We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Oil-Fortified Maize Porridge Increases Absorption of Lumefantrine in Children with Uncomplicated Falciparum Malaria.
- Authors
Mwebaza, Norah; Jerling, Markus; Gustafsson, Lars L.; Silva, Antero V.; Pohanka, Anton; Obua, Celestino; Waako, Paul; Beck, Olof; Homann, Manijeh Vafa; Färnert, Anna; Hellgren, Urban
- Abstract
Artemether-lumefantrine (AL) is a first-line treatment for uncomplicated malaria. Absorption of lumefantrine (LUM) is fat dependent, and in children, intake is recommended with milk. We investigated whether oil-fortified maize porridge can be an alternative when milk is not available. In an open-label pharmacokinetic study, Ugandan children <5 years with uncomplicated Plasmodium falciparum malaria were randomized to receive standard six-dose AL treatment [one tablet (20 mgA/120 mg LUM) if <15 kg and two tablets if >15 kg] with milk (A) or maize porridge plus oil (B). Parametric two-sample t-test was used to compare relative oral LUM bioavailability. The primary end-point was LUM exposure till 8 hr after the first dose (AUC0-8 hr). Secondary outcome included day 7 concentrations (d7LUM), LUM exposure between days 7 and 28 (AUCd7-28) and day 28 PCR-adjusted parasitological response. Evaluable children (n = 33) included 16 in arm A and 17 in arm B. The AUC0-8 hr was comparable between A and B [geometric mean (95% CI): 6.01 (3.26-11.1) versus 6.26 (4.5-8.43) hr*μg/mL, p = 0.9]. Less interindividual variability in AUC0-8 hr was observed in B ( p = 0.01), but d7LUM and AUCd7-28 were comparable. Children receiving two tablets had significantly higher exposure than those receiving one tablet [median d7LUM (505 versus 289 ng/mL, p = 0.02) and AUCd7-28 (108 versus 41 hr*μg/mL, p = 0.006)]. One parasitological failure (d28 recrudescence) was observed. Our findings suggest that oil-fortified maize porridge can be an alternative to milk in augmenting absorption of LUM. The lower LUM exposure observed in children dosed with one AL tablet needs further attention.
- Subjects
UGANDA; ENRICHED foods; PORRIDGE; MALARIA treatment; PLASMODIUM falciparum; CHILDREN; PHARMACOKINETICS; T-test (Statistics)
- Publication
Basic & Clinical Pharmacology & Toxicology, 2017, Vol 120, Issue 5, p457
- ISSN
1742-7835
- Publication type
Article
- DOI
10.1111/bcpt.12714