Comparing Sulfadoxine-Pyrimethamine+Chloroquine and Dihydroartemisinin-Piperaquine to Control for Malaria Prevention in Malawian School Children: Results from a Randomized Controlled Trial

The trial enrolled 646 primary school children in Malawi to assess the efficacy of two IPTsc regimens. Dihydroartemisinin-piperaquine (DP) is highly efficacious but raises concerns about accelerating artemisinin resistance if used widely for prevention. Sulfadoxine-pyrimethamine plus chloroquine (SP+CQ) is a non-artemisinin combination that could serve as a safer alternative for mass drug administration. Results from this study will help guide malaria control policy for school-age children, who are a major transmission reservoir. The findings are particularly relevant for sub-Saharan African settings where seasonal malaria chemoprevention is expanding.