Evidence map›Paper›PMID 41381245›Full record

Trial reportBMJ paediatrics open2025

Impact of biannual azithromycin on weight-for-age z-score among infants in 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

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ paediatrics open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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, 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, San Francisco, California, USA.
Zijun LiuF.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Carolyn BrandtF.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Emily ColbyF.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Catherine OldenburgF.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Travis PorcoF.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Benjamin F ArnoldF.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Thomas M LietmanF.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Kieran S O'brienF.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA kieran.obrien@ucsf.edu.

Funding

Gates Foundation INV-002454
6 · The paper itself

Abstract

backgroundThe AVENIR cluster-randomised trial evaluated whether biannual mass drug administration (MDA) of azithromycin improved childhood mortality among infants in Niger, a high-mortality, high-malnutrition setting.

methodsWeight-for-age z-score (WAZ) was a prespecified secondary outcome of the trial. In this analysis, 2880 communities in the Dosso and Tahoua regions and 51 687 infants with two sequential weight measurements were included. Weight was assessed at baseline and 6 months post treatment, and WAZ was calculated using WHO standards. To include two subsequent measures of WAZ, infants at baseline were 1-5 months old. Linear mixed-effects models compared mean WAZ between azithromycin and placebo arms, with additional analyses examining community-level means, categorical underweight outcomes and predefined subgroups.

resultsAt follow-up, mean WAZ was -1.39 in the azithromycin arm and -1.38 in the placebo arm, with no detectable difference (mean difference 0.00, 95% CI -0.05 to 0.04, p=0.94). Odds of moderate-to-severe or severe underweight also did not differ between groups. Subgroup analyses by baseline nutritional status, age, sex, community size and distance to health centres showed consistent null effects, though a small, non-significant improvement in WAZ was observed in infants treated during the rainy season compared with the dry season.

conclusionThese findings align with prior large-scale trials that demonstrated mortality benefits but no sustained effects of azithromycin on growth. Taken together, the results suggest that while azithromycin MDA reduces childhood mortality, it is unlikely to provide medium-term improvements in weight gain, highlighting the need for complementary nutritional interventions to address undernutrition in similar settings.

Indexed as

Anti-Bacterial AgentsAzithromycinBody WeightMass Drug AdministrationFemaleHumansInfantInfant MortalityMaleNigerThinnessAnti-Bacterial AgentsAzithromycinChild HealthEpidemiologyInfant

Identifiers

PMID41381245
PMCPMC12699659

What OpenQuestion holds

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Registered trials

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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.