Malaria with other antimalarials (known as artemisinin-combination therapy, or ACT), which decreases resistance to any single drug component. These additional antimalarials include: amodiaquine, lumefantrine, mefloquine or sulfadoxine/pyrimethamine. Another recommended combination is dihydroartemisinin and piperaquine. ACT is about 90% effective when used to treat uncomplicated malaria. To treat malaria during pregnancy, the WHO recommends the use of quinine plus clindamycin early in the pregnancy (1st trimester), and ACT in later stages (2nd and 3rd trimesters). In the 2000s (decade), malaria with partial resistance to artemisins emerged in Southeast Asia. Infection with "P. vivax", "P. ovale" or "P. malariae" usually do not require
Sex effects of water pollution longer present much of a threat. This is also true for small amounts of chemicals present in the water. However, when there are very large amounts of chemicals, organic or inorganic, present in the water as it cycles through the atmosphere, harmful effects can be seen in areas where this water falls as precipitation. This precipitation re-enters the ongoing circulation of water pollution. Another path in which the water can circulate is by flowing directly to the ocean. Pollutants are prevalent in coastal and open-ocean waters as contaminated water flows from point sources to the sea. These pollutants are then