Figure 4.

Simulated piperaquine (PQ) concentrations for dihydroartemisinin-piperaquine dosing with or without an initial loading dose for chemoprevention during pregnancy. A, Modeled PQ concentrations over weeks of pregnancy for 8 different dosing strategies. All simulations used 5000 virtual subjects, with chemoprevention initiation at 20 weeks, and continuing through 40 weeks of gestation. Regimens indicate PQ dosing in mg. For regimens with loading dose, daily regimens begin either 3 days (D3) or 4 weeks (W24) following loading dose, and weekly regimens begin either 1 week (W21) or 4 weeks (W24) following loading dose. The horizontal dotted line represents a target PQ concentration of 10.3 ng/mL. B, Percentage of women predicted to have >95% of duration of pregnancy above target concentration for each dosing regimen. C, Model-predicted probabilities of parasitemia during pregnancy with different dosing regimens. Abbreviations: LAMP, loop-mediated isothermal amplification; Q4W, every 4 weeks; QD, once daily; QW, once weekly.