Evidence map›Paper›PMID 39334260›Full record

ArticleTrials2024

Impact of oral azithromycin and intermittent preventive treatment with sulfadoxine-pyrimethamine regimen on child mortality in Sierra Leone: trial protocol for a randomised, two-arm, double-blinded, placebo-controlled clinical trial (ICARIA).

Kwabena Owusu-Kyei, Haily Chen, Maureen Chileshe, Llorenç Quintó, Maya Sibley, Antía Figueroa-Romero, Mireia Llach, Máximo Ramírez, Andreu Bofill, Mohamed Samai and 2 more

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04235816 (Evaluation of the Impact on Childhood Mortality of Azithromycin Plus Intermittent Preventive Treatment Administered Through the Expanded Program on Immunization in Sierra Leone), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04235816 phase3active not recruitingnot on this map

Evaluation of the Impact on Childhood Mortality of Azithromycin Plus Intermittent Preventive Treatment Administered Through the Expanded Program on Immunization in Sierra Leone

TypeinterventionalSponsorBarcelona Institute for Global HealthRan2021 to 2026Enrolled20,560ConditionsChild MortalityArmsAzithromycin, Placebo
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Early-life carriage and antibiotic resistance ofFrontiers in microbiology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kwabena Owusu-KyeiBarcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain. kwabena.owusukyei@isglobal.org.ORCID http://orcid.org/0009-0006-3733-7936
Haily ChenBarcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain.
Maureen ChilesheBarcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain.
Llorenç QuintóBarcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain.
Maya SibleyBarcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain.
Antía Figueroa-RomeroBarcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain.
Mireia LlachBarcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain.
Máximo RamírezBarcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain.
Andreu BofillBarcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain.
Mohamed SamaiCollege of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
Clara MenéndezBarcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain.
ICARIA Trial Team

Funding

Grand Challenges in Global Health OPP1196642Wellcome Trust
6 · The paper itself

Abstract

backgroundAzithromycin has been shown to be beneficial in preventing infectious diseases, including malaria, infectious diarrhoea and pneumonia. A cluster randomised control trial on azithromycin MDA in children in Niger, Malawi and Tanzania found a reduction in all-cause under-five (U5) mortality in communities who received azithromycin compared to placebo. However, the reduction was largest and statistically significant only in Niger. The purpose of this trial is to evaluate the impact of azithromycin plus intermittent preventive treatment in infants (IPTi), recently renamed by the World Health Organisation as perennial malaria chemoprevention (PMC), with sulfadoxine-pyrimethamine (SP) on all-cause mortality up to 18 months of age in children living in areas of high mortality burden through the Expanded Program on Immunisation (EPI) in Sierra Leone.

methodsThe Improving Care through Azithromycin Research for Infants in Africa (ICARIA) trial is a phase III two-arm, individually randomised, double-blinded, placebo-controlled trial administering oral AZI (20 mg/kg bodyweight) at three time points to children attending EPI visits in Sierra Leone. A total of 20,560 infants attending the first EPI contact at around 6 weeks of age are recruited and randomised to AZI or placebo in a 1:1 ratio. The second and third AZI/placebo doses are given at 9 and 15 months of age. The primary outcome of the trial is all-cause mortality rate at 18 months of age assessed through mortality surveillance. Other trial outcomes include the impact on antimicrobial resistance, and on the immune response to certain key routine EPI immunisations, the safety of the intervention, the prevalence of SP resistance markers and the feasibility, and acceptability of adding AZI to the EPI programme. DISCUSSION: The trial will provide the evidence needed to inform policy regarding the adoption and large-scale implementation of AZI in areas of high-mortality burden in sub-Saharan Africa.

trial registrationClinicalTrials.gov NCT04235816. Registered on 22 January 2020. Pan-African Clinical Trials Registry PACTR202004540256535. Registered on 14 April 2020.

Indexed as

AntimalarialsAzithromycinChild MortalityDrug CombinationsPyrimethamineRandomized Controlled Trials as TopicSulfadoxineAdministration, OralClinical Trials, Phase III as TopicDouble-Blind MethodDrug Administration ScheduleFemaleHumansInfantMalariaMaleAntimalarialsAzithromycinDrug Combinationsfanasil, pyrimethamine drug combinationPyrimethamineSulfadoxineAzithromycinIntermittent preventive treatmentMacrolide resistanceMortalityPlaceboRandomised controlled trial

Identifiers

PMID39334260
PMCPMC11430122

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.