Nigeria’s research institute tackles child mortality with mass drug administration study

The Nigerian Institute of Medical Analysis(NIMR) has carried out a mass drug administration of Azithromycin to “over 4 million kids” within the nation, as a part of a significant research aimed toward tackling little one mortality.

The research, referred to as Security and Antimicrobial Resistance of Mass Administration of Azithromycin in Nigeria (SARMAAN), targets kids aged one to 11 months in communities with excessive toddler mortality charges.

Presenting findings from the challenge on Tuesday throughout a media briefing, the NIMR’s Director of Analysis and principal investigator for the SARMAAN challenge, Oliver Ezechi, stated the primary section (SARMAAN I) was carried out throughout six states: Kano, Kebbi, Jigawa, Sokoto, Abia, and Akwa Ibom.

Mr Ezechi, a advisor obstetrician-gynaecologist, famous that the intervention goals to scale back Nigeria’s under-five demise charge, which stays among the many highest on the planet, by testing the protection and effectiveness of giving Azithromycin routinely to infants in high-risk communities.

He added that the research additionally monitored potential antimicrobial resistance (AMR) linked to the repeated use of the antibiotic.

“This challenge is about utilizing proof to drive options to considered one of our most urgent public well being challenges, little one survival,” he stated.

Why Azithromycin?

Azithromycin is a broad-spectrum antibiotic primarily identified to deal with bacterial infections.

The World Well being Organisation (WHO) recommends its periodic use in high-risk areas as a part of built-in little one survival methods, significantly the place toddler mortality exceeds 60 per 1,000 dwell births and under-five mortality exceeds 80 per 1,000.

Nevertheless, considerations about AMR stay in international locations like Nigeria. Mr Ezechi defined that SARMAAN I instantly addressed these considerations via NIMR’s information assortment on AMR developments.

Over three cycles of population-based AMR testing, the resistance charges declined from 41.1 per cent in cycle one to 26.5 per cent in cycle three, countering fears that mass drug administration would exacerbate AMR.

Mr Ezechi’s presentation confirmed that NIMR recorded a formidable protection per state, with Akwa Ibom reaching the best with 99 per cent, Kebbi, Sokoto and Abia states at 97 per cent respectively, adopted by Kano and Jigawa at 94 and 94 per cent respectively.

He admitted that one of many key drivers of success was early engagement with conventional and spiritual leaders.

Security considerations, subsequent section

The director additionally famous that the protection profile was constructive, with 98 per cent of handled kids having no opposed results, and solely two per cent reported vomiting and passage of stool.

Mr Ezechi famous that with the outcomes from SARMAAN I, the Nigerian authorities, via NIMR, has initiated SARMAAN II, increasing the goal age from one to 11 months to 1 to 59 months.

This section will contain over 9 million kids in seven states: Kano, Kaduna, Katsina, Kebbi, Sokoto, Jigawa, and Bauchi.

Achievements, Challenges

Past the profitable drug administration, researchers say the challenge has facilitated progress in Nigeria’s efforts to scale back little one mortality.

Talking on the important thing achievements of SARMAAN, Abideen Salako, a Analysis Fellow and Guide Paediatrician at NIMR, stated the initiative has helped set up that mass azithromycin administration is protected and doesn’t exacerbate antimicrobial resistance.

Up to now, over 3.5 million doses of azithromycin have been administered to kids throughout 96 native authorities areas in eight states below each SARMAAN I and II phases.

Mr Salako famous that the programme additionally demonstrated robust neighborhood acceptance, fostered state-level possession, and created direct and oblique employment alternatives for Nigerians concerned in implementation.

One main impediment, in response to Folahanmi Akinosolu one other analysis fellow at NIMR, is the poor recognition of the position analysis performs in nationwide improvement.

Mr Akinosolu, who’s a Public Well being specialist, defined that some states initially refused to take part even after figuring out a excessive illness prevalence.

“We needed to return to the identical policymakers as much as six instances to advocate earlier than they agreed,” he stated.

The analysis crew additionally confronted weak infrastructure, safety considerations, particularly in areas deemed unsafe for fieldwork and human useful resource constraints.

“We needed to transport organic samples from northern states to Lagos as a result of native labs weren’t well-equipped,” stated Mr Salako. “This not solely elevated prices but additionally delayed outcomes.”

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Concerning the analysis crew

The SARMAAN challenge is spearheaded by NIMR’s Centre for Reproductive and Inhabitants Well being Research (CRePHS), led by Mr Ezechi.

The centre works in collaboration with the Federal Ministry of Well being and companions like Sightsavers, eHealth Africa, Malaria Consortium, and Corona Administration Programs.

CRePHS’s broader work spans HIV/AIDS, cervical most cancers, and reproductive well being.

Mr Ezechi additionally famous that the centre has different programmes, together with a capacity-building initiative for younger researchers known as Emory-Nigeria HIV Analysis Coaching Programme.