Journal article

Malaria Parasite Clearance: What Are We Really Measuring?

David S Khoury, Sophie G Zaloumis, Matthew J Grigg, Ashraful Haque, Miles P Davenport

TRENDS IN PARASITOLOGY | ELSEVIER SCI LTD | Published : 2020

Abstract

Antimalarial drugs are vital for treating malaria and controlling transmission. Measuring drug efficacy in the field requires large clinical trials and thus we have identified proxy measures of drug efficacy such as the parasite clearance curve. This is often assumed to measure the rate of drug activity against parasites and is used to predict optimal treatment regimens required to completely clear a blood-stage infection. We discuss evidence that the clearance curve is not measuring the rate of drug killing. This has major implications for how we assess optimal treatment regimens, as well as how we prioritise new drugs in the drug development pipeline.

Grants

Awarded by Australian Research Council (ARC)


Awarded by National Health and Medical Research Council (NHMRC) of Australia


Awarded by Australian Centre for Research Excellence on Malaria Elimination - National Health and Medical Research Council of Australia


Funding Acknowledgements

The complete list of authors includes those named in the author list, as well as themembers of the Interdisciplinary Approaches to Malaria Consortium which includes Deborah Cromer, Maria Rebelo, Pengxing Cao, James M. McCaw, Julie A. Simpson, Jennifer A. Flegg, Danny W. Wilson, Nicholas M. Anstey, and James S. McCarthy. All authors contributed directly to the development of the ideas and writing of this publication. Spacing requirements precluded naming all authors explicitly in the author list, and so some authors have been named under the aforesaid study group, but this is not a reflection of lesser input from these contributors. Mathematical modelling was performed by D.S.K and S.G.Z. This work was funded by the Australian Research Council (ARC; Grant Nos DP120100064 and DP180103875 to M.P.D., D.C., A.H., and D.S. K.; DP170103076 to J.M.M. and J.A.S.; and DE170100785 to S.G.Z.), and the National Health and Medical Research Council (NHMRC) of Australia [Grant Nos 1082022 (to M.P.D. and D.C.), 1141921 (to D.S.K.), 1080001 (to M.P.D.), 1138860 (to M.J.G.), 1135820, 1132975 (to N.M.A.), 1100394 (to J.A.S. and J.M.M.), 1028643, 1028641, 1126399 (to A.H.), 1143974 (to D.W.W.), and 1104975 (to J.A.S.)]. This work was supported in part by the Australian Centre for Research Excellence on Malaria Elimination, funded by the National Health and Medical Research Council of Australia 1134989 (to N.M.A., J.S.M., J.A.S., and J.M.M.).