Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Severe acute malnutrition (SAM) has been reported to be associated with increased malaria morbidity in Sub-Saharan African children and may affect the pharmacology of antimalarial drugs. This population pharmacokinetic-pharmacodynamic study included 131 SAM and 266 non-SAM children administered artemether-lumefantrine twice daily for 3 days. Lumefantrine capillary plasma concentrations were adequately described by two transit-absorption compartments followed by two distribution compartments. Allometrically scaled body weight and an enzymatic maturation effect were included in the pharmacokinetic model. Mid-upper arm circumference (MUAC) was associated with decreased absorption of lumefantrine (25.4% decrease per 1 cm reduction). Risk of recurrent malaria episodes (i.e. reinfection) were characterised by an interval-censored time-to-event model with a sigmoid EMAX -model describing the effect of lumefantrine. SAM children were at risk of under-exposure to lumefantrine and an increased risk of malaria reinfection compared to well-nourished children. Research on optimised regimens should be considered for malaria treatment in malnourished children. This article is protected by copyright. All rights reserved.

Original publication




Journal article


Clin Pharmacol Ther

Publication Date



Lumefantrine, malaria, malnutrition, non-linear mixed effects modelling, population pharmacokinetic-pharmacodynamic model, severe acute malnutrition children