Globally, childhood mortality has shown a promising downward trend in recent years, however,
many sub-Saharan countries still have relatively high child mortality rates. In previous
studies within Niger, Tanzania, and Malawi, mass azithromycin treatment to children aged 1-59
months old effectively reduced all-cause childhood mortality. A similar study will be
conducted in Burkina Faso to replicate the results of mass azithromycin treatment.
The investigators propose an individually randomized placebo-controlled trial alongside the
MORDOR II Burkina Faso trial to evaluate the effect of a single dose of azithromycin (20
mg/kg) on potential mediators of the effect of azithromycin on all-cause mortality. Many
questions surround the mechanism behind azithromycin's effect on reducing childhood
mortality. Further questions exist regarding antibiotic resistance and how mass antibiotic
administration can impact intestinal microflora. The goal of this study is to demonstrate the
changes in the gut microbiome after antibiotic administration and to measure the growth of
children after receiving a single dose of azithromycin. Additionally we will measure
resistance markers, inflammatory markers, and IgA-bound bacteria. We hypothesize that a
single dose of azithromycin will lead to a significant increase in child growth and that the
gut microbiome will be significantly different in children who received azithromycin compared
to those who received placebo.
Objectives:
1. . To determine the effect of a single dose of azithromycin for children aged 8 days-59
months on longitudinal changes in the intestinal microbiome over a 6-month period. We
hypothesize that a single dose of azithromycin will result in a significant difference
in the intestinal microbiome within the treatment group compared to the placebo group
after a 6-month period within children ages 8 days-59 months.
2. . To determine the effect of a single dose of azithromycin for children aged 8 days-59
months on child growth over a 6-month period. We hypothesize that a single dose of
azithromycin will increase child growth over a 6-month period in children aged 8 days-59
months.
3. . To determine the effect of a single dose of azithromycin for children aged 8 days to
59 months on the presence of macrolide genetic resistance determinants within the first
two weeks post-treatment. The investigators hypothesize that a single dose of
azithromycin will increase the presence of macrolide resistance determinants over a 2
week period in children aged 8 days to 59 months.
The study will be conducted in Nouna Town in northwestern Burkina Faso.
Phase:
Phase 4
Details
Lead Sponsor:
University of California, San Francisco
Collaborators:
Bill and Melinda Gates Foundation Centre de Recherche en Sante de Nouna, Burkina Faso