A trial of combination antimalarial therapies in children from Papua New Guinea.

Background Malaria control is difficult where there is intense year-round transmission of multiple plasmodium species, such as in Papua New Guinea. Methods Between April 2005 and July 2007, we conducted an open-label, randomized, parallel-group study of conventional chloroquine–sulfadoxine–pyrimethamine and artesunate–sulfadoxine–pyrimethamine, dihydroartemisinin–piperaquine, and artemether–lumefantrine in children in Papua New Guinea 0.5 to 5 years of age who had falciparum or vivax malaria. The primary end point was the rate of adequate clinical and parasitologic response at day 42 after the start of treatment with regard to Plasmodium falciparum, after correction for reinfections identified through polymerase-chain-reaction (PCR) genotyping of polymorphic loci in parasite DNA. Secondary end points included the rate of adequate clinical and parasitologic response at day 42 with regard to P. vivax without correction through PCR genotyping. Results Of 2802 febrile children screened, 482 with falciparum ma...