Effect of five years of biannual azithromycin mass drug administration on enteric fever seroincidence in Niger: A randomized control trial

The study examined the impact of mass distribution of the antibiotic azithromycin on enteric fever incidence in rural Niger. The research lasted five years (2015-2020) and included 30 communities with a total of 1,417 children aged 1-59 months. Half of the communities received azithromycin twice yearly, while the other half received placebo. Enteric fever incidence doubled over five years in both groups - in placebo communities it increased from 68.5 to 145.2 cases per 100 person-years. In the azithromycin group, incidence rose from 74.7 to 135.2 cases per 100 person-years. No significant difference was found between the groups overall. However, in children under 2 years of age, azithromycin showed a potential protective effect. The findings emphasize the importance of introducing typhoid conjugate vaccine in Niger.