Longitudinal Outcomes in a Cohort of Ugandan Children Randomized to Artemether-lumefantrine Versus Dihydroartemisinin-piperaquine for the Treatment of Malaria. Artemisinin-based combination therapy (ACT) has become the standard of care for the treatment of uncomplicated Plasmodium falciparum malaria. Although several ACT regimens are approved, data guiding optimal choices of ACTs are limited. We compared short- and long-term outcomes in a cohort of young Ugandan children randomized to two leading ACTs. Overall, 312 children were randomized to artemether-lumefantrine or dihydroartemisinin-piperaquine at the time of the first episode of uncomplicated malaria (median age 10.5 months). The same treatment was given for all subsequent episodes of uncomplicated malaria and children were followed until they reached 5 years of age. The cohort included a subgroup that was HIV-infected (n=44) or HIV-exposed (n=175) prescribed trimethoprim-sulfamethoxazole prophylaxis. Outcomes included time to recurrent malaria following individual treatments and the overall incidences of treatments for malaria, complicated malaria, and hospitalizations.
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