# Heterogeneity of the effect of Azithromycin on morbidity and mortality among children in Burkina Faso

> **NIH NIH F31** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2024 · $30,814

## Abstract

PROJECT SUMMARY
Mass treatment of preschool children with azithromycin (AZ) and routine administration of seasonal
malaria chemoprevention (SMC), have been effective in reducing infections and mortality among
children.5,22 However, it is not clear how concomitant use of sulfadoxine in SMC and AZ affects child
morbidity and mortality. As mass distribution of AZ in sub-Saharan Africa is being scaled-up, research
is needed to determine whether routine SMC administration enhances the effect of AZ and whether
administering AZ in SMC or no SMC seasons is more beneficial for reducing child morbidity and
mortality. Additionally, previous studies show healthcare access and utilization lower with increasing
distance from facilities and with increasing community poverty, suggesting that mass treatment with
antibiotics maybe more beneficial for communities with potentially less access to healthcare and less
treatment/antibiotic exposure.13 Further research is needed to examine whether the effect of AZ varies
by distance to healthcare facilities and community wealth and whether distant and poorer communities
with less access to treatment would benefit more from AZ.
The goal of the proposed research is to examine factors that may modify the effectiveness of AZ
in reducing child morbidity and mortality. The study will examine whether the administration of SMC
modifies the effect of AZ on child mortality and morbidity (Aim 1A and 1B) and assess whether distance
from health facility (Aim 2A) and community wealth (Aim 2B) modify the effects of AZ on infectious
morbidity and mortality among children. Analyses will use data collected from a cluster randomized trial
(CRCT) of treatment with AZ vs placebo, along with primary healthcare surveillance, pre-census data
and Burkina Faso’s National Malaria Control Program (NMCP) data. The proposal will provide valuable
and timely insight on heterogeneity of the effect of AZ to help guide how, where and when to implement
MDA AZ programs, which is a current research gap.17, 36 By providing insights on how to maximize the
benefit of interventions that improve child health, knowledge gained from this research will advance the
NICHD’s mission of increasing children’s survival and potential to live healthy and productive lives free
from disease. The proposed training, guided by an exemplary mentorship team, will enhance the
applicant’s expertise in infectious disease and social epidemiology, methods, and analyses of CRCT
and surveillance data, and statistical methods for studying heterogeneity and interactions between
interventions as well as principal component analysis. The methodological skills, research competency,
and content expertise Elisabeth will gain will prepare her for a career as a future independent academic
researcher focused on strategies to reduce infectious diseases and mortality among children.

## Key facts

- **NIH application ID:** 10995089
- **Project number:** 1F31HD114434-01A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Elisabeth A Gebreegziabher
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $30,814
- **Award type:** 1
- **Project period:** 2024-09-09 → 2025-04-08

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10995089

## Citation

> US National Institutes of Health, RePORTER application 10995089, Heterogeneity of the effect of Azithromycin on morbidity and mortality among children in Burkina Faso (1F31HD114434-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10995089. Licensed CC0.

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