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Developing regional weight-for-age growth references for malaria-endemic countries to optimize age-based dosing of

Daniel J Hayes1, Stef van Buuren2, Feiko O ter Kuile1

  • 1Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, England .

Bulletin of the World Health Organization
|April 18, 2015
PubMed

Insights

Regional weight-for-age growth differences were found across malaria-endemic areas. These new references can optimize antimalarial drug dosing for children and adults.

Area of Science:

  • Global Health
  • Anthropometry
  • Pharmacology

Background:

  • Accurate dosing of antimalarials is crucial for treatment efficacy.
  • Existing growth standards may not reflect regional variations in malaria-endemic populations.
  • Age-based dosing requires reliable weight-for-age data.

Purpose of the Study:

  • To develop regional weight-for-age growth references.
  • To optimize age-based dosing of antimalarials in Africa, the Americas, South-East Asia, and the Western Pacific.

Main Methods:

  • Compiled a weight-for-age database from 1,263,119 individuals (1995-2012) in 64 malaria-endemic countries.
  • Utilized a generalized additive model for location, scale, and shape (GAMLSS) to generate regional growth references.
  • Weighted countries by population at risk of malaria for dosing optimization.

Main Results:

  • Significant differences in weight-for-age distributions were observed between regions and global standards.
  • For example, adult males in the Americas weighed 6.0 kg more than those in South-East Asia/Western Pacific.
  • Adult females in the Americas weighed 10.4 kg more than those in South-East Asia/Western Pacific.

Conclusions:

  • Substantial variations in weight-for-age growth curves exist in malaria-endemic regions.
  • Derived growth references can guide evidence-based optimization of antimalarial dosing.
  • These references are applicable to other age-prescribed medications.
Abstract

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