SARMAAN
Safety and Antimicrobial Resistance of Mass Administration of Azithromycin in Nigeria (SARMAAN) Project in Jigawa.
Nigeria significantly contributes to the global burden of child mortality, responsible for 10% of all deaths among children under five worldwide. The country has an estimated infant mortality rate (IMR) of 67 per 1,000 live births and an under-5 mortality rate (U5MR) of 132 per 1,000 live births. However, childhood mortality is not evenly spread across the nation, with the Northern regions and rural areas being disproportionately affected. Common causes of childhood illness and death include acute respiratory infections, diarrheal diseases, malaria, sepsis, and malnutrition. The 2018 National Demographic and Health Survey (NDHS) revealed an increase in the under-5 mortality rate from 129 to 132 per 1,000 live births, while the infant mortality rate slightly decreased from 69 to 67 per 1,000 live births between 2013 and 2018.
Azithromycin is an antibiotic widely used to treat trachoma, the leading cause of preventable blindness globally, as well as various bacterial infections such as respiratory and bowel infections. Evidence from the MORDOR study conducted in three sub-Saharan countries demonstrated a cumulative 14% reduction in mortality among children under five who received Azithromycin, with the most significant impact observed in infants.
The SARMAAN project is designed to reduce child mortality in Nigeria through the Mass Administration of Azithromycin to children from 1 to 11 months, twice a year. The pilot project began in Jigawa state across the 27 LGAs to determine the effect of Mass Administration of Azithromycin among children 1 to 11 months old on the safety and pattern of antimicrobial resistance (AMR) in children. It also sets out to determine the cost-effectiveness, feasibility and acceptability of delivering Azithromycin MAM through the Trachoma/NTDs platform in the state.
The first round of distribution of Azithromycin was conducted in March 2022 where 231,289 children were treated achieving 91% therapeutic coverage. In the 2023, two rounds of treatment were conducted where 245,996 and 245,826 children received the Azithromycin treatment.
