Protective efficacy was 69 % [ 95 % confidence interval ( 95 % CI ) 53-80 , P < 0.001 ] for dihydroartemisinin-piperaquine , 49 % ( 95 % CI 23-66 , P = 0.001 ) for trimethoprim-sulfamethoxazole and 9 % for sulfadoxine-pyrimethamine ( 95 % CI -35 to 38 , P = 0.65 ) .