Increased Dosing of Malaria Drug in Children May Lower Infection Risk

Piperaquine is a long-acting malaria drug that kills residual parasites and decreases the risk of reinfection. A study led by Uppsala University researcher Martin Bergstrand shows that increasing the dose used in children could potentially decrease the yearly incidence of malaria by 70%.

 The study was published yesterday in Science Translational Medicine.The researchers developed a mathematical model to assess the relationship between piperaquine concentrations in patient plasma and the risk among healthy males of acquiring a malaria infection. Piperaquine concentrations of 6.7 ng/mL and 20 ng/mL were found to reduce the risk of acquiring a malaria infection by 50% and 95%, respectively.

 Simulations were used to translate the results from the studied male population to a population of children. This showed that increasing the dose in children could potentially decrease the yearly incidence of malaria from 6% to 2%, during preventive treatment under certain conditions – a relative decrease of 70 per cent.

The modelling and simulation of vulnerable populations such as children and pregnant women is a valuable method, since actual dosing studies on these groups are difficult to perform.

 The researchers also used mathematical models to investigate the consequence of a potential emerging resistance to piperaquine. These simulations indicated that even moderate resistance to piperaquine can be expected to drastically compromise the usefulness of piperaquine in preventive therapy. A doubling of the piperaquine concentration needed to reduce the risk of a malaria infection by 50% would increase the yearly incidence from 2% to 10% under similar conditions. This emphasizes the need for a correct use of piperaquine, in order to minimize the risk for development of widespread resistance.

Date: October 31, 2014

Source:  Uppsala University

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