Optimizing the programmatic deployment of the anti-malarials artemether-lumefantrine and dihydroartemisinin-piperaquine using pharmacological modelling

Hodel, Eva Maria; Kay, Katherine; Hayes, Daniel J; Terlouw, Dianne J; Hastings, Ian M

doi:10.1186/1475-2875-13-138

Table 5 Predicted artemether-lumefantrine (AM-LF) treatment outcome (in %) in populations of 10,000 individuals at 63 days follow-up for different treatment scenarios group by dosing regimen (according to Table 2 ) and geographical region

From: Optimizing the programmatic deployment of the anti-malarials artemether-lumefantrine and dihydroartemisinin-piperaquine using pharmacological modelling

Treatment scenario	Treatment outcome	Age-based dosing regimen				Weight-based dosing regimen
		Global	Africa	Asia	Latin America	Global	Africa	Asia	Latin America
Full course, i e, twice daily over three days at 0, 8, 24, 36, 48 and 60 hours	All parasites cleared	99.83	99.81	99.83	99.81	99.83	99.82	99.85	99.82
	Parasites below LoD	0.01	0.02	0.01	0.02	0.01	0.02	0.01	0.02
	Recrudescence	0.15	0.16	0.15	0.16	0.15	0.15	0.13	0.15
	Parasites always above LoD	0.01	0.01	0.01	0.01	0.01	0.01	0.01	0.01
Fifth dose missed	All parasites cleared	99.78	99.75	99.77	99.68	99.79	99.75	99.78	99.68
	Parasites below LoD	0.01	0.02	0.01	0.02	0.01	0.02	0.01	0.02
	Recrudescence	0.20	0.22	0.21	0.29	0.19	0.22	0.20	0.29
	Parasites always above LoD	0.01	0.01	0.01	0.01	0.01	0.01	0.01	0.01
Sixth dose missed	All parasites cleared	99.78	99.75	99.77	99.68	99.79	99.75	99.78	99.68
	Parasites below LoD	0.01	0.02	0.01	0.02	0.01	0.02	0.01	0.02
	Recrudescence	0.20	0.22	0.21	0.29	0.19	0.22	0.20	0.29
	Parasites always above LoD	0.01	0.01	0.01	0.01	0.01	0.01	0.01	0.01
Fifth and sixth dose missed	All parasites cleared	99.52	99.39	99.55	99.24	99.56	99.4	99.53	99.24
	Parasites below LoD	0.02	0.01	0.02	0.02	0.02	0.01	0.02	0.02
	Recrudescence	0.45	0.58	0.42	0.72	0.41	0.58	0.44	0.72
	Parasites always above LoD	0.01	0.02	0.01	0.02	0.01	0.01	0.01	0.02
Third, fourth, fifth and sixth dose missed	All parasites cleared	95.33	96.56	96.93	96.35	95.07	94.53	95.34	94.21
	Parasites below LoD	0.01	0.01	0.03	0.02	0.01	0.01	0.01	0.00
	Recrudescence	4.50	3.30	2.92	3.48	4.75	5.21	4.50	5.53
	Parasites always above LoD	0.16	0.13	0.12	0.15	0.17	0.25	0.15	0.26
Third, fourth, fifth and sixth dose delayed by 12 hours	All parasites cleared	99.83	99.82	99.83	99.81	99.83	99.83	99.85	99.82
	Parasites below LoD	0.01	0.02	0.01	0.02	0.01	0.02	0.01	0.02
	Recrudescence	0.15	0.15	0.15	0.16	0.15	0.14	0.13	0.15
	Parasites always above LoD	0.01	0.01	0.01	0.01	0.01	0.01	0.01	0.01
Increased IC₅₀ by 50-fold for LF and 10-fold for AM and DHA	All parasites cleared	76.85	73.89	77.62	72.5	75.1	72.99	76.17	71.49
	Parasites below LoD	0.02	0.02	0.02	0.00	0.02	0.01	0.01	0.01
	Recrudescence	15.49	17.02	15.15	17.7	16.35	17.4	15.72	18.18
	Parasites always above LoD	7.64	9.07	7.21	9.80	8.53	9.60	8.10	10.32
Administered without food, i e, 50% lower dose for LF	All parasites cleared	99.82	99.81	99.83	99.81	99.82	99.8	99.85	99.75
	Parasites below LoD	0.01	0.02	0.01	0.02	0.01	0.02	0.01	0.02
	Recrudescence	0.16	0.16	0.15	0.16	0.16	0.16	0.13	0.21
	Parasites always above LoD	0.01	0.01	0.01	0.01	0.01	0.02	0.01	0.02

DHA: dihydroartemisinin; IC₅₀: Concentration producing half the desired effect; LoD: limit of detection (10⁸ parasites).

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ISSN: 1475-2875

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