Poor adherence to seasonal malaria chemoprevention (SMC) might affect the protective effectiveness of SMC. Here, we evaluated the population pharmacokinetic properties of amodiaquine and its active metabolite, desethylamodiaquine, in children receiving SMC under directly observed ideal conditions (n = 136), and the adherence of SMC at an implementation phase in children participating in a case-control study to evaluate SMC effectiveness (n = 869). Amodiaquine and desethylamodiaquine concentration-time profiles were described simultaneously by two-compartment and three-compartment disposition models, respectively. The developed methodology to evaluate adherence showed a sensitivity of 65-71% when the first dose of SMC was directly observed and 71-73% when no doses were observed in a routine programmatic setting. Adherence simulations and measured desethylamodiaquine concentrations in the case-control children showed complete adherence (all doses taken) in < 20% of children. This result suggests that more efforts are needed urgently to improve the adherence to SMC among children in this area.

中文翻译：

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当用于非洲儿童的季节性疟疾化学预防时，阿莫地喹的粘附性和种群药代动力学特性。

对季节性疟疾化学预防（SMC）的依从性差可能会影响SMC的保护效果。在这里，我们评估了在直接观察到的理想条件下（n = 136）接受SMC的儿童中阿莫地喹及其活性代谢物desethylamodiaquine的群体药代动力学特性，以及参与病例对照研究的儿童在实施阶段对SMC的依从性评估SMC的有效性（n = 869）。二室和三室处置模型分别同时描述了氨二喹和去乙基重氮的浓度-时间曲线。在常规程序设置中，当直接观察到SMC的第一剂时，开发的评估依从性的方法显示出敏感性为65-71％，而当未观察到任何剂量时，敏感性为71-73％。病例对照儿童的依从性模拟和测得的去甲乙二酰胺浓度表明，<20％的儿童完全依从（所有剂量）。该结果表明，该地区儿童迫切需要做出更多努力，以提高他们对SMC的依从性。