Although SP remains cost-effective and effective for IPTp, there are two main challenges with the use of SP: i) widespread use of SP can lead to an increase in the prevalence of drug resistance molecular markers, including those encoding forPlasmodium falciparum dihydrofolate reductase (dhfr) and Pf dihydropteroate synthase (dhps) and ii) SP, used either for curative or preventive treatment, is associated with microscopic and sub microscopic gametocytaemia, both of which contribute to sustained malaria transmission. Here, DHFR is linked to malaria.