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dc.contributor.authorPalang Chotsirien_US
dc.contributor.authorLise Denoeud-Ndamen_US
dc.contributor.authorElisabeth Baudinen_US
dc.contributor.authorOusmane Guindoen_US
dc.contributor.authorHalimatou Diawaraen_US
dc.contributor.authorOumar Attaheren_US
dc.contributor.authorMichiel Smiten_US
dc.contributor.authorPhilippe J. Guerinen_US
dc.contributor.authorOgobara K. Doumboen_US
dc.contributor.authorLubbe Wiesneren_US
dc.contributor.authorKaren I. Barnesen_US
dc.contributor.authorRichard M. Hoglunden_US
dc.contributor.authorAlassane Dickoen_US
dc.contributor.authorJean Francois Etarden_US
dc.contributor.authorJoel Tarningen_US
dc.contributor.otherUniversity of Bamako Faculty of Medicine, Pharmacy and Odonto-Stomatologyen_US
dc.contributor.otherMahidol Universityen_US
dc.contributor.otherNuffield Department of Clinical Medicineen_US
dc.contributor.otherUniversity of Cape Townen_US
dc.contributor.otherWorldWide Antimalarial Resistance Network (WWARN)en_US
dc.identifier.citationClinical Pharmacology and Therapeutics. Vol.106, No.6 (2019), 1299-1309en_US
dc.description.abstract© 2019 The Authors Clinical Pharmacology & Therapeutics published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics Severe acute malnutrition (SAM) has been reported to be associated with increased malaria morbidity in Sub-Saharan African children and may affect the pharmacology of antimalarial drugs. This population pharmacokinetic (PK)-pharmacodynamic study included 131 SAM and 266 non-SAM children administered artemether-lumefantrine twice daily for 3 days. Lumefantrine capillary plasma concentrations were adequately described by two transit-absorption compartments followed by two distribution compartments. Allometrically scaled body weight and an enzymatic maturation effect were included in the PK model. Mid-upper arm circumference was associated with decreased absorption of lumefantrine (25.4% decreased absorption per 1 cm reduction). Risk of recurrent malaria episodes (i.e., reinfection) were characterized by an interval-censored time-to-event model with a sigmoid maximum-effect model describing the effect of lumefantrine. SAM children were at risk of underexposure to lumefantrine and an increased risk of malaria reinfection compared with well-nourished children. Research on optimized regimens should be considered for malaria treatment in malnourished children.en_US
dc.rightsMahidol Universityen_US
dc.titleSevere Acute Malnutrition Results in Lower Lumefantrine Exposure in Children Treated With Artemether-Lumefantrine for Uncomplicated Malariaen_US
Appears in Collections:Scopus 2019

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