1, 1-12

Abstract: Abstract Young children are the population most severely affected by Plasmodium falciparum malaria. Seasonal malaria chemoprevention (SMC) with amodiaquine and sulfadoxine-pyrimethamine provides substantial benefit to this vulnerable population, but resistance to the drugs will develop. Here, we evaluate the use of dihydroartemisinin-piperaquine as an alternative regimen in 179 children (aged 2.33–58.1 months). Allometrically scaled body weight on pharmacokinetic parameters of piperaquine result in lower drug exposures in small children after a standard mg per kg dosage. A covariate-free sigmoidal EMAX-model describes the interval to malaria re-infections satisfactorily. Population-based simulations suggest that small children would benefit from a higher dosage according to the WHO 2015 guideline. Increasing the dihydroartemisinin-piperaquine dosage and extending the dose schedule to four monthly doses result in a predicted relative reduction in malaria incidence of up to 58% during the high transmission season. The higher and extended dosing schedule to cover the high transmission period for SMC could improve the preventive efficacy substantially.

Date: 2019
References: Add references at CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
https://www.nature.com/articles/s41467-019-08297-9 Abstract (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:nat:natcom:v:10:y:2019:i:1:d:10.1038_s41467-019-08297-9

Ordering information: This journal article can be ordered from
https://www.nature.com/ncomms/

DOI: 10.1038/s41467-019-08297-9

Access Statistics for this article

Nature Communications is currently edited by Nathalie Le Bot, Enda Bergin and Fiona Gillespie

More articles in Nature Communications from Nature
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().