Study procedures
malaria, fever
MALARIA
HIV‐unexposed children began chemoprevention at 6 months of age and, because HIV‐exposed participants received daily trimethoprim‐sulfamethoxazole (TS) while breastfeeding per national guidelines, they began chemoprevention at 6 months of age or upon breastfeeding cessation, whichever was later. All participants received chemoprevention until 24 months of age and were followed off chemoprevention until 36 months of age. Children were randomized in equal numbers to no chemoprevention, a once monthly dose of sulfadoxine‐pyrimethamine (SP), a daily dose of TS, or a monthly treatment course (daily dosing for 3 consecutive days) of dihydroartemisinin‐piperaquine (DP). Each regimen was administered according to weight‐bands specified by the manufacturer at the time of the study (Table Children received all medical care at a dedicated study clinic to ensure accurate diagnosis of incident malaria. Children returned monthly for weight and height measurements and the parent/guardian was asked if the child had breast fed in the last 7 days. At any visit, if a child had a fever (>37.5°C) or a history of fever within the last 24 h, a thick blood smear was taken to evaluate for malaria. If the blood smear was positive, the child was diagnosed with and treated for malaria. The time of incident malaria was defined as the day of a visit where malaria was diagnosed which occurred greater than 14 days after a prior episode.Monthly age, weight, and height measurements were used to calculate weight‐for‐age z‐score (WAZ), ZHA, and weight‐for‐height z‐score (WHZ). Z‐scores were calculated using the World Health Organization's (WHO) Anthro macro.