{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:57:45Z","timestamp":1787317065436,"version":"build-2736575974"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,1,8]],"date-time":"2021-01-08T00:00:00Z","timestamp":1610064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"U.K. Medical Research Council, Department for International Development, National Institute for Health Research, and the Wellcome Trust","award":["MR\/K007319\/1"],"award-info":[{"award-number":["MR\/K007319\/1"]}]},{"name":"Wellcome Trust Master\u2019s Fellowship in Public Health and Tropical Medicine","award":["205311\/Z\/16\/Z"],"award-info":[{"award-number":["205311\/Z\/16\/Z"]}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"publisher","award":["MR\/R010161\/1"],"award-info":[{"award-number":["MR\/R010161\/1"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mass drug administration (MDA) with azithromycin (AZ) is being considered as a strategy to promote child survival in sub-Saharan Africa, but the mechanism by which AZ reduces mortality is unclear. To better understand the nature and extent of protection provided by AZ, we explored the profile of protection by time since administration, using data from a household-randomized, placebo-controlled trial in Burkina Faso and Mali.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 2014 and 2016, 30\u2009977 children aged 3\u201359 months received seasonal malaria chemoprevention (SMC) with sulfadoxine-pyrimethamine plus amodiaquine and either AZ or placebo monthly, on 4 occasions each year. Poisson regression with gamma-distributed random effects, accounting for the household randomization and within-individual clustering of illness episodes, was used to compare incidence of prespecified outcomes between SMC+AZ versus SMC+placebo groups in fixed time strata post-treatment. The likelihood ratio test was used to assess evidence for a time-treatment group interaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Relative to SMC+placebo, there was no evidence of protection from SMC+AZ against hospital admissions and deaths. Additional protection from SMC+AZ against malaria was confined to the first 2 weeks post-administration (protective efficacy (PE): 24.2% [95% CI: 17.8%, 30.1%]). Gastroenteritis and pneumonia were reduced by 29.9% [21.7; 37.3%], and 34.3% [14.9; 49.3%], respectively, in the first 2 weeks postadministration. Protection against nonmalaria fevers with a skin condition persisted up to 28 days: PE: 46.3% [35.1; 55.6%].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The benefits of AZ-MDA are broad-ranging but short-lived. To maximize impact, timing of AZ-MDA must address the challenge of targeting asynchronous morbidity and mortality peaks from different causes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1905","type":"journal-article","created":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T20:26:56Z","timestamp":1610051216000},"page":"e2379-e2386","source":"Crossref","is-referenced-by-count":17,"title":["The Duration of Protection from Azithromycin Against Malaria, Acute Respiratory, Gastrointestinal, and Skin Infections When Given Alongside Seasonal Malaria Chemoprevention: Secondary Analyses of Data from a Clinical Trial in Hound\u00e9, Burkina Faso, and Bougouni, Mali"],"prefix":"10.1093","volume":"73","author":[{"given":"Mphatso Dennis","family":"Phiri","sequence":"first","affiliation":[{"name":"Malaria Epidemiology Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, 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Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakiswend\u00e9 Serge","family":"Yerbanga","sequence":"additional","affiliation":[{"name":"Le D\u00e9partement Biom\u00e9dical et de Sant\u00e9 Publique, Institut de Recherche en Sciences de la Sant\u00e9, Bobo-Dioulasso, Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amadou","family":"Barry","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amadou","family":"Tapily","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samba","family":"Coumare","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismaila","family":"Thera","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Kuepfer","sequence":"additional","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Milligan","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, 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