2024
Persistent and multiclonal malaria parasite dynamics despite extended artemether-lumefantrine treatment in children
Goodwin J, Kajubi R, Wang K, Li F, Wade M, Orukan F, Huang L, Whalen M, Aweeka F, Mwebaza N, Parikh S. Persistent and multiclonal malaria parasite dynamics despite extended artemether-lumefantrine treatment in children. Nature Communications 2024, 15: 3817. PMID: 38714692, PMCID: PMC11076639, DOI: 10.1038/s41467-024-48210-7.Peer-Reviewed Original ResearchConceptsDay 7 lumefantrine concentrationsArtemether-lumefantrine treatmentRing-stage parasitesEarly post-treatmentEarly post-treatment periodArtemether-lumefantrineArtemisinin resistanceDay regimenMulticlonal infectionsEfficacious therapyFollow-upRandomized trialsPersistent clonesTransmission settingsEffective treatmentPost-treatment periodRegimensAntimalarial studiesStandard diagnosticsStandard 3DaysPost-treatmentChildrenTreatmentTherapy
2022
Impact of Drug Exposure on Resistance Selection Following Artemether‐Lumefantrine Treatment for Malaria in Children With and Without HIV in Uganda
Kay K, Goodwin J, Ehrlich H, Ou J, Freeman T, Wang K, Li F, Wade M, French J, Huang L, Aweeka F, Mwebaza N, Kajubi R, Riggs M, Ruiz‐Garcia A, Parikh S. Impact of Drug Exposure on Resistance Selection Following Artemether‐Lumefantrine Treatment for Malaria in Children With and Without HIV in Uganda. Clinical Pharmacology & Therapeutics 2022, 113: 660-669. PMID: 36260349, PMCID: PMC9981240, DOI: 10.1002/cpt.2768.Peer-Reviewed Original ResearchConceptsLopinavir-ritonavirLumefantrine concentrationsSensitive parasitesRecurrence riskPopulation PK/PD modelArtemether-lumefantrine treatmentTrimethoprim-sulfamethoxazole prophylaxisPK/PD modelPopulation PK modelFirst-order absorptionHigh transmission regionsAntiretroviral regimensLumefantrine exposureLumefantrine susceptibilityPfcrt K76Pfmdr1 N86Suboptimal dosingArtemether-lumefantrineTwo-compartment modelHIV statusRecurrent infectionsCombination therapyDrug exposurePrimary treatmentArtemisinin resistance
2016
Parasite Clearance and Artemether Pharmacokinetics Parameters Over the Course of Artemether-Lumefantrine Treatment for Malaria in Human Immunodeficiency Virus (HIV)-Infected and HIV-Uninfected Ugandan Children
Kajubi R, Huang L, Were M, Kiconco S, Li F, Marzan F, Gingrich D, Nyunt MM, Ssebuliba J, Mwebaza N, Aweeka FT, Parikh S. Parasite Clearance and Artemether Pharmacokinetics Parameters Over the Course of Artemether-Lumefantrine Treatment for Malaria in Human Immunodeficiency Virus (HIV)-Infected and HIV-Uninfected Ugandan Children. Open Forum Infectious Diseases 2016, 3: ofw217. PMID: 28018925, PMCID: PMC5170492, DOI: 10.1093/ofid/ofw217.Peer-Reviewed Original ResearchParasite clearanceArtemether-lumefantrineDHA exposureUgandan childrenHuman immunodeficiency virus (HIV) infectionArtemether-lumefantrine treatmentDaily blood smearsEarly parasite clearanceInitial parasite clearanceImmunodeficiency virus infectionLopinavir/ritonavirHuman immunodeficiency virusParasite clearance ratesAL efficacyArtemisinin pharmacokineticsAntiretroviral therapyHIV statusImmunodeficiency virusPK exposureArtemisinin resistanceTreatment outcomesVirus infectionHIVPharmacokinetic parametersBlood smearsAntiretroviral Choice for HIV Impacts Antimalarial Exposure and Treatment Outcomes in Ugandan Children
Parikh S, Kajubi R, Huang L, Ssebuliba J, Kiconco S, Gao Q, Li F, Were M, Kakuru A, Achan J, Mwebaza N, Aweeka FT. Antiretroviral Choice for HIV Impacts Antimalarial Exposure and Treatment Outcomes in Ugandan Children. Clinical Infectious Diseases 2016, 63: 414-422. PMID: 27143666, PMCID: PMC4946019, DOI: 10.1093/cid/ciw291.Peer-Reviewed Original ResearchConceptsArtemether-lumefantrine treatmentLPV/rRecurrent malariaLumefantrine exposureDrug exposureCritical drug-drug interactionsFirst-line antiretroviral therapy regimensArtemisinin-based combination therapyLopinavir/ritonavirAntiretroviral therapy regimensPlasmodium falciparum malariaHuman immunodeficiency virusDay 7 concentrationsMalaria-endemic regionsDrug-drug interactionsAntimalarial exposureAntimalarial componentPharmacokinetic samplingArtemether-lumefantrineFalciparum malariaClinical outcomesDosing regimensTherapy regimensImmunodeficiency virusCombination therapy
2015
The epidemiological impact of HIV antiretroviral therapy on malaria in children
Greenhalgh S, Ndeffo M, Galvani AP, Parikh S. The epidemiological impact of HIV antiretroviral therapy on malaria in children. AIDS 2015, 29: 473-482. PMID: 25486414, PMCID: PMC4391884, DOI: 10.1097/qad.0000000000000550.Peer-Reviewed Original ResearchConceptsHIV protease inhibitorsRecurrent malariaMalaria transmissionAntiretroviral therapyArtemether-lumefantrineAnnual incidenceProtease inhibitorsFirst-line antiretroviral regimenFirst-line antiretroviral therapyArtemether-lumefantrine treatmentHIV-negative childrenFirst-line antimalarialsHIV prevalence settingsHIV antiretroviral therapyRecent clinical trialsHIV prevalence levelsMalaria transmission settingsMalaria transmission intensityAntiretroviral regimenAntimalarial treatmentHIV prevalenceProphylactic effectPrevalence settingsClinical trialsHealth burden