Treatment of uncomplicated malaria with artesunate plus sulfadoxine–pyrimethamine is failing in Somalia: evidence from therapeutic efficacy studies and <i>Pfdhfr</i> and <i>Pfdhps</i> mutant alleles

Abstract

The high treatment failure rate observed in Jamame, together with the presence of molecular mutations associated with SP resistance, indicates P. falciparum resistance to SP. In Jowhar, high treatment failure rates were absent despite the presence of molecular mutations; signs of resistance in vivo may have been masked by the stronger immunity of the older study population. The study underscores the need to update Somalia's national malaria treatment policy.