Efficacy of artesunate + sulphadoxine/pyrimethamine and artemether + lumefantrine and <i>dhfr</i> and <i>dhps</i> mutations in Somalia: evidence for updating the malaria treatment policy

Abstract

The findings demonstrate a failing first-line treatment (AS + SP), with a failure rate above the threshold (10%) for policy change, and a high prevalence of quintuple mutations. In contrast, AL was highly efficacious. Based on these findings and the results from a previous AS + SP study, AL was selected to replace AS + SP as the first-line treatment for uncomplicated malaria in Somalia in 2016. Dihydroartemisinin + piperaquine (DHA + PPQ) has been recommended as the second-line treatment. Routine monitoring of recommended ACTs should continue to inform treatment policy.