Simple jQuery Dropdowns
Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/31837
Title: A robust design for identification of the Parasite Clearance Estimator
Authors: Kris M. Jamsen
Stephen B. Duffull
Joel Tarning
Ric N. Price
Julie A. Simpson
University of Melbourne
University of Otago
Mahidol University
Nuffield Department of Clinical Medicine
Menzies School of Health Research
WorldWide Antimalarial Resistance Network (WWARN)
Keywords: Immunology and Microbiology;Medicine
Issue Date: 18-Nov-2013
Citation: Malaria Journal. Vol.12, No.1 (2013)
Abstract: Background: Anti-malarial efficacy needs to be monitored continually to ensure optimal dosing in the face of emerging anti-malarial drug resistance. The efficacy of artemisinin based combination therapies (ACT) is assessed by repeated measurements of parasite density in the blood of patients following treatment. Parasite density is measured from a capillary or venous blood sample, but this can be logistically and ethically challenging if multiple samples are required within a short time period. The aim of this work was to apply optimal design theory to derive clinically feasible blood sampling schedules from which parasite clearance could be defined using the Parasite Clearance Estimator (PCE), a recently developed tool to identify and quantify artemisinin resistance. Methods. Robust T-optimal design methodology was applied to offer a sampling schedule that allows for discrimination across models that best describe an individual patient's parasite-time profile. The design was based on typical parasite-time profiles derived from the literature combined with key sampling constraints of no more than six samples per patient within 48 hours of initial treatment. The design was evaluated with a simulation-estimation procedure that implemented the PCE. Results: The optimal sampling times (sampling windows) were: 0 (0 to 1.1), 5.8 (4.0 to 6.0), 9.9 (8.4 to 11.5), 24.8 (24.0 to 24.9), 36.3 (34.8 to 37.2) and 48 (47.3, 48.0) hours post initial treatment. The simulation-estimation procedure showed that the design supported identification of the appropriate method by the PCE to determine an individual's parasite clearance rate constant (the main output calculation from the PCE). Conclusions: The proposed sampling design requires six samples per patient within the first 48 hours. The derived design requires validation in a real world setting, but should be considered for future studies that intend to employ the PCE. © 2013 Jamsen et al.; licensee BioMed Central Ltd.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84887344885&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/31837
ISSN: 14752875
Appears in Collections:Scopus 2011-2015

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.