Chandramohan D, et al. - Among African children, researchers ascertained if the addition of azithromycin to the monthly sulfadoxine–pyrimethamine plus amodiaquine used for seasonal malaria chemoprevention could decrease mortality and morbidity. For this investigation, children 3 to 59 months of age were randomly assigned, according to household, to receive either azithromycin or placebo, together with sulfadoxine–pyrimethamine plus amodiaquine, during the annual malaria-transmission season in Burkina Faso and Mali. Among children in Burkina Faso and Mali, the addition of azithromycin to the antimalarial agents used for seasonal malaria chemoprevention did not lead to a lower incidence of death or hospital admission that was not due to trauma or surgery than antimalarial agents plus placebo, although a lower disease burden was observed with azithromycin than with placebo. Among children who received antimalarial agents plus placebo, the incidences of clinic visits for gastrointestinal infections, upper respiratory tract infections, and nonmalarial febrile illnesses, without adjustment for multiple comparisons, were lower among those who received antimalarial agents plus azithromycin.