{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:00:32Z","timestamp":1787320832263,"version":"build-2736575974"},"reference-count":12,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    The twice-yearly mass distribution of azithromycin to children aged 1\u201359 months reduces all-cause child mortality. It has been suggested in some studies that mass azithromycin distributions may reduce malaria mortality and parasitemia; however, these studies have been conducted in the absence of seasonal malaria chemoprevention (SMC). Here, we evaluate malaria parasitemia in a cluster randomized trial of azithromycin versus a placebo in Burkina Faso, where SMC was being administered. Thin and thick smears were taken from a random sample of 15 children per cluster in 40 clusters that had been receiving twice-yearly azithromycin or a placebo for 36 months (six distributions). We found no evidence of a difference in malaria parasitemia between children in the azithromycin and placebo clusters (mean difference \u20136% prevalence; 95% CI \u201317% to 6%;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.33). These results suggest that reductions in malaria parasitemia may not be a major contributor to the effect of azithromycin on child mortality in settings in which SMC is administered.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0093","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T14:25:35Z","timestamp":1750170335000},"page":"607-610","source":"Crossref","is-referenced-by-count":2,"title":["Malaria Parasitemia after Mass Distribution of Azithromycin to Prevent Child Mortality in Burkina Faso: Results from a Cluster Randomized Trial"],"prefix":"10.4269","volume":"113","author":[{"given":"Boubacar","family":"Coulibaly","sequence":"first","affiliation":[{"name":"Centre de Recherche en Sant\u00e9 de Nouna, Nouna, Burkina Faso;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Si\u00e9","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Sant\u00e9 de Nouna, Nouna, Burkina Faso;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamadou","family":"Ouattara","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Sant\u00e9 de Nouna, Nouna, Burkina Faso;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamadou","family":"Bountogo","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Sant\u00e9 de Nouna, Nouna, Burkina Faso;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Compaor\u00e9","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Sant\u00e9 de Nouna, Nouna, Burkina Faso;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adama","family":"Compaor\u00e9","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Sant\u00e9 de Nouna, Nouna, Burkina Faso;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moustapha","family":"Nikiema","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Sant\u00e9 de Nouna, Nouna, Burkina Faso;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestor Demb\u00e9l\u00e9","family":"Sibiri","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Sant\u00e9 de Nouna, Nouna, Burkina Faso;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00f4me Nankon\u00e9","family":"Tiansi","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Sant\u00e9 de Nouna, Nouna, Burkina Faso;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elodie","family":"Lebas","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Fetterman","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiyu","family":"Hu","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy","family":"Doan","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"},{"name":"Department of Ophthalmology, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin F.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"},{"name":"Department of Ophthalmology, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Lietman","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"},{"name":"Department of Ophthalmology, University of California, San Francisco, California;"},{"name":"Department of Epidemiology & Biostatistics, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine E.","family":"Oldenburg","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California, San Francisco, California;"},{"name":"Department of Ophthalmology, University of California, San Francisco, California;"},{"name":"Department of Epidemiology & Biostatistics, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"JAMA","first-page":"482","article-title":"Mass azithromycin distribution to prevent child mortality in Burkina Faso: The CHAT randomized clinical trial","volume":"331","author":"Oldenburg","year":"2024"},{"key":"b2","series-title":"N Engl J Med","first-page":"1583","article-title":"Azithromycin to reduce childhood mortality in sub-Saharan Africa","volume":"378","author":"Keenan","year":"2018"},{"key":"b3","series-title":"N Engl J Med","first-page":"699","article-title":"Azithromycin to reduce mortality\u2014An adaptive cluster-randomized trial","volume":"391","author":"O\u2019Brien","year":"2024"},{"key":"b4","series-title":"Lancet Global Health","first-page":"e288","article-title":"Cause-specific mortality of children younger than 5 years in communities receiving biannual mass azithromycin treatment in Niger: Verbal autopsy results from a cluster-randomised controlled trial","volume":"8","author":"Keenan","year":"2020"},{"key":"b5","series-title":"PLoS Med","first-page":"e1002835","article-title":"Biannual mass azithromycin distributions and malaria parasitemia in pre-school children in Niger: A cluster-randomized, placebo- controlled trial","volume":"16","author":"Arzika","year":"2019"},{"key":"b6","series-title":"J Biol Chem","first-page":"2494","article-title":"In vitro efficacy, resistance selection, and structural modeling studies implicate the malarial parasite apicoplast as the target of azithromycin","volume":"282","author":"Sidhu","year":"2007"},{"key":"b7","series-title":"Antimicrob Agents Chemother","first-page":"3485","article-title":"Multiple antibiotics exert delayed effects against the Plasmodium falciparum apicoplast","volume":"51","author":"Dahl","year":"2007"},{"key":"b8","series-title":"Malar J","first-page":"360","article-title":"Effect of a single dose of oral azithromycin on malaria parasitaemia in children: A randomized controlled trial","volume":"20","author":"Coulibaly","year":"2021"},{"key":"b9","series-title":"BMC Infect Dis","first-page":"285","article-title":"Malaria positivity following a single oral dose of azithromycin among children in Burkina Faso: A randomized controlled trial","volume":"22","author":"Brogdon","year":"2022"},{"key":"b10","series-title":"Trials","first-page":"675","article-title":"A double-masked placebo-controlled trial of azithromycin to prevent child mortality in Burkina Faso, West Africa: Community Health with Azithromycin Trial (CHAT) study protocol","volume":"20","author":"Si\u00e9","year":"2019"},{"key":"b11","series-title":"Glob Health Action","first-page":"5284","article-title":"The health and demographic surveillance system (HDSS) in Nouna, Burkina Faso, 1993\u20132007","volume":"3","author":"Si\u00e9","year":"2010"},{"key":"b12","series-title":"N Engl J Med","first-page":"2197","article-title":"Effect of adding azithromycin to seasonal malaria chemoprevention","volume":"380","author":"Chandramohan","year":"2019"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/3\/article-p607.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/3\/article-p607.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/3\/article-p607.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T13:14:04Z","timestamp":1756905244000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/3\/article-p607.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,3]]},"references-count":12,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.25-0093","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2025.04.26.25326479","asserted-by":"object"}]},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,3]]}}}