Malaria patients are receiving the wrong doses of drugs, and this project aims to fix that by systematically recalculating how much medicine they actually need. Current antimalarial treatments often fail because doses are not tailored to how individual patients absorb and process the drugs. This leads to unnecessary deaths, prolonged illness, and the spread of drug-resistant parasites. The research addresses a fundamental gap: we lack field-ready methods to measure drug levels in patients, track whether they take their medication, and link drug exposure to treatment outcomes. If successful, this work will produce optimised dose regimens for both falciparum and vivax malaria, safer use of primaquine to prevent relapses, and a pre-referral rectal antimalarial-antibiotic formulation for severe cases in remote communities. It will also create a web-based repository of pre-1970 malaria literature and a global network for low-cost antimicrobial drug assays. These changes could reduce malaria deaths, slow the emergence of resistance, and improve treatment for severely ill children in malaria-endemic areas. The project also extends to severe influenza chemotherapy, broadening its impact on infectious disease management.
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Antimalarial treatment is often inadequate. Malaria morbidity and mortality can be reduced and antimalarial drug resistance prevented by optimising the doses of currently available drugs. I propose to: 1. Develop field adapted methodologies for conducting antimalarial population pharmacokinetic studies, assessments of adherence, and better methods of antimalarial pharmacodynamic assessment. 2. Study pharmacokinetic-pharmacodynamic relationships for currently available and in-development antim alarials to optimise dosing. 3. Evaluate the efficacy and effectiveness of optimum dose regimens for falciparum malaria. 4. Optimise and assess the safety of radical treatment of vivax malaria and gametocytocidal treatment of falciparum malaria with primaquine. 5. Develop improved antimalarial strategies for malaria elimination. 6. Develop pre-referral rectal antimalarial-antibiotic formulations for treating severe malaria and bacterial infections in the community. 7. Evaluate immediate a ntibiotic treatment for severely ill hospitalised children in malaria endemic areas. 8. Provide a web-based open access repository of all scientific publications on malaria conducted before 1970, and support web-based open-access provision of information on antimalarial drug resistance. 9. Improve the chemotherapy of severe influenza 10. Develop a network of antimicrobial pharmacology providing high throughput, low cost, field adapted assays of antiretroviral, antituberculosis, and antimalar ial drugs to support clinical trials and resistance monitoring.
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