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New approaches are needed for malaria control where the burden has remained high despite scaled up coverage of long-lasting insecticide-treated nets (LLIN) and prompt access to artemisinin-based combination therapies (ACTs).1 Bigira and colleagues evaluated three regimens for chemoprevention of malaria in young children in eastern Uganda, in an area of very high year-round malaria transmission and high resistance to antifolate drugs, including sulfadoxine-pyrimethamine (SP) and sulfamethoxazole.
Children between 6 and 24 months of age were randomised to receive daily trimethoprim-sulfamethoxazole (TS), monthly SP, monthly dihydroartemisinin-piperaquine (DP) or no intervention. All study participants were given LLINs. Follow-up continued to 36 months of age. The primary outcome was incidence of uncomplicated malaria, treated with artemether-lumefantrine (AL).
Between 6 and 24 months of age, …