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An individual patient data meta-analysis of 2,017 patients from 19 studies has found a high risk of recurrence following treatment of P. vivax malaria with artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) unless they are co-administered with primaquine. The research supports recommendations that these artemisinin-based combination therapies (ACT) should be combined with primaquine.