{
  "abstract": "Twice yearly distribution of azithromycin has been shown to reduce all-cause child mortality in several contexts. Azithromycin likely reduces mortality via reduction in clinical or subclinical infections. Treating infections may improve child nutritional status to further reduce mortality risk. Here, we used data from a placebo-controlled cluster randomized trial of azithromycin for prevention of child mortality in Burkina Faso to evaluate the effects of twice-yearly azithromycin on mid-upper arm circumference (MUAC) in children aged 1–59 months and weight-for-age Z-score (WAZ) in infants aged 1–11 months. The Child Health with Azithromycin Trial (CHAT) was a 1:1 cluster randomized trial of twice-yearly azithromycin compared to matching placebo for prevention of all-cause mortality in children aged 1–59 months. Measurements were collected every 6 months, including MUAC measurements in all children and weight measurements in infants aged 1–11 months to calculate weight-based dosing. We evaluated MUAC and WAZ at the community level and longitudinally at the individual child level, accounting for the cluster randomized design of the trial. 80,282 children aged 1–59 months, of whom 26,983 were infants aged 1–11 months, in 284 communities were included in analyses. At the community level, we found no evidence of a difference in mean MUAC or WAZ after 36 months or over time. There was no evidence of a difference in change over time in MUAC (P-value for interaction = 0.94) or WAZ (P = 0.18) at the individual level. We found no evidence to support an effect of twice-yearly mass azithromycin distribution on measures of undernutrition in children in this setting in Burkina Faso. Trial registration: ClinicalTrials.gov NCT03676764",
  "abstract_shown": true,
  "affiliations": [
    "Centre de Recherche en Sante de Nouna, Nouna, Burkina Faso",
    "Francis I Proctor Foundation, University of California, San Francisco, California, United States of America",
    "Department of Ophthalmology, University of California, San Francisco, California, United States of America",
    "Department of Epidemiology & Biostatistics, University of California, San Francisco, California, United States of America"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Mamadou Ouattara"
    },
    {
      "affs": [
        1
      ],
      "name": "Huiyu Hu"
    },
    {
      "affs": [
        2
      ],
      "name": "Mamadou Bountogo"
    },
    {
      "affs": [
        3
      ],
      "name": "Boubacar Coulibaly"
    },
    {
      "name": "Valentin Boudo"
    },
    {
      "name": "Guillaume Compaoré"
    },
    {
      "name": "Clarisse Dah"
    },
    {
      "name": "Elodie Lebas"
    },
    {
      "name": "Kieran S. O’Brien"
    },
    {
      "name": "Benjamin F. Arnold"
    },
    {
      "name": "Thomas M. Lietman"
    },
    {
      "name": "Ali Sié"
    },
    {
      "name": "Catherine E. Oldenburg"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dgrjh2e30qd2m.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pgph.0007473",
  "fulltext_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007473",
  "id": "dgrjh2e30qd2m",
  "issns": [
    "2767-3375"
  ],
  "landing_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007473",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2916|Child Nutrition and Water Access"
    ],
    [
      "plos",
      "/Biology and life sciences/Microbiology/Microbial control/Antimicrobials/Antibiotics"
    ],
    [
      "plos",
      "/Biology and life sciences/Nutrition"
    ],
    [
      "plos",
      "/Biology and life sciences/Nutrition/Malnutrition"
    ],
    [
      "plos",
      "/Biology and life sciences/Population biology/Population metrics/Death rates"
    ],
    [
      "plos",
      "/Medicine and health sciences/Nutrition"
    ],
    [
      "plos",
      "/Medicine and health sciences/Nutrition/Malnutrition"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pediatrics/Child health"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pharmacology/Drugs/Antimicrobials/Antibiotics"
    ],
    [
      "plos",
      "/Medicine and health sciences/Public and occupational health/Child health"
    ],
    [
      "plos",
      "/People and places/Population groupings/Age groups/Children"
    ],
    [
      "plos",
      "/People and places/Population groupings/Age groups/Children/Infants"
    ],
    [
      "plos",
      "/People and places/Population groupings/Families/Children"
    ],
    [
      "plos",
      "/People and places/Population groupings/Families/Children/Infants"
    ],
    [
      "plos",
      "/Research and analysis methods/Research design/Survey research/Census"
    ]
  ],
  "openalex": "W7221594061",
  "pdf_url": "https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0007473&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-13",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/dgrjh2e30qd2m.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:30Z",
      "native_id": "10.1371/journal.pgph.0007473",
      "source": "plos",
      "url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007473"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:nutrition",
      "subfield": "nutrition"
    }
  ],
  "title": "Mass azithromycin distribution and nutritional status among children aged 1–59 months: A secondary analysis of a cluster randomized trial",
  "title_text": "Mass azithromycin distribution and nutritional status among children aged 1–59 months: A secondary analysis of a cluster randomized trial",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:30Z",
  "url": "https://research.draconitic.com/paper/dgrjh2e30qd2m",
  "venue": "PLOS Global Public Health",
  "versions": []
}