Pharmacological properties of triple antimalarial drug combinations in malnourished children

Malaria remains a key driver of high mortality in sub-Saharan Africa, particularly in Niger. Malnourished children are particularly vulnerable to malaria, and more likely to die from it. Malaria drug resistance to several commonly used drugs has emerged and spread. As a new approach to treat multi-drug resistant malaria, we have proposed to increase the number of drugs to 3 in malaria treatments (i.e. triple-artemisinin combination therapies, TACTs). Epicentre Niger is one site in a multicentre RCT evaluating TACTs, and is uniquely placed given the high rate of malnutrition. We will use Wellcome funding to evaluate the pharmacokinetic properties of TACTs in this critical population of malnourished children, with the aim of understanding the complex relationship between malnutrition and drug efficacy. This funding will specifically target aid for a vulnerable and neglected population, while providing evidence to reduce the impact of two of the most devastating crises in the region.