High levels of poverty afflicting many Kenyan families have become a hotspot for malaria, common among malnourished children with the most affected being children below the age of five and the ACT malaria drug know as artemether-lumefantrine (coartem) among children has been performing terribly in severely malnourished children
A new study published in the Clinical Pharmacology and Therapeutics Journal has found that severe malnutrition is associated with lower exposure to this drug which is the most common treatment for uncomplicated malaria caused by parasites known as Plasmodium Falciparum that is predominant in Kenya.
The researchers say that altered physiology in malnourished children may change the uptake and distribution of antimalarial drugs into the body. But there has been not enough research because malnourished children and other vulnerable patients such as pregnant women and very young children are often excluded from malaria drugs clinical studies because it is a challenge to recruit the large numbers.
The institutions conducting the study compared the effect of the Artemether Lumefantrine drug in the treatment of malaria in two hospitals in Mali and Niger among 131 children with severe malnutrition compared to 226 children without malnutrition.
Results of the study indicated that severely malnourished children had an average of 19 per cent less exposure to the anti-malaria drug compared to other children which resulted to an increased risk of drug failure hence contacting new malaria infections during the follow-up period.
In general, all children were found to have significantly lower drug exposure compared to adults, yet they have currently prescribed the same dosing regimen as adults — having the artemether-lumefantrine drug twice daily for three days.
“Malnourished children are more severely affected by malaria and they have lower levels of antimalarial drug in their bodies after standard treatment. This needs further study so that we can treat these patients better. Those suffering from both severe acute malnutrition and malaria need care the most,” said Dr Rebecca Grais, a Research Director in one of the institutions insisting the improving treatment protocols among this vulnerable group of children.