Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
The Duration of Protection from Azithromycin Against Malaria, Acute Respiratory, Gastrointestinal, and Skin Infections When Given Alongside Seasonal Malaria Chemoprevention: Secondary Analyses of Data from a Clinical Trial in Houndé, Burkina Faso, and Bougouni, Mali.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 18 citations in OpenAlex.
- Biannual Mass Azithromycin Distributions for Preschool Children and Malaria Parasitemia: A Secondary Analysis of the MORDOR Cluster Randomized Trial.JAMA network open · 2025Trial
- Temporal Trends in Phenotypic Macrolide and Nonmacrolide Resistance for Streptococcus pneumoniae Nasopharyngeal Samples Up to 36 Months after Mass Azithromycin Administration in a Cluster-Randomized Trial in Niger.The American journal of tropical medicine and hygiene · 2023Trial
- Malaria positivity following a single oral dose of azithromycin among children in Burkina Faso: a randomized controlled trial.BMC infectious diseases · 2022Trial
- Comparing Azithromycin to Amoxicillin in the Management of Uncomplicated Severe Acute Malnutrition in Burkina Faso: A Pilot Randomized Trial.The American journal of tropical medicine and hygiene · 2022Trial
- Effect of 3 Days of Oral Azithromycin on Young Children With Acute Diarrhea in Low-Resource Settings: A Randomized Clinical Trial.JAMA network open · 2021Trial
- Effect of a single dose of oral azithromycin on malaria parasitaemia in children: a randomized controlled trial.Malaria journal · 2021Trial
- Prevalence, species diversity, and antimicrobial resistance profiles ofMicrobiology spectrum · 2026Article
- A single dose of azithromycin versus placebo for malaria in infants: A cluster-randomized trial.PLOS global public health · 2026Article
- The role of Seasonal Malaria Chemoprevention in the effect of Azithromycin on Child Mortality: A Secondary Analysis of the CHAT Cluster Randomized Clinical Trial.medRxiv : the preprint server for health sciences · 2025Article
- The role of seasonal malaria chemoprevention in the effect of azithromycin on child mortality: A secondary analysis of the CHAT cluster randomized clinical trial.PLOS global public health · 2025Article
- Seasonal malaria chemoprevention in Africa and China's upgraded role as a contributor: a scoping review.Infectious diseases of poverty · 2023Article
- Projected health impact of post-discharge malaria chemoprevention among children with severe malarial anaemia in Africa.Nature communications · 2023Article
- Targeting malaria parasites with novel derivatives of azithromycin.Frontiers in cellular and infection microbiology · 2022Article
Corrections and comments
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Authors and funding
18 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundMass drug administration (MDA) with azithromycin (AZ) is being considered as a strategy to promote child survival in sub-Saharan Africa, but the mechanism by which AZ reduces mortality is unclear. To better understand the nature and extent of protection provided by AZ, we explored the profile of protection by time since administration, using data from a household-randomized, placebo-controlled trial in Burkina Faso and Mali.
methodsBetween 2014 and 2016, 30 977 children aged 3-59 months received seasonal malaria chemoprevention (SMC) with sulfadoxine-pyrimethamine plus amodiaquine and either AZ or placebo monthly, on 4 occasions each year. Poisson regression with gamma-distributed random effects, accounting for the household randomization and within-individual clustering of illness episodes, was used to compare incidence of prespecified outcomes between SMC+AZ versus SMC+placebo groups in fixed time strata post-treatment. The likelihood ratio test was used to assess evidence for a time-treatment group interaction.
resultsRelative to SMC+placebo, there was no evidence of protection from SMC+AZ against hospital admissions and deaths. Additional protection from SMC+AZ against malaria was confined to the first 2 weeks post-administration (protective efficacy (PE): 24.2% [95% CI: 17.8%, 30.1%]). Gastroenteritis and pneumonia were reduced by 29.9% [21.7; 37.3%], and 34.3% [14.9; 49.3%], respectively, in the first 2 weeks postadministration. Protection against nonmalaria fevers with a skin condition persisted up to 28 days: PE: 46.3% [35.1; 55.6%].
conclusionsThe benefits of AZ-MDA are broad-ranging but short-lived. To maximize impact, timing of AZ-MDA must address the challenge of targeting asynchronous morbidity and mortality peaks from different causes.
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