{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T14:15:53Z","timestamp":1780496153860,"version":"3.54.1"},"reference-count":60,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2016,2,26]],"date-time":"2016-02-26T00:00:00Z","timestamp":1456444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T00:00:00Z","timestamp":1456790400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"HHS | National Institutes of Health","award":["RO1 HD068174"],"award-info":[{"award-number":["RO1 HD068174"]}]},{"name":"University of California, San Francisco, Clinical and Translational Sciences Institute","award":["TL1 TR000144"],"award-info":[{"award-number":["TL1 TR000144"]}]},{"name":"Center for AIDS Research, University of California, San Francisco","award":["P30 AI022763"],"award-info":[{"award-number":["P30 AI022763"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Artemether-lumefantrine is a first-line regimen for the treatment of uncomplicated malaria during the second and third trimesters of pregnancy. Previous studies have reported changes in the pharmacokinetics and clinical outcomes following treatment with artemether-lumefantrine in pregnant women compared to nonpregnant adults; however, the results are inconclusive. We conducted a study in rural Uganda to compare the pharmacokinetics of artemether-lumefantrine and the treatment responses between 30 pregnant women and 30 nonpregnant adults with uncomplicated<jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Plasmodium falciparum<\/jats:named-content>malaria. All participants were uninfected with HIV, treated with a six-dose regimen of artemether-lumefantrine, and monitored clinically for 42 days. The pharmacokinetics of artemether, its metabolite dihydroartemisinin, and lumefantrine were evaluated for 21 days following treatment. We found no significant differences in the overall pharmacokinetics of artemether, dihydroartemisinin, or lumefantrine in a direct comparison of pregnant women to nonpregnant adults, except for a statistically significant but small difference in the terminal elimination half-lives of both dihydroartemisinin and lumefantrine. There were seven PCR-confirmed reinfections (5 pregnant and 2 nonpregnant participants). The observation of a shorter terminal half-life for lumefantrine may have contributed to a higher frequency of reinfection or a shorter posttreatment prophylactic period in pregnant women than in nonpregnant adults. While the comparable overall pharmacokinetic exposure is reassuring, studies are needed to further optimize antimalarial efficacy in pregnant women, particularly in high-transmission settings and because of emerging drug resistance. (This study is registered at ClinicalTrials.gov under registration no. NCT01717885.)<\/jats:p>","DOI":"10.1128\/aac.01605-15","type":"journal-article","created":{"date-parts":[[2015,12,15]],"date-time":"2015-12-15T04:43:50Z","timestamp":1450154630000},"page":"1274-1282","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":31,"title":["Artemether-Lumefantrine Pharmacokinetics and Clinical Response Are Minimally Altered in Pregnant Ugandan Women Treated for Uncomplicated Falciparum Malaria"],"prefix":"10.1128","volume":"60","author":[{"given":"Myaing M.","family":"Nyunt","sequence":"first","affiliation":[{"name":"Institute for Global Health, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vy K.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Kajubi","sequence":"additional","affiliation":[{"name":"Infectious Disease Research Collaboration, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liusheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Ssebuliba","sequence":"additional","affiliation":[{"name":"Infectious Disease Research Collaboration, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Kiconco","sequence":"additional","affiliation":[{"name":"Infectious Disease Research Collaboration, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses W.","family":"Mwima","sequence":"additional","affiliation":[{"name":"Infectious Disease Research Collaboration, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Achan","sequence":"additional","affiliation":[{"name":"Infectious Disease Research Collaboration, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Aweeka","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Parikh","sequence":"additional","affiliation":[{"name":"Yale School of Public Health, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norah","family":"Mwebaza","sequence":"additional","affiliation":[{"name":"Infectious Disease Research Collaboration, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","unstructured":"World Health Organization. 2014. World malaria report. World Health Organization Geneva Switzerland. http:\/\/www.who.int\/malaria\/publications\/world_malaria_report_2014\/wmr-2014-no-profiles.pdf?ua=1."},{"key":"e_1_3_2_3_2","first-page":"624","article-title":"Estimating mortality, morbidity and disability due to malaria among Africa's non-pregnant population","volume":"77","author":"Snow RW","year":"1999","unstructured":"Snow RW, Craig M, Deichmann U, Marsh K. 1999. Estimating mortality, morbidity and disability due to malaria among Africa's non-pregnant population. Bull World Health Organ 77:624\u2013640.","journal-title":"Bull World Health Organ"},{"key":"e_1_3_2_4_2","first-page":"1005","article-title":"An analysis of malaria in pregnancy in Africa","volume":"61","author":"Brabin BJ","year":"1983","unstructured":"Brabin BJ. 1983. An analysis of malaria in pregnancy in Africa. Bull World Health Organ 61:1005\u20131016.","journal-title":"Bull World Health Organ"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000221"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2001.64.36"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1989.41.161"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.272.5267.1502"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1996.55.61"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1996.55.33"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1086\/314752"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1086\/315449"},{"key":"e_1_3_2_13_2","unstructured":"World Health Organization. 2015. Guidelines for the treatment of malaria 3rd ed. World Health Organization Geneva Switzerland. http:\/\/www.who.int\/malaria\/publications\/atoz\/9789241549127\/en\/."},{"key":"e_1_3_2_14_2","first-page":"313","article-title":"Metabolism of beta-arteether to dihydroqinghaosu by human liver microsomes and recombinant cytochrome P450","volume":"26","author":"Grace JM","year":"1998","unstructured":"Grace JM, Aguilar AJ, Trotman KM, Peggins JO, Brewer TG. 1998. Metabolism of beta-arteether to dihydroqinghaosu by human liver microsomes and recombinant cytochrome P450. Drug Metab Dispos 26:313\u2013317.","journal-title":"Drug Metab Dispos"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03192305"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1993.48.377"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1993.49.301"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-706X(97)00141-1"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2006.01784.x"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199937020-00002"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1368-7646(98)80208-2"},{"key":"e_1_3_2_22_2","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/S0090-9556(24)15130-6","article-title":"Biliary metabolites of beta-artemether in rats: biotransformations of an antimalarial endoperoxide","volume":"28","author":"Maggs JL","year":"2000","unstructured":"Maggs JL, Bishop LP, Edwards G, O'Neill PM, Ward SA, Winstanley PA, Park BK. 2000. Biliary metabolites of beta-artemether in rats: biotransformations of an antimalarial endoperoxide. Drug Metab Dispos 28:209\u2013217.","journal-title":"Drug Metab Dispos"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.30.9.1005"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.3109\/00498259109044406"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjp.0702023"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200544100-00001"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-006-0118-y"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-006-0199-7"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pt.2007.11.008"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-8-253"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.2165\/11594550-000000000-00000"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2014.00009"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-11-293"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00195-09"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02595-14"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00683-13"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70202-4"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1038\/psp.2013.59"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.44.3.697-704.2000"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1086\/503423"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2125.1998.00830.x"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2011.03.004"},{"key":"e_1_3_2_43_2","volume-title":"Vitamin and Mineral Nutrition Information System","author":"World Health Organization","year":"2011","unstructured":"World Health Organization. 2011. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. World Health Organization, Geneva, Switzerland. http:\/\/www.who.int\/vmnis\/indicators\/haemoglobin.pdf."},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-9203(98)90917-8"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2006.75.836"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.4155\/bio.11.303"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.4155\/bio.13.91"},{"key":"e_1_3_2_48_2","volume-title":"National Institute of Allergy and Infectious Diseases","author":"National Institute of Allergy and Infectious Diseases","year":"2004","unstructured":"National Institute of Allergy and Infectious Diseases. 2004. Division of AIDS table for grading the severity of adult and pediatric adverse events. National Institute of Allergy and Infectious Diseases, National Institutes of Health. Bethesda, Maryland. http:\/\/www.niaid.nih.gov\/labsandresources\/resources\/daidsclinrsrch\/documents\/daidsaegradingtable.pdf."},{"key":"e_1_3_2_49_2","unstructured":"World Health Organization. 2009. Methods for surveillance of antimalarial drug efficacy. World Health Organization Geneva Switzerland. http:\/\/www.who.int\/malaria\/publications\/atoz\/9789241597531\/en\/."},{"key":"e_1_3_2_50_2","unstructured":"World Health Organization. 2006. Global database on body mass index: an interactive surveillance tool for monitoring nutrition transition. World Health Organization Geneva Switzerland. http:\/\/apps.who.int\/bmi\/."},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pt.2008.01.006"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200501"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00267-15"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)70024-1"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.77.6.suppl.14"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.14-0312"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2006.75.219"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000247114.43714.90"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12660"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2011.04103.x"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01312-10"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.01605-15","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.01605-15","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T19:56:49Z","timestamp":1748721409000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/AAC.01605-15"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3]]},"references-count":60,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2016,3]]}},"alternative-id":["10.1128\/AAC.01605-15"],"URL":"https:\/\/doi.org\/10.1128\/aac.01605-15","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,3]]},"assertion":[{"value":"2015-07-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-11-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-02-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}