Combination therapy based on artemisinins, which forms the basis of a newer class of antimalarial drugs, has been advocated recently to improve efficacy and limit the spread of resistance. But these drugs may not be the ideal treatment for uncomplicated malaria, especially in highly endemic areas in Africa.

In the regions of Africa that have the highest transmission rates, cheaper combinations of older medicines, principally amodiaquine and sulfadoxine pyrimethamine, worked better. Patients on these drugs have at least as good a chance of preventing recurrent malarial infection (defined as either new infections or the previous infection returning) compared with patients treated with the newer, more expensive artemisinin …