Antifolate resistance markers and complexity of infection in children with sickle cell anaemia receiving malaria chemoprevention in Uganda: a molecular sub-study of the CHEMCHA randomised trial

Background Sickle cell anaemia (SCA) is a major public health problem in Uganda. Monthly sulfadoxine-pyrimethamine (SP) remains the standard malaria chemoprevention regimen despite widespread antifolate resistance in East Africa. We assessed Pfdhfr and Pfdhps resistance mutations and the complexity of infection (COI) among children with SCA receiving malaria chemoprevention. Methods This prospective study of antifolate resistance was nested within the CHEMCHA randomised controlled trial comparing monthly SP with weekly dihydroartemisinin-piperaquine (DP) for malaria chemoprevention. Participan

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