thelancet.com
Weekly dihydroartemisinin–piperaquine versus monthly sulfadoxine–pyrimethamine for malaria chemoprevention in children with sickle cell anaemia in Uganda and Malawi (CHEMCHA): a randomised, double-blind, placebo-controlled trial
Malaria chemoprophylaxis with weekly dihydroartemisinin–piperaquine in children with sickle cell anaemia is safe and considerably more efficacious than monthly sulfadoxine–pyrimethamine. However, monthly sulfadoxine–pyrimethamine was associated with fewer episodes of non-malaria-related illnesses, especially in children 5 years or older not receiving penicillin prophylaxis, which might reflect its antimicrobial effects. In areas with high P falciparum antifolate resistance, dihydroartemisinin–piperaquine should be considered as an alternative to sulfadoxine–pyrimethamine for malaria chemoprevention in children younger than 5 years with sickle cell anaemia receiving penicillin-V prophylaxis.