Short-Term Malaria Reduction by Single-Dose Azithromycin during Mass Drug Administration for Trachoma, Tanzania

Schachterle, Stephen E.; Mtove, George; Levens, Joshua; Clemens, Emily G.; Shi, Lirong; Raj, Amrita; Dumler, J. Stephen; Muñoz, Beatriz; West, Shelia; Sullivan, David J.

doi:10.3201/eid2006.131302

Cited by 37 publications

(46 citation statements)

References 26 publications

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“…48,49 Unintended benefits of mass azithromycin distribution for trachoma control have previously been shown for common childhood infectious illness, such as diarrhea, pneumonia, and malaria. [50][51][52][53] The present study suggests that weight gain benefits of empiric antibiotic use may be observed with some antibiotic classes but not others, a hypothesis that should be tested in future studies of programs using empiric antibiotic treatment with various antibiotic classes. If true, collateral weight gain benefits of empiric antibiotic treatment could represent an opportunity for intervention in regions with high burdens of malnutrition, but such benefits may depend on the class of antibiotics used.…”

Section: Discussionmentioning

confidence: 71%

Effect of Antibiotics on Short-Term Growth among Children in Burkina Faso: A Randomized Trial

Sié

Dah

Ouermi

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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Antibiotics improve both weight and height gain in randomized trials of preschool children with preexisting morbidity. Here, we assess the effect of a short course of three different antibiotics (amoxicillin, azithromycin, and cotrimoxazole) on short-term linear and ponderal growth in a population-based sample of preschool children in rural Burkina Faso. We randomized households with at least two children in the Nouna district, Burkina Faso, to a 5-day course of amoxicillin, azithromycin, cotrimoxazole, or placebo. Within each antibiotic-randomized household, one child was randomly assigned to receive the antibiotic and the other to receive the placebo. Weight and height measurements were taken at baseline and 30 days following the last study medication dose. Weight-for-height (WHZ), height-for-age (HAZ), and weight-for-age (WAZ) scoreswere calculated based on the 2006 World Health Organization standards. Of the 124 households and 248 children enrolled, 229 had anthropometry measurements at 1 month and were analyzed. Children randomized to amoxicillin gained significantly more weight compared with both the placebo household (mean difference 317 g, 95% confidence interval [CI]: 115-519 g) and placebo sibling (mean difference 315 g, 95% CI: 147-482 g) controls. Growth velocity in g/kg/day, and WHZ and WAZ scores were higher in amoxicillin-treated children compared with placebo households and siblings. There were no differences in weight gain in children randomized to azithromycin or cotrimoxazole compared with placebo households or placebo siblings. There were no differences in height gain or HAZ across any of the study arms. Amoxicillin may have short-term growth-promoting effects in healthy children.

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Section: Discussionmentioning

confidence: 71%

Effect of Antibiotics on Short-Term Growth among Children in Burkina Faso: A Randomized Trial

Sié

Dah

Ouermi

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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“…Almost 900 million doses of azithromycin have been distributed by trachoma control programmes since 1999 42 and in Amhara alone 15 million doses are administered every year. 3 Mass distribution of azithromycin is likely to become more common as more evidence emerges of off-target effects such as reducing infectious diseases, 23,[43][44][45] diarrheal diseases 46 and childhood mortality. 22,[47][48][49][50] There is concern about the impact of these programmes on development of antimicrobial resistance in Ct and other bacteria.…”

Section: Resultsmentioning

confidence: 99%

Genomics of Ocular Chlamydia trachomatis after 5 years of SAFE interventions for trachoma in Amhara, Ethiopia

Pickering

Chernet

Sata

et al. 2020

Preprint

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BackgroundTo eliminate trachoma as a public health problem, the WHO recommends the SAFE strategy. As part of the SAFE strategy in the Amhara Region, Ethiopia, the Trachoma Control Program distributed over 124 million doses of antibiotic between 2007 and 2015. Despite these interventions, trachoma remained hyperendemic in many districts and a considerable level of Chlamydia trachomatis (Ct) infection was evident. Methods

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“…18,19 Azithromycin has some activity against malaria and has been shown in some studies of mass distribution for trachoma to affect parasitemia and splenomegaly. 10,12,20 In the same study in which communities were measured at the same time points, azithromycin was effective at reducing the burden of malaria parasitemia. Azithromycin distribution could hypothetically affect the relationship between malaria parasitemia and nutritional status if it affected either condition individually.…”

Section: Discussionmentioning

confidence: 96%

“…Azithromycin has modest activity against malaria by targeting the plasmodial apicoplast. 7,8 Although studies of mass azithromycin distribution for trachoma control have yielded mixed results, [9][10][11][12] a study of biannual mass azithromycin distribution for child mortality demonstrated a significant decrease in malaria parasitemia in communities receiving azithromycin compared with those receiving placebo. 13 Any relationship between malaria and malnutrition could potentially be affected by distribution of azithromycin to children given the overall effect in a reduction in malaria parasitemia.…”

Section: Introductionmentioning

confidence: 99%

Malaria Parasitemia and Nutritional Status during the Low Transmission Season in the Presence of Azithromycin Distribution among Preschool Children in Niger

Arzika

Maliki

Boubacar

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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The relationship between malaria and malnutrition is complicated, and existence of one may predispose or exacerbate the other. We evaluated the relationship between malaria parasitemia and nutritional status in children living in communities participating in a cluster-randomized trial of biannual azithromycin compared with placebo for prevention of childhood mortality. Data were collected during the low malaria transmission and low food insecurity season. Parasitemia was not associated with weight-for-height Z-score (24 months: P = 0.11 azithromycin communities, P = 0.75 placebo communities), weight-for-age Z-score (24 months: P = 0.83 azithromycin, P = 0.78 placebo), height-for-age Z-score (24 months: P = 0.30 azithromycin, P = 0.87 placebo), or mid-upper arm circumference (24 months: P = 0.12 azithromycin, P = 0.56 placebo). There was no statistically significant evidence of a difference in the relationship in communities receiving azithromycin or placebo. During the low transmission season, there was no evidence that malaria parasitemia and impaired nutritional status co-occur in children.

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Short-Term Malaria Reduction by Single-Dose Azithromycin during Mass Drug Administration for Trachoma, Tanzania

Abstract: This drug might be beneficial in areas to which malaria and trachoma are endemic.

Cited by 37 publications

References 26 publications

Effect of Antibiotics on Short-Term Growth among Children in Burkina Faso: A Randomized Trial

Effect of Antibiotics on Short-Term Growth among Children in Burkina Faso: A Randomized Trial

Genomics of Ocular Chlamydia trachomatis after 5 years of SAFE interventions for trachoma in Amhara, Ethiopia

Malaria Parasitemia and Nutritional Status during the Low Transmission Season in the Presence of Azithromycin Distribution among Preschool Children in Niger

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