Evidence map›Paper›PMID 40147984›Full record

Trial reportBMJ open2025

Mass distribution of azithromycin and child mortality among underweight infants in rural Niger: a subgroup analysis of the AVENIR cluster-randomised trial.

Brittany Peterson, Ahmed Arzika, Ramatou Maliki, Amza Abdou, Bawa Aichatou, Ismael M Bello, Diallo Beidi, Nasser Galo, Nasser Harouna, Alio M Karamba and 12 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04224987 (Azithromycine Pour la Vie Des Enfants au Niger - Implémentation et Recherche), 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.

NCT04224987 phase4completednot on this map

Azithromycine Pour la Vie Des Enfants au Niger - Implémentation et Recherche: Essai mortalité et résistance (Azithromycin for Child Survival in Niger: Mortality Trial and Resistance Trial)

TypeinterventionalSponsorUniversity of California, San FranciscoRan2020 to 2024Enrolled864,493ConditionsMortality, Resistance Bacterial, Child, OnlyArmsAzithromycin, Placebo
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
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

22 authors.

Brittany PetersonF. I. Proctor Foundation, University of California, San Francisco, California, USA.ORCID http://orcid.org/0009-0008-8815-1642
Ahmed ArzikaCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Ramatou MalikiCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Amza AbdouProgramme Nationale de Santé Oculaire, Niamey, Niger.
Bawa AichatouCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Ismael M BelloCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Diallo BeidiCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Nasser GaloCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Nasser HarounaCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Alio M KarambaCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Sani MahamadouCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Moustapha AbarchiCentre de Recherche et Interventions en Santé Publique, Birni N'Gaoure, Niger.
Almou IbrahimProgramme Nationale de Santé Oculaire, Niamey, Niger.
Elodie LebasF. I. Proctor Foundation, University of California, San Francisco, California, USA.
Zijun LiuF. I. Proctor Foundation, University of California, San Francisco, California, USA.
Carolyn BrandtF. I. Proctor Foundation, University of California, San Francisco, California, USA.
Emily ColbyF. I. Proctor Foundation, University of California, San Francisco, California, USA.
Catherine E OldenburgF. I. Proctor Foundation, University of California, San Francisco, California, USA.ORCID http://orcid.org/0000-0002-0763-399X
Travis C PorcoF. I. Proctor Foundation, University of California, San Francisco, California, USA.ORCID http://orcid.org/0000-0001-8813-3171
Benjamin ArnoldF. I. Proctor Foundation, University of California, San Francisco, California, USA.ORCID http://orcid.org/0000-0001-6105-7295
Thomas M LietmanF. I. Proctor Foundation, University of California, San Francisco, California, USA.
Kieran Sunanda O'BrienF. I. Proctor Foundation, University of California, San Francisco, California, USA kieran.obrien@ucsf.edu.

Funding

Gates Foundation INV-002454
6 · The paper itself

Abstract

objectiveAzithromycin has been shown to reduce all-cause child mortality. This subgroup analysis investigates azithromycin's mortality impact by underweight status using

designThe AVENIR trial randomised communities into three arms: azithromycin for children aged 1-59 months, azithromycin for infants aged 1-11 months or placebo. Weight-for-age z-score was used to categorise children into subgroups of either moderate to severe underweight or not and severe underweight or not.

setting2880 communities with a population of less than 2500 people in the Dosso and Tahoua regions of Niger that participated in the AVENIR trial were included.

participants97 572 children aged 1-59 months who had weight captured during at least one census participated.

resultsUnderweight subgroups had higher overall mortality compared with non-underweight subgroups. IRDs of deaths in children aged 1-11 months comparing communities receiving azithromycin to children 1-59 months of age to placebo were -6.2 deaths per 1000 person-years (95% CI -9.3 to -2.6) overall, -8.0 (95% CI -15.9 to -0.4) in the moderate to severe subgroup and -11.2 (95% CI -26.0 to -2.1) in the severe subgroup. Similar trends were noted in the azithromycin 1-11 month comparison. Malnutrition was not a statistically significant effect modifier for either comparison.

conclusionsAlthough analyses suggest the potential for stronger effects in more severe underweight subgroups, we were unable to demonstrate underweight status as an effect modifier. In fact, azithromycin mass drug administration to children 1-59 months old reduced mortality in all subgroups, and, especially as the number of lives saved would be the highest by treating all subgroups, our results do not support restricting eligibility for this intervention. TRIAL REGISTRATION NUMBER: clinicaltrials.gov NCT04224987.

Indexed as

Anti-Bacterial AgentsAzithromycinChild MortalityInfant MortalityThinnessChild, PreschoolFemaleHumansInfantMaleMass Drug AdministrationNigerRural PopulationAnti-Bacterial AgentsAzithromycinCommunity child healthMass Drug AdministrationMortality

Identifiers

PMID40147984
PMCPMC11956350

What OpenQuestion holds

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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.