Niamey

Researchers are evaluating the impact of mass drug administration MDA of azithromycin on child survival and antimicrobial resistance AMR in Niger. This adaptive platform trial aims to monitor under-5 mortality rates and AMR as the azithromycin program expands nationwide. The study also assesses how long the benefits of azithromycin MDA last considering the potential risk of increasing AMR, following World Health Organization guidelines for ongoing monitoring. Participants receive azithromycin distributed door-to-door to children aged 1 to 59 months by community health workers. The trial includes three groups continuous azithromycin distribution for four years, delayed distribution starting after two years, and stopping distribution after two years. The trial uses cluster randomization and plans re-randomization every two years to adapt interventions as needed. Throughout the study, researchers will monitor all-cause mortality at two and four years, along with resistance to macrolides found in nasopharyngeal and rectal swabs. Additional assessments include tracking infectious clinic visits and program costs. Participants and communities will be observed and tested regularly to understand the balance between azithromycins benefits and the development of antimicrobial resistance over time.

This registry collects detailed information about children diagnosed with cancer who are treated in pediatric oncology units affiliated with the French African Oncology Group in French-speaking Africa. Its goal is to gather data on patient numbers, cancer stage, treatments received, and outcomes to support better planning and delivery of pediatric oncology care in the region. The registry aims to provide valuable insights for local and national health authorities to improve pediatric cancer programs. Children and adolescents under 18 years old who present at participating pediatric oncology units and have any type of cancer are included in this observational registry. Data collected includes demographic information, socioeconomic status, clinical details, treatment status, vital status, treatment abandonment, and loss to follow-up. The information is entered online using the REDCap system and securely stored by the IT department at Gustave ROUSSY in Paris. Participants information is gathered continuously during their treatment and follow-up at the hospital units. The main measures tracked include the number of children suspected of having cancer within 12-month periods, their vital status, illness status, and treatment status. This ongoing data collection helps monitor outcomes and supports healthcare planning. Participation involves no experimental treatment and is focused on data recording and observation over time.

This research aims to evaluate whether a high-dose first-line treatment is as safe as the standard dosing for patients previously treated for rifampicin-susceptible recurrent Tuberculosis TB. This randomized clinical trial includes people with recurrent pulmonary TB to compare two regimens, focusing on safety and effectiveness in preventing resistance and relapse over time. The study has two stages Stage 1 compares a standard 6-month regimen 6EHRZ with a high-dose regimen 6EHRZ that uses triple doses of rifampicin and isoniazid alongside pyrazinamide and ethambutol. If the high-dose regimen is not found non-inferior, the study continues with the standard regimen and an adapted intervention. Stage 2 shifts to an observational cohort using only the standard regimen due to safety concerns. Patients receive daily treatment under supervision with monthly clinic visits and liver function tests at set intervals. Participants are closely monitored during and after treatment, including regular checks for adverse effects, treatment response, and TB relapse through sputum tests at six months and one year post-treatment. Researchers track safety outcomes such as serious adverse events and liver toxicity, as well as bacterial effectiveness and resistance development, with follow-up lasting up to 18 months.