Reviewer 1's Review

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1. The authors have observed a 9% difference in parasite clearance at 24 hours post-treatment between mefloquine+artesunate (MAS3) and Artekin. However, there was no difference in parasite clearance at 48 hours, in fever clearance time and in early treatment failures. Although the observed difference in parasite clearance at 24 hours is statistically significant this is not really clinically significant - significance of this observation is a bit over-emphasised.

2. The rate of gametocyte clearance seems to be faster with MAS3. In addition to comparing the prevalence of gametocytes at day 7 and 14, the rate of clearance by day 7 and 14 needs to compared. Given that emergence of new gametocytes were higher with Artekin the authors have to acknowledge that even though the parasite clearance at 24 hours is faster with Artekin over all the gametocyte production seems to be higher with Artekin than MAS3. The RR of emergence of new gametocytes given in the abstract looks incorrect [3.6% vs 0.9%; RR 1.04, 95% CI 0.22 - 4.85]

3. Although the authors acknowledge that the higher incidence of adverse effects associate with MAS3 could be exaggerated because of the potential limitations of an open label study. However, they suggest that since insomnia was higher in children who were treated with MAS3 than with Artekin these differences are "real". One could equally argue that there was no difference in all other solicited adverse events between the two drugs in children and that insomnia in children is often observed/reported by the caretakers and therefore one cannot rule out the effect of respondent bias completely in the observed differences in adverse events between the two drug groups.

4. It is worthwhile to report how many participants in each drug group received replacement dose due to vomiting within one hour. I presume there was no difference between the drug groups. From the practical point of view the risk of vomiting within one hour is an important parameter to consider the appropriate drug regimen.

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N.B. These are the general comments made by the reviewer when reviewing this paper in light of which the manuscript was revised. Specific points addressed during revision of the paper are not shown.