Drugs and treatments#

The following parameters determine the efficacy of drugs and other treatments.

For more information on the drugs used to treat malaria, see Antimalarial drugs.

Note

Parameters are case-sensitive. For Boolean parameters, set to 1 for true or 0 for false. Minimum, maximum, or default values of “NA” indicate that those values are not applicable for that parameter.

EMOD does not use true defaults; that is, if the dependency relationships indicate that a parameter is required, you must supply a value for it. However, many of the tools used to work with EMOD will use the default values provided below.

JSON format does not permit comments, but you can add “dummy” parameters to add contextual information to your files. Any keys that are not EMOD parameter names will be ignored by the model.

Parameter

Data type

Minimum

Maximum

Default

Description

Example

Bodyweight_Exponent

float

0

100000

0

The effect of bodyweight on maximum drug concentration in an individual patient. Drug_Cmax is divided by patient bodyweight raised to the power of Bodyweight_Exponent to account for the influence of body size on volume of distribution.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether",
            "Bodyweight_Exponent": 2
        }
    ]
}

Drug_Cmax

float

0

100000

1000

The maximum drug concentration used.

Note

This parameter and the Drug_PKPD_C50 parameter must use the same units.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether",
            "Drug_Cmax": 1000,
            "Drug_PKPD_C50": 100
        }
    ]
}

Drug_Decay_T1

float

0

100000

1

The primary drug decay rate, in days.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether",
            "Drug_Decay_T1": 1,
            "Drug_Decay_T2": 1
        }
    ]
}

Drug_Decay_T2

float

0

100000

1

The secondary drug decay rate, in days.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether",
            "Drug_Decay_T1": 1,
            "Drug_Decay_T2": 1
        }
    ]
}

Drug_Dose_Interval

float

0

100000

1

The interval between doses of drugs, in days.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether",
            "Drug_Dose_Interval": 1
        }
    ]
}

Drug_Fulltreatment_Doses

float

1

100000

3

The number of doses for a full treatment of a drug.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether",
            "Drug_Fulltreatment_Doses": 3
        }
    ]
}

Drug_Gametocyte02_Killrate

float

0

100000

0

The log reduction per day in early-stage gametocytes.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Chloroquine",
            "Drug_Gametocyte02_Killrate": 0,
            "Drug_Gametocyte34_Killrate": 0,
            "Drug_GametocyteM_Killrate": 0
        }
    ]
}

Drug_Gametocyte34_Killrate

float

0

100000

0

The log reduction per day in late-stage gametocytes.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Chloroquine",
            "Drug_Gametocyte02_Killrate": 0,
            "Drug_Gametocyte34_Killrate": 0,
            "Drug_GametocyteM_Killrate": 0
        }
    ]
}

Drug_GametocyteM_Killrate

float

0

100000

0

The log reduction per day in mature gametocyte numbers at saturated drug concentrations.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Chloroquine",
            "Drug_Gametocyte02_Killrate": 0,
            "Drug_Gametocyte34_Killrate": 0,
            "Drug_GametocyteM_Killrate": 0
        }
    ]
}

Drug_Hepatocyte_Killrate

float

0

100000

0

The log reduction in hepatocyte numbers per day.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Chloroquine",
            "Drug_Hepatocyte_Killrate": 0
        }
    ]
}

Drug_PKPD_C50

float

0

100000

100

The concentration at which drug killing rates are half of the maximum.

Note

This parameter and the Drug_Cmax parameter must use the same units.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether_Lumefantrine",
            "Drug_Cmax": 1000,
            "Drug_PKPD_C50": 100
        }
    ]
}

Drug_Vd

float

0

100000

10

The volume of drug distribution in a pharmacokinetic two compartment model. The first compartment comprises central organs and tissues and the second compartment comprises peripheral tissues. This value is the ratio of the volume of the second compartment to that of the first.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether_Lumefantrine",
            "Drug_Vd": 3
        }
    ]
}

Fractional_Dose_By_Upper_Age

array of json objects

NA

NA

NA

An array to specify the fraction of the adult dose to use for children at various ages. Contains Upper_Age_In_Years and Fraction_Of_Adult_Dose values.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether_Lumefantrine",
            "Fractional_Dose_By_Upper_Age": [
                {
                    "Fraction_Of_Adult_Dose": 0.25,
                    "Upper_Age_In_Years": 3
                },
                {
                    "Fraction_Of_Adult_Dose": 0.5,
                    "Upper_Age_In_Years": 6
                },
                {
                    "Fraction_Of_Adult_Dose": 0.75,
                    "Upper_Age_In_Years": 10
                }
            ]
        }
    ]
}

Fraction_Of_Adult_Dose

float

0

1

NA

The fraction of the adult drug dose given to children below the age defined in Upper_Age_In_Years. Set in the Fractional_Dose_By_Upper_Age array.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether_Lumefantrine",
            "Fractional_Dose_By_Upper_Age": [
                {
                    "Fraction_Of_Adult_Dose": 0.25,
                    "Upper_Age_In_Years": 3
                },
                {
                    "Fraction_Of_Adult_Dose": 0.5,
                    "Upper_Age_In_Years": 6
                },
                {
                    "Fraction_Of_Adult_Dose": 0.75,
                    "Upper_Age_In_Years": 10
                }
            ]
        }
    ]
}

Malaria_Drug_Params

array of json objects

NA

NA

NA

This is an array of JSON objects where each object in the array contains the parameters for an anti-malarial drug.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether_Lumefantrine",
            "PKPD_Model": "FIXED_DURATION_CONSTANT_EFFECT",
            "Bodyweight_Exponent": 0,
            "Drug_Cmax": 1000,
            "Drug_Decay_T1": 1,
            "Drug_Decay_T2": 1,
            "Drug_Dose_Interval": 1,
            "Drug_Fulltreatment_Doses": 3,
            "Drug_Gametocyte02_Killrate": 2.3,
            "Drug_Gametocyte34_Killrate": 2.3,
            "Drug_GametocyteM_Killrate": 0,
            "Drug_Hepatocyte_Killrate": 0,
            "Drug_PKPD_C50": 100,
            "Drug_Vd": 10,
            "Max_Drug_IRBC_Kill": 4.6
        },
        {
            "Name": "Artemisinin",
            "PKPD_Model": "FIXED_DURATION_CONSTANT_EFFECT",
            "Bodyweight_Exponent": 0,
            "Drug_Cmax": 1000,
            "Drug_Decay_T1": 1,
            "Drug_Decay_T2": 1,
            "Drug_Dose_Interval": 1,
            "Drug_Fulltreatment_Doses": 3,
            "Drug_Gametocyte02_Killrate": 2.3,
            "Drug_Gametocyte34_Killrate": 2.3,
            "Drug_GametocyteM_Killrate": 0,
            "Drug_Hepatocyte_Killrate": 0,
            "Drug_PKPD_C50": 100,
            "Drug_Vd": 10,
            "Max_Drug_IRBC_Kill": 4.61
        }
    ]
}

Max_Drug_IRBC_Kill

float

5

100000

5

The maximum log reduction in IRBCs per day due to treatment.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether_Lumefantrine",
            "Max_Drug_IRBC_Kill": 4.6
        }
    ]
}

PKPD_Model

enum

NA

NA

FIXED_DURATION_CONSTANT_EFFECT

Determines which pharmacokinetic pharmacodynamic model to use. Possible values are:

FIXED_DURATION_CONSTANT_EFFECT

This is the simplified model of drug action. Each dose of the drug has a constant effect for a fixed duration of time, after which the effect is zero.

CONCENTRATION_VERSUS_TIME

This model of drug action uses continuous pharmacokinetics with two-compartment decay. Effects of each drug depend on the concentration at that point in time.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether_Lumefantrine",
            "PKPD_Model": "FIXED_DURATION_CONSTANT_EFFECT"
        }
    ]
}

Upper_Age_In_Years

float

0

125

NA

The age, in years, below which children are given a fraction of the adult drug dose, as defined in Fraction_Of_Adult_Dose. Note that this parameter can be specified for each drug included in the configuration file, and different fractional doses may be used for different age groups.

 
{
    "Malaria_Drug_Params": [
        {
            "Name": "Artemether_Lumefantrine",
            "Fractional_Dose_By_Upper_Age": [
                {
                    "Fraction_Of_Adult_Dose": 0.25,
                    "Upper_Age_In_Years": 3
                },
                {
                    "Fraction_Of_Adult_Dose": 0.5,
                    "Upper_Age_In_Years": 6
                },
                {
                    "Fraction_Of_Adult_Dose": 0.75,
                    "Upper_Age_In_Years": 10
                }
            ]
        }
    ]
}