Keenan JD, Arzika AM, Maliki R, et al. - Researchers sought to ascertain the causes of mortality among deceased children using verbal autopsy. They designed a 2-year cluster-randomized controlled trial including 594 community clusters in Niger were assigned randomly (1:1 ratio) to receive biannual mass distributions of either oral azithromycin (approximately 20 mg per kg of body weight) or placebo targeted to children aged 1–59 months. In this trial, 3,615 child deaths were reported between Nov 23, 2014, and July 31, 2017, by use of biannual house-to-house censuses, and verbal autopsies were done between May 26, 2015, and May 17, 2018, to distinguish the cause of death. In this study, 303 communities (n = 40,375 children at baseline) in Niger received mass azithromycin and 291 communities (n = 35,747 children at baseline) received a placebo between Nov 23, 2014, and July 31, 2017. In children aged 1–59 months, they noted that mass azithromycin distribution occurred in approximately a third fewer deaths due to meningitis and dysentery, and fifth fewer deaths due to malaria and pneumonia. Between the azithromycin and placebo groups, the lack of difference in the distribution of causes of death could be attributable to the broad spectrum of azithromycin activity and the study setting, in which most childhood deaths were due to infections.