Kenyan researchers launch antibiotic trial for malnourished children with diarrhoea

The Kenya Medical Research Institute (KEMRI) and Amsterdam UMC, a university medical centre in the Netherlands, have launched a clinical trial to test whether antibiotics can reduce deaths and hospital admissions among malnourished children with acute watery diarrhoea in Kenya and Tanzania, KEMRI said on 23 October 2026.

The trial is called TARGET, short for Targeted Antibiotic Therapy for High-Risk Children with Watery Diarrhoea and Malnutrition. It will enrol about 2,800 children and compare two antibiotics, azithromycin and ciprofloxacin, with a placebo, a dummy treatment with no active drug. It has no results yet.

Current World Health Organization (WHO) guidelines do not routinely recommend antibiotics for acute watery diarrhoea, although bacterial infections may contribute to severe outcomes in some children, KEMRI said. Malnutrition makes children more vulnerable to infections and complications, and stronger evidence is needed to guide their treatment, it said.

In its fact sheet of 7 March 2024, the WHO says diarrhoea kills around 443,832 children under five every year and is a leading cause of malnutrition in that age group. It says diarrhoea should be treated with oral rehydration solution, a mix of clean water, sugar and salt, and that a 10–14-day course of dispersible zinc tablets shortens the illness.

Beyond the drug comparison, the study will look at stool-based biomarkers, measurable substances in a child's stool, that could help identify children most likely to benefit from antibiotics. It will also include laboratory work on bacterial infections and antimicrobial resistance, which is when bacteria stop responding to the drugs meant to kill them, and will examine the relationship between climate change and diarrhoeal disease.

Dr Richard Omore, the KEMRI principal investigator, said: "We must generate robust evidence to guide decisions rather than rely on assumptions." Dr Vanessa Harris, a clinical infectious disease specialist at Amsterdam UMC, called the trial "a great opportunity to address an important gap in the management of children with malnutrition and acute watery diarrhoea". Both were quoted in KEMRI's statement.

The consortium met in Kenya from 13 to 15 October 2026 for its kick-off. KEMRI is the Kenyan partner. In Tanzania the partners are Haydom Lutheran Hospital, the National Institute for Medical Research and the Tanzania Meteorological Authority. The University of Virginia, Emory University and the University of Washington in the United States are associated partners.

The trial is supported by the Global Health EDCTP3 Joint Undertaking, with co-funding from the European Union, KEMRI said. The Joint Undertaking announced on 8 June 2026 that TARGET would receive €5.8 million. The European Commission's CORDIS project database lists Amsterdam UMC as coordinator and gives KEMRI a net EU contribution of €1,841,235, out of a total of €5,799,966.25.

The project has also advertised three PhD and six Master's degree scholarships to support emerging researchers and strengthen local scientific expertise, KEMRI said.