Treatment History and Treatment Dose Are Important Determinants of Sulfadoxine‐Pyrimethamine Efficacy in Children with Uncomplicated Malaria in Western Kenya

Abstract
This study retrospectively studied amendable determinants of sulfadoxine-pyrimethamine (SP) efficacy involving 2869 treatments among 1072 Kenyan children <5 years old who had uncomplicated malaria. The dose was based on age: one-quarter tablet was given to infants <1 year old, one-half tablet was given to 1–3-year-old children, and a full tablet was given to 4-year-old children. Only 23.5% received the internationally recommended target dose of 25/1.25 mg of SP per kg of body weight. SP intake in the previous 15–35 days (adjusted relative risk, 1.67; 95% confidence interval, 1.35–2.07) and low SP dose (25% of children <5 years. Many age-based dose recommendations need urgent revision, because SP is increasingly used as first-line treatment in sub-Saharan Africa

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