DHPS and malaria: [32] SP use is prevalent is Uganda: until recently, SP was recommended first-line therapy for malaria, and at the time of this study was still commonly used for treatment of suspected malaria. [33] Taken together, the previous literature linking SP and the P57S mutation, the high prevalence of the P57S mutation in our study, and the widespread use of SP in Uganda during this period, suggest that sulfadoxine may differentially select for the P57S mutation in the dhps gene of P. jirovecii.