Publication: Optimal dosing of dihydroartemisinin-piperaquine for seasonal malaria chemoprevention in young children
Issued Date
2019-12-01
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ISSN
20411723
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2-s2.0-85060817483
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Mahidol University
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SCOPUS
Bibliographic Citation
Nature Communications. Vol.10, No.1 (2019)
Suggested Citation
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, Joel Tarning Optimal dosing of dihydroartemisinin-piperaquine for seasonal malaria chemoprevention in young children. Nature Communications. Vol.10, No.1 (2019). doi:10.1038/s41467-019-08297-9 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/50019
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Title
Optimal dosing of dihydroartemisinin-piperaquine for seasonal malaria chemoprevention in young children
Abstract
© 2019, The Author(s). 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 E MAX -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.