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PASTEUR INSTITUTE - Research programme "BIRDY" on antibiotic-resistant diseases among young children in low-income countries

Project leader

Pasteur Institute

Location Madagascar
Dates 01/01/2014 31/12/2017
Intervention Area Health
Funding 600 000,00 €
Organisation internationale Institut Pasteur


Low-income countries account for more than 90% of the 8 million deaths of children under five throughout the world every year. These deaths are primarily linked to infectious diseases. The neonatal period (0–28 days), in other words 2% of a child’s life between the ages of 0 and 5, accounts for 40% of these deaths. The majority of these deaths are very likely linked to systemic bacterial infections. Moreover, the environment in these countries appears to have become particularly favourable to the emergence and spread of antibiotic-resistant bacteria (antibiotics are freely available and of dubious quality, living conditions are precarious, etc.). Resistance to antibiotics could contribute to significantly increasing mortality linked to these infections. Recent examples of the emergence and rapid spread of bacterial strains which are resistant to almost all currently available antibiotics reinforces the likelihood of this threat.

Although numerous institutional documents make reference to the existence of the problem of antibiotic-resistant bacteria in low-income countries, the data available is not sufficient to accurately assess the particular contribution of these problems to public health issues, in light of other infectious diseases which are considered to be the priority challenges facing these countries.


  • Children recruited into the Birdy cohort (recruitment goal: 2,500 children), who will benefit from optimum treatment in the event of an infection
  • Local health partners taking part in the project (primarily hospitals and secondary health centres), as well as matrons in Antananarivo and Moramanga, who will receive useful materials and equipment and be able to strengthen their medical expertise
  • In Antananarivo: Tsaralalana Hospital, Befelatanana Hospital, CenHoSoa (military hospital), Marie Stopes Clinic, St François d’Assise Clinic, Ste Fleur Clinic, Andravoahangy Basic Health Centre, Organisation Sanitaire Tananarivienne Inter Entreprises (OSTIE, Antananarivo Inter-Company Health Organisation), Dr Fidy Clinic, Modern Medical Center, Basic Health Centre Antanimeha
  • In Moramanga: District hospital, Mother and Child Health Centre, Urban Basic Health Centre, SMIMO health centre
  • The Institut Pasteur’s Pharmacoepidemiology and Infectious Disease Unit, which will benefit from increased staffing to enable it to coordinate the programme at the international level; at the heart of the unit’s activities, this will also serve as a genuine platform that can be used for ancillary research projects of interest (funded through other sources)
  • The Institut Pasteur of Madagascar will benefit from increased staffing to enable it to coordinate the Birdy programme at the local level, and it will also see a strengthening of its expertise (dedicated training, thesis project for the local epidemiology coordinator) and its equipment

Main objective

Implementation of the Birdy programme to combat antibiotic resistance among children in Madagascar. 

Specific objectives

  • To document in Madagascar cases of severe infection caused by resistant bacteria during the neonatal period and early childhood
  • To alert national and international policymakers on the problem of antibiotic resistance in low-income countries
  • To improve the treatment of children recruited as part of the Birdy cohort
  • To train young scientists in research (primarily in epidemiology and bacteriology), with a focus on antibiotic resistance
  • To introduce the Birdy programme into other low-income countries (Senegal, Cambodia)