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Modelling the therapeutic dose range of single low dose primaquine to reduce malaria transmission through age-based dosing

Overview of attention for article published in BMC Infectious Diseases, April 2017
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Title
Modelling the therapeutic dose range of single low dose primaquine to reduce malaria transmission through age-based dosing
Published in
BMC Infectious Diseases, April 2017
DOI 10.1186/s12879-017-2378-9
Pubmed ID
Authors

Daniel Joseph Hayes, Clifford George Banda, Alexandra Chipasula-Teleka, Dianne Janette Terlouw

Abstract

Low-dose primaquine is a key candidate for use in malaria transmission reduction and elimination campaigns such as mass drug administration (MDA). Uncertainty about the therapeutic dose range (TDR) required for general and paediatric populations challenge the implementation of the World Health Organisation's recommendation to add 0.25 mg/kg to current standard antimalarial treatment in such settings. Modelling work shows that for low-dose primaquine to have an impact, high efficacy and extensive population coverage are needed. In practice, age-based dose regimens, often used in MDA, could lead to safety concerns and a different effectiveness profile. We aimed to define TDRs for primaquine and to assess dosing accuracy of age-based dose regimens. Optimised regional age-based dosing regimens for low-dose primaquine were developed in steps. First, we identified potential TDR options based on suggested published efficacy and safety thresholds (i.e. 0.1-0.4, 0.125-0.375, 0.15-0.35 mg/kg). We then used our previously defined weight-for-age growth references and age-based dose optimisation tool to model predicted regimen accuracies for Africa, Asia and Latin America based on low-dose primaquine tablets (3.75 mg and 7.5 mg) currently under development by Sanofi while employing the identified dose range options and pre-specified regimen characteristics. Dose regimens employing TDRs of 0.1-0.4 and 0.125-0.375 mg/kg had the highest average predicted dose accuracies in all regions with the widest dose range of 0.1-0.4 mg/kg resulting in ≥99% dose accuracy in all three regions. The narrower 0.15-0.35 mg/kg range was on average predicted to correctly dose 91.4% of the population in Africa, 93.2% in Asia and 92.6% in Latin America. This range would prescribe ≥20% of 3-year-olds doses below 0.15 mg/kg and ≥20% of 11-year-olds doses above 0.35 mg/kg. Widening the TDR from 0.15-0.35 to 0.1-0.4 mg/kg increased the dose accuracy by ≥20% in Africa, ≥15% in Asia and ≥10% in Latin America. Optimised age-based dose regimens derived from wider TDRs are predicted to attain the dose accuracies required for effective MDA in malaria transmission reduction and elimination settings. We highlight the need for a clearly defined TDR and for safety and efficacy trials to focus on doses compatible with age-based dosing often employed in such settings.

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The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 32 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 32 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 7 22%
Researcher 5 16%
Student > Ph. D. Student 5 16%
Student > Bachelor 3 9%
Student > Doctoral Student 3 9%
Other 2 6%
Unknown 7 22%
Readers by discipline Count As %
Medicine and Dentistry 5 16%
Agricultural and Biological Sciences 5 16%
Pharmacology, Toxicology and Pharmaceutical Science 4 13%
Nursing and Health Professions 2 6%
Social Sciences 2 6%
Other 6 19%
Unknown 8 25%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 April 2017.
All research outputs
#15,164,176
of 23,322,258 outputs
Outputs from BMC Infectious Diseases
#4,197
of 7,806 outputs
Outputs of similar age
#185,630
of 310,627 outputs
Outputs of similar age from BMC Infectious Diseases
#107
of 170 outputs
Altmetric has tracked 23,322,258 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,806 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.3. This one is in the 41st percentile – i.e., 41% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 310,627 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 37th percentile – i.e., 37% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 170 others from the same source and published within six weeks on either side of this one. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.