Aweeka co-leads new study of drugs to prevent malaria in young children, pregnant women

Francesca Aweeka, PharmD, a faculty member in the School’s Department of Clinical Pharmacy, will co-lead a new five-year, $3.4 million study funded by the National Institutes of Health (NIH) to address one of the world’s most vexing health problems—preventing malaria, especially in the most vulnerable populations, pregnant women and young children in Africa.

A mosquito-transmitted parasitic illness, malaria sickens about 200 million people annually, according to the World Health Organization. While the disease can be effectively treated in most adults with combinations of fast-acting and longer-lasting drugs, it kills nearly 600,000 people each year. Most of those deaths occur among African children.

The study focuses on chemoprevention therapy, in which full courses of treatment are given at regular intervals (e.g., monthly) to high-risk groups. Chemoprevention is seen as a key tool to control and eventually eliminate malaria, since if the blood-borne single-celled parasites (plasmodia) can be killed in their human hosts, they will not be subsequently spread via mosquito bites.

In Africa, the effectiveness of older regimens for preventing malaria has been severely compromised by the emergence of drug-resistant malarial parasites. This has prompted the recent introduction of new regimens—specifically the combination of dihydroartemisinin (DHA), which rapidly kills most of the parasites, and piperaquine (PQ), which provides on-going treatment effects for weeks after dosing.

But while intermittent DHA/PQ therapy is expected to provide effective prevention, the new study, co-led by Philip Rosenthal, MD, of the UCSF School of Medicine, will address key questions about its use in pregnant women and young children:

  • As compared to the non-pregnant adults in whom such drug therapies are typically tested, how do the bodies of young children (from newborn to two years of age) and pregnant women absorb, distribute, metabolize, and excrete the drugs? Such analysis, known as pharmacokinetics, is crucial to determining safe and effective doses. Indeed, available evidence suggests that young children do not get adequate doses of DHA/PQ, while evidence-based guidelines for pregnant women do not exist.
  • The study will also address which dosing regimens (dosage size and schedule) and resulting blood concentrations of the combined drugs will maximize their preventive effects against malaria in those target populations as well as prevent the development of new types of drug-resistant parasites.

The study will leverage the research infrastructure developed in Uganda in recent years in a collaboration with Makerere University and researcher Moses Kamya, MMed, PhD, MPH, by UCSF School of Medicine’s Grant Dorsey, MD, and Diane Havlir, MD, as well as Rosenthal and Aweeka. Studies there have sought to determine the safe and effective dosing of drugs to concurrently treat malaria and HIV in pregnant women and young children in a region with high rates of both infections.

About the School: The UCSF School of Pharmacy aims to solve the most pressing health care problems and strives to ensure that each patient receives the safest, most effective treatments. Our discoveries seed the development of novel therapies, and our researchers consistently lead the nation in NIH funding. The School’s doctor of pharmacy (PharmD) degree program, with its unique emphasis on scientific thinking, prepares students to be critical thinkers and leaders in their field.