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Peer reviewedOpen accessMalariaTrachoma

Effect of Adding Azithromycin to Seasonal Malaria Chemoprevention

New England Journal of Medicine·

Daniel Chandramohan, Alassane Dicko, Issaka Zongo, Issaka Sagara, Matthew Cairns, Irene Kuepfer, Modibo Diarra, Amadou Barry, Amadou Tapily, Frederic Nikiema, Serge Yerbanga, Samba Coumare, Ismaila Thera, Abdourhamane Traore, Paul Milligan, Halidou Tinto, Ogobara Doumbo, Jean-Bosco Ouedraogo, Brian Greenwood

DOI
10.1056/nejmoa1811400
PMID
30699301
PMCID
OpenAlex
W2913974122
Study type
Journal article
Publisher
Massachusetts Medical Society
Article type
journal-article
Integrity
current

Why this research matters now

The trial addresses whether an added drug strategy could improve child outcomes during seasonal malaria chemoprevention in two African countries. The primary endpoint was serious illness or death, making the question relevant to child health and malaria-control programs.

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Structured evidence summary

Research question

The study asked whether adding azithromycin to monthly sulfadoxine-pyrimethamine plus amodiaquine seasonal malaria chemoprevention would reduce mortality or morbidity in young children in Burkina Faso and Mali.

Study design

This was a randomized household-level trial comparing azithromycin with placebo, given alongside standard seasonal malaria chemoprevention over three transmission seasons. Outcomes were assessed using active and passive surveillance.

Population and setting

The population was children aged 3 to 59 months in Burkina Faso and Mali during the annual malaria-transmission season. Children aged out at 5 years and new children were enrolled each year.

Main findings

The addition of azithromycin did not reduce the combined endpoint of death or hospital admission compared with placebo. The abstract also reports fewer gastrointestinal infections, upper respiratory tract infections, and nonmalarial febrile illnesses with azithromycin, while malaria parasitemia and adverse events were similar between groups.

Public-health relevance

The trial addresses whether an added drug strategy could improve child outcomes during seasonal malaria chemoprevention in two African countries. The primary endpoint was serious illness or death, making the question relevant to child health and malaria-control programs.

Important limitations

No explicit limitations are stated in the supplied abstract. This summary is limited to the single provided abstract and metadata, so the original paper would be needed for decision-grade interpretation.

GIDS interpretation

The article is discoverable as a peer-reviewed trial on pediatric malaria chemoprevention, with metadata linking it to malaria, trachoma, surveillance, transmission dynamics, and treatment. This is contextual classification only and does not indicate a live surveillance signal.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 12 auditable classifier relationships to diseases, places, topics, and study design.

about diseaseaddresses topicaddresses topicaddresses topicevaluates interventionhas pathogen typestudied instudied instudied population settingstudies populationstudies populationuses study design