In Uganda, artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DHA-PQ) showed excellent treatment efficacy for uncomplicated malaria in prior trials. Because resistance to artemisinins and piperaquine is increasing in southeast Asia and the prevalence of Plasmodium falciparum polymorphisms associated with resistance has changed, we reassessed treatment efficacies at three sites in Uganda.

In a randomised, single-blinded clinical trial, children aged 6–59 months with uncomplicated falciparum malaria were treated with AL or DHA-PQ and followed for 42 days. Primary end points were risks of recurrent parasitemia, either unadjusted or adjusted to distinguish recrudescence from new infection. We assessed selection by study regimens of relevant P. falciparum genetic polymorphisms associated with drug resistance. The study concluded that AL and DHA-PQ remain effective for the treatment of malaria in Uganda and that neither regimen selected for genetic polymorphisms associated with drug resistance.

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Country: Uganda