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To determine whether dihydroartemisinin‐piperaquine (DHA‐PPQ) is non‐inferior to artesunate‐amodiaquine (ASAQ) for treating uncomplicated malaria infection in pregnancy.

A total of 417 second/ third trimester pregnant women with confirmed asymptomatic Plasmodium falciparum parasitaemia were randomised to receive DHA‐PPQ or ASAQ over 3 days. Women were followed up on days 1, 2, 3, 7, 14, 28 and 42 after treatment start and at delivery for parasitological, haematological, birth outcomes and at 6‐week post‐partum to ascertain the health status of the babies. Parasitological efficacy (PE) by days 28 and 42 were co‐primary outcomes. Analysis was per‐protocol (PP) and modified intention‐to‐treat (ITT). Non‐inferiority was declared if the two‐sided 95% confidence interval for PE at the endpoints excluded 5% lower efficacy for DHA‐PPQ. Secondary outcomes were assessed for …