Publicador de contenidos

Investigación, Salud Materna, Infantil y Reproductiva


Improving Care through Azithromycin Research for Infants in Africa

Logo del proyecto ICARIA
30/04/2019 - 1/04/2025
Bill & Melinda Gates Foundation, "la Caixa" Banking Foundation

Half of the 5.4 million children under 5 years of age (U5) who die in the world annually live in the African region where falciparum malaria is a major cause of death. Intermittent preventive treatment of malaria in infants (IPTi), consisting of the administration of sulphadoxine-pyrimethamine to infants, is a safe, efficacious and cost-effective  intervention in reducing malaria. Despite the WHO recommendation  (2010) to administer IPTi alongside routine vaccinations in areas of high to moderate perennial transmission, IPTi is not implemented in most of African malaria endemic countries. Recent studies in some African countries showed that azithromycin (AZi)– is associated with a significant reduction in child mortality when used for mass drug administration in the elimination of trachoma. Evaluation of the impact on mortality reduction of the addition of AZi to IPTi (ITPi+) and assessment of bottlenecks for IPTi scale-up are needed before promoting their large scale-up.

Specific objectives

To evaluate the impact of azithromycin, plus intermittent preventive treatment with sulphadoxine-pyrimethamine administered through the Expanded Program on Immunisation on all-cause mortality at 18 months of age in young children living in areas of high mortality and malaria burden in Sub-Saharan Africa.

To identify implementation bottlenecks for intermittent preventive treatment with sulphadoxine-pyrimethamine administered through the Expanded Program on Immunisation scale-up in Sierra Leone.


Carrying out an individually randomized placebo-controlled trial of IPTi in addition to AZi in (20,560) infants exposed to high malaria endemicity and mortality burden in Sierra Leone (SL). This approach will enable to obtain conclusive evidence of the effect of IPTi together with AZi in U5’s mortality reduction and address knowledge and implementation gaps to scale-up ITPi/IPTi+: 1. 

Evaluation of the Expanded Program on Immunisation (EPI) as a delivery channel to ensure the long-term sustainability of interventions targeted to young children 2. Evaluation of knowledge gaps related to the effect of AZi as a tool to reduce infant mortality, such as a) potential development of macrolide resistance; b) understanding the mechanisms of action of AZi in reducing mortality; c) Ascertaining the seasonality effect on mortality and the frequency of adverse events; and d) Determining the potential interactions of the drug with the vaccines routinely given through the EPI system.

Total funding

US$ 12,224,453

Nuestro equipo


  • Clara Menéndez Santos
    Clara Menéndez Santos

ISGlobal Team

Ver más

Otros proyectos

Ver proyectos pasados


Combatiendo la Resistencia Bacteriana en Europa


Development of Novel Gastrointestinal Biomarkers for Use in HIV Incidence Determination in a Sub-Saharan African Setting


Combatting Bacterial Resistance in Europe - Carbapenem Resistance


Improving Maternal and Infant Health by reducing malaria risks in African women: evaluation of the safety and efficacy of dihydroartemisinin-piperaquine for intermittent preventive treatment of malaria in HIV-infected pregnant women


Integrating and decentralizing diabetes and hypertension services in Africa


Predicting the Future: Incipient Tuberculosis


Large Clinical Trial in Africa on the Treatment of Mild Cases of COVID-19


Evaluating a new stool based qPCR for diagnosis of tuberculosis in children and people living with HIV


Reconnecting Transmission to Global Tuberculosis Control by Mapping Pathogen Transmission Events to Host Infection Status


Quantifiable stool-based TB PCR to Improve Diagnostics and Treatment Monitoring


ENDing COVID-19 Variants Of concern through Cohort studies (END-VOC)


Digital Twins Enabled Indoor Air Quality Management for Healthy Living


Community knowledge generation through scientific culture, urban ecology and art


Building Scalable Pathogen Genomic Epidemiology in Ethiopia

Hepatitis C Free Baleares

Eliminating hepatitis C on the Balearic Islands (Mallorca, Menorca and Ibiza): a study in governmental and non-governmental addiction service centres, a mobile methadone unit and a prison to test and link people who use drugs to HCV care.


Nuevas moléculas de oro coordinadas con flavonoides contra bacterias patógenas multirresistentes prioritarias


Validación continuada de la autopsia mínimamente invasiva (MIA) para la investigación de la causa de muerte en niños pequeños, y desarrollo de un centro de investigación y formación sobre el estudio de la causa de muerte


Identification of Prematurity and Pre-Eclampsia as Causes of Mortality


MULTIple doses of IPTi Proposal: a Lifesaving high Yield intervention


Prevalence and impact of SARS-CoV-2 infection on maternal and infant health in African populations


Impact of perceptions of COVID-19 vaccines on health-seeking behaviours in Sierra Leone


Respiratory syncytial virus (RSV) in African pregnant women and children


Towards preparedness for new maternal vaccinations: Understanding barriers and facilitators to maternal vaccine acceptance

HIV drug resistance (HIVDR)

Description of HIV drug resistance patterns and its association with the risk of HIV mother to child transmission among pregnant women from southern Mozambique


PReparing for Optimal Phase III/IV maTErnal Group B StreptococCal vaccine Trials in Africa