Antimicrobial resistance
We will express AMR as the proportion of The nasopharyngeal and rectal samples will be collected from 4–14-month-old and 49–59-month-old children at the first visit to the village, at 12 months (MDA 5), at 24 months (visit 9), and at 36 months, i.e., 1 year after the last MDA for the villages. We will primarily calculate the proportion of R/I isolates from all isolates and secondarily the proportion of children with R/I isolate in their sample.We will test a sample of 1350 children aged 4–14 months at 24 months and aged 49–59 months at 36 months. At the three other time points, we will test 450 children (taken randomly from approximately 20 clusters/arm) from 4–14 months old and 49–59 months old, respectively. In total, this will mean 5400 AMR-analyses for We hypothesize the prevalence of AMR will exhibit an initial increase among 4–14-month-old individuals, followed by a subsequent decrease after cessation of the MDA intervention. In comparison, we anticipate that AMR prevalence will remain stationary among 49–59-month-old individuals across all three study arms throughout the course of the MDA cycles, as well as following the cessation of the intervention (Fig. The assumptions of AMR prevalence at baseline and follow-up visits in the 4–14-month-old and 49–59-month-old children. Graph is generated with hypothetical data for illustration of what the study team hypothesizesWe will employ probability weighting to account for the stratified sampling procedure used to select individuals from the village-age strata. The weights are calculated as the inverse of the selection probability for each individual in the sample, which enables weighted analysis of the dataset.