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Evaluation of the paediatric dose of chloroquine in the treatment of Plasmodium vivax malaria

Overview of attention for article published in Malaria Journal, July 2016
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Title
Evaluation of the paediatric dose of chloroquine in the treatment of Plasmodium vivax malaria
Published in
Malaria Journal, July 2016
DOI 10.1186/s12936-016-1420-5
Pubmed ID
Authors

Arletta Añez, Manuel Moscoso, Cecilia Garnica, Carlos Ascaso

Abstract

Chloroquine (CQ) continues to be the first-line medication used worldwide in the treatment of Plasmodium vivax malaria. The dose recommended by the World Health Organization is 25 mg/kg independently of the age of the subject. Nonetheless, the pharmacokinetics and pharmacodynamics of drugs in children are different from those in adults and may influence the drug concentrations in blood and become risk factors for therapeutic failure and/o resistance to CQ. This study is a secondary analysis of the data from a clinical trial in which children over 5 years of age were administered 25 mg/kg of CQ, and CQ concentrations in blood were measured at day 7 of follow-up. Models of regression and comparison were used to evaluate and compare the CQ dose taken per kg/body weight, the CQ dose calculated based on body surface area, CQ levels in blood on day 7 and the age of the population. The younger the study population the greater the difference between the dose per kg/body weight (real dose) and that calculated according to the BSA (theoretical dose). The difference between the two doses was -181.206 mg in the 5-9 years of age group (CI 95 % -195.39; -167.02 mg) and -71.39 mg (CI 95 % -118.61; -23.99 mg) in the 10-14-year-old group. The CQ concentrations in blood on day 7 differed in patients over and under 15 years (p = 0.008). A negative correlation was found between the real and theoretical dose (difference in dose) and the age in years (R2 = 0.529, p = 0.001). A negative correlation was also found between the difference in dose (mg) and CQ concentrations on day 7 (ng/ml) (r = -0.337, p = 0.001). Children under 15 years were found to have a higher rate of therapeutic failure than those over 15 (28 vs 4.2 %, respectively) (Kaplan-Meier p = 0.005). A CQ dose of 25 mg/kg for the treatment of P. vivax malaria may be too low in children as demonstrated by the reduction in CQ concentrations in blood at day 7 of follow-up. This under-dosage is probably associated with the higher rate of therapeutic failure found in children under 15 years (28 vs 4.3 %). These results suggest the need to review the paediatric doses of CQ currently used.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 23 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 23 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 6 26%
Student > Bachelor 4 17%
Student > Master 3 13%
Student > Ph. D. Student 3 13%
Student > Postgraduate 2 9%
Other 2 9%
Unknown 3 13%
Readers by discipline Count As %
Medicine and Dentistry 6 26%
Pharmacology, Toxicology and Pharmaceutical Science 5 22%
Chemistry 2 9%
Biochemistry, Genetics and Molecular Biology 1 4%
Earth and Planetary Sciences 1 4%
Other 3 13%
Unknown 5 22%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. 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 25 July 2016.
All research outputs
#13,124,303
of 22,880,691 outputs
Outputs from Malaria Journal
#3,292
of 5,579 outputs
Outputs of similar age
#190,325
of 363,111 outputs
Outputs of similar age from Malaria Journal
#63
of 139 outputs
Altmetric has tracked 22,880,691 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 5,579 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.8. This one is in the 39th percentile – i.e., 39% 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 363,111 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 139 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 51% of its contemporaries.