Solomon A , Zondervan M , Kuper H , Buchan J , Mabey DAF , 2006. Trachoma Control: A Guide for Programme Managers. Geneva, Switzerland: World Health Organization.
Resnikoff S , Pascolini D , Etya’ale D , Kocur I , Pararajasegaram R , Pokharel GP , Mariotti SP , 2004. Global data on visual impairment in the year 2002. Bull World Health Organ 82: 844–851.
Francis V , Turner V , Blindness WHOPftPo , 1995. Achieving Community Support for Trachoma Control: A Guide for District Health Work. Geneva, Switzerland: World Health Organization.
International Trachoma Initiative home page Available at: http://www.trachoma.org/. Accessed February 12, 2022.
Tao X et al.2021. The effectiveness of azithromycin mass drug administration on trachoma: a systematic review. Chin Med J (Engl) 134: 2944–2953.
Arzika AM , Maliki R , Boubacar N , Kane S , Cotter SY , Lebas E , 2019. Biannual mass azithromycin distributions and malaria parasitemia in pre-school children in Niger: a cluster-randomized, placebo-controlled trial. PLoS Med 16: e1002835.
Coles CL , Levens J , Seidman JC , Mkocha H , Munoz B , West S , 2012. Mass distribution of azithromycin for trachoma control is associated with short-term reduction in risk of acute lower respiratory infection in young children. Pediatr Infect Dis J 31: 341–346.
Coles CL , Seidman JC , Levens J , Mkocha H , Munoz B , West S , 2011. Association of mass treatment with azithromycin in trachoma-endemic communities with short-term reduced risk of diarrhea in young children. Am J Trop Med Hyg 85: 691–696.
Keenan JD et al.2018. Azithromycin to reduce childhood mortality in Sub-Saharan Africa. Engl J Med 378: 1583–1592.
Zeng L et al.2020. Safety of azithromycin in pediatrics: a systematic review and meta-analysis. Eur J Clin Pharmacol 76: 1709–1721.
O’Brien KS , Emerson P , Hooper PJ , Reingold AL , Dennis EG , Keenan JD , Lietman TM , Oldenburg CE , 2019. Antimicrobial resistance following mass azithromycin distribution for trachoma: a systematic review. Lancet Infect Dis 19: e14–e25.
O’Brien KS , Emerson P , Hooper PJ , Reingold AL , Dennis EG , Keenan JD , Lietman TM , Oldenburg CE , 2018. Antimicrobial resistance following mass azithromycin distribution for trachoma: a systematic review. Lancet Infect Dis 19: e14–e25.
Chandramohan D et al.2019. Effect of adding azithromycin to seasonal malaria chemoprevention. N Engl J Med 380: 2197–2206.
Keenan JD et al.2019. Longer-term assessment of azithromycin for reducing childhood mortality in Africa. N Engl J Med 380: 2207–2214.
Keenan JD , Ayele B , Gebre T , Zerihun M , Zhou Z , House JI , Gaynor BD , Porco TC , Emerson PM , Lietman TM , 2011. Childhood mortality in a cohort treated with mass azithromycin for trachoma. Clin Infect Dis 52: 883–888.
O’Brien KS et al.2018. Childhood mortality after mass distribution of azithromycin: a secondary analysis of the PRET cluster-randomized trial in Niger. PLoS Negl Trop Dis 37: 1082–1086.
Porco TC et al.2009. Effect of mass distribution of azithromycin for trachoma control on overall mortality in Ethiopian children: a randomized trial. JAMA 302: 962–968.
Bloch EM , Munoz B , Mrango Z , Weaver J , Mboera LEG , Lietman TM , Sullivan DJ Jr , West SK , 2019. The impact on malaria of biannual treatment with azithromycin in children age less than 5 years: a prospective study. Malar J 18: 284.
Hart JD , Edwards T , Burr SE , Harding-Esch EM , Takaoka K , Holland MJ , Sillah A , Mabey DC , Bailey RL , 2014. Effect of azithromycin mass drug administration for trachoma on spleen rates in Gambian children. Trop Med Int Health 19: 207–211.
Hart JD , Samikwa L , Sikina F , Kalua K , Keenan JD , Lietman TM , Burr SE , Bailey RL , 2020. Effects of biannual azithromycin mass drug administration on malaria in malawian children: a cluster-randomized trial. Am J Trop Med Hyg 103: 1329–1334.
Schachterle SE , Mtove G , Levens JP , Clemens E , Shi L , Raj A , Dumler JS , Munoz B , West S , Sullivan DJ , 2014. Short-term malaria reduction by single-dose azithromycin during mass drug administration for trachoma, Tanzania. Emerg Infect Dis 20: 941–949.
Gaynor BD et al.2014. Impact of mass azithromycin distribution on malaria parasitemia during the low-transmission season in Niger: a cluster-randomized trial. Am J Trop Med Hyg 90: 846–851.
O’Brien KS et al.2017. Mass azithromycin and malaria parasitemia in Niger: results from a community-randomized trial. Am J Trop Med Hyg 97: 696–701.
Oldenburg CE et al.2018. Annual versus biannual mass azithromycin distribution and malaria parasitemia during the peak transmission season among children in Niger. Pediatr Infect Dis J 37: 506–510.
Sadiq ST , Glasgow KW , Drakeley CJ , Muller O , Greenwood BM , Mabey DC , Bailey RL , 1995. Effects of azithromycin on malariometric indices in The Gambia. Lancet 346: 881–882.
Whitty CJ , Glasgow KW , Sadiq ST , Mabey DC , Bailey R , 1999. Impact of community-based mass treatment for trachoma with oral azithromycin on general morbidity in Gambian children. Pediatr Infect Dis J 18: 955–958.
Doan T et al.2018. Mass azithromycin distribution and community microbiome: a cluster-randomized trial. Open Forum Infect Dis 5: ofy182.
Doan T et al.2019. Gut microbiome alteration in MORDOR I: a community-randomized trial of mass azithromycin distribution. Nat Med 25: 1370–1376.
Leach AJ , Shelby-James TM , Mayo M , Gratten M , Laming AC , Currie BJ , Mathews JD , 1997. A prospective study of the impact of community-based azithromycin treatment of trachoma on carriage and resistance of Streptococcus pneumoniae. Clin Infect Dis 24: 356–362.
Batt SL , Charalambous BM , Solomon AW , Knirsch C , Massae PA , Safari S , Sam NE , Everett D , Mabey DC , Gillespie SH , 2003. Impact of azithromycin administration for trachoma control on the carriage of antibiotic-resistant Streptococcus pneumoniae. Antimicrob Agents Chemother 47: 2765–2769.
Burr SE et al.2014. Mass administration of azithromycin and Streptococcus pneumoniae carriage: cross-sectional surveys in The Gambia. Bull World Health Organ 92: 490–498.
Coles CL , Mabula K , Seidman JC , Levens J , Mkocha H , Munoz B , Mfinanga SG , West S , 2013. Mass distribution of azithromycin for trachoma control is associated with increased risk of azithromycin-resistant Streptococcus pneumoniae carriage in young children 6 months after treatment. Clin Infect Dis 56: 1519–1526.
Fry AM , Jha HC , Lietman TM , Chaudhary JS , Bhatta RC , Elliott J , Hyde T , Schuchat A , Gaynor B , Dowell SF , 2002. Adverse and beneficial secondary effects of mass treatment with azithromycin to eliminate blindness due to trachoma in Nepal. Clin Infect Dis 35: 395–402.
Haug S et al.2010. The decline of pneumococcal resistance after cessation of mass antibiotic distributions for trachoma. Clin Infect Dis 51: 571–574.
Skalet AH et al.2010. Antibiotic selection pressure and macrolide resistance in nasopharyngeal Streptococcus pneumoniae: a cluster-randomized clinical trial. PLoS Med 7: e1000377.
Doan T , Hinterwirth A , Arzika AM , Worden L , Chen C , Zhong L , Oldenburg CE , Keenan JD , Lietman TM , 2020. Reduction of coronavirus burden with mass azithromycin distribution. Clin Infect Dis 71: 2282–2284.
Amza A et al.2013. A cluster-randomized controlled trial evaluating the effects of mass azithromycin treatment on growth and nutrition in Niger. Am J Trop Med Hyg 88: 138–143.
Keenan JD et al.2019. Linear growth in preschool children treated with mass azithromycin distributions for trachoma: a cluster-randomized trial. PLoS Negl Trop Dis 13: e0007442.
Amza A et al.2014. Does mass azithromycin distribution impact child growth and nutrition in Niger? A cluster-randomized trial. PLoS Negl Trop Dis 8: e3128.
Burr SE , Hart J , Edwards T , Harding-Esch EM , Holland MJ , Mabey DC , Sillah A , Bailey RL , 2014. Anthropometric indices of Gambian children after one or three annual rounds of mass drug administration with azithromycin for trachoma control. BMC Public Health 14: 1176.
Gore-Langton GR et al.2020. Effect of adding azithromycin to the antimalarials used for seasonal malaria chemoprevention on the nutritional status of African children. Trop Med Int Health 25: 740–750.
Oldenburg CE et al.2018. Safety of azithromycin in infants under six months of age in Niger: a community randomized trial. PLoS Negl Trop Dis 12: e0006950.
Kalter HD , Roubanatou AM , Koffi A , Black RE , 2015. Direct estimates of national neonatal and child cause-specific mortality proportions in Niger by expert algorithm and physician-coded analysis of verbal autopsy interviews. J Glob Health 5: 010415.
Keenan JD et al.2020. Cause-specific mortality of children younger than 5 years in communities receiving biannual mass azithromycin treatment in Niger: verbal autopsy results from a cluster-randomised controlled trial. Lancet Glob Health 8: e288–e295.
Porco TC et al.2019. Efficacy of mass azithromycin distribution for reducing childhood mortality across geographic regions. Am J Trop Med Hyg 103: 1291–1294.
Oron AP , Burstein R , Mercer LD , Arzika AM , Kalua K , Mrango Z , West SK , Bailey RL , Porco TC , Lietman TM , 2020. Effect modification by baseline mortality in the MORDOR azithromycin trial. Am J Trop Med Hyg 103: 1295–1300.
Oldenburg CE et al.2019. Mass azithromycin distribution to prevent childhood mortality: a pooled analysis of cluster-randomized trials. Am J Trop Med Hyg 100: 691–695.
Porco TC et al.2018. Mass oral azithromycin for childhood mortality: timing of death after distribution in the MORDOR trial. Clin Infect Dis 68: 2114–2116.
Varo R , Chaccour C , Bassat Q , 2020. Update on malaria. Med Clin (Barc) 155: 395–402.
Bojang E et al.2017. Short-term increase in prevalence of nasopharyngeal carriage of macrolide-resistant Staphylococcus aureus following mass drug administration with azithromycin for trachoma control. BMC Microbiol 17: 75.
|Past two years||Past Year||Past 30 Days|
|Full Text Views||98||98||8|
The effects of azithromycin mass drug administration (MDA) on trachoma and yaws have been addressed. However, the secondary effects of azithromycin MDA remain unclear. This study aimed to explore the secondary effects of azithromycin MDA. PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched from conception to January 5, 2022. Studies on secondary effects of azithromycin MDA were included. A total of 34 studies were included. Six of them reported on child mortality, 10 on malaria, and 20 on general morbidity and condition. Azithromycin MDA reduced child mortality, and quarterly MDA may be most beneficial for reducing child mortality. The effect of azithromycin MDA on malaria was weak. No association was observed between azithromycin MDA and malaria parasitemia (rate ratio: 0.71, 95% confidence interval: 0.43–1.15). Azithromycin MDA was associated with a lower risk of respiratory tract infections and diarrhea. Additionally, it was associated with a lower risk of fever, vomiting, and headache. The carriage of pathogenic organisms such as Streptococcus pneumoniae and gut Campylobacter species was reduced. However, these secondary effects of azithromycin MDA appeared to last only a few weeks. Moreover, no association was observed between azithromycin MDA and nutritional improvement in children. In conclusion, azithromycin MDA had favorable secondary effects on child mortality and morbidity. However, the effects were short term.
Financial support: This work was supported by the National Science Foundation of China (Nos. 81971433, 81971428, 82171710); the grants from the WHO (WHO Registration 2018/859223-0); the National Key R&D Program of China (2021YFC2701704, 2017YFA0104200); and the grants from the Science and Technology Bureau of Sichuan Province (2021YJ0017, 2020YFS0041), the Fundamental Research Funds for the Central University (SCU2021D009), and National Key Project of Neonatal Children (1311200003303).
Authors’ addresses: Jinhui Li, Tao Xiong, Tao Xiong, Jun Tang, Jing Shi, Hua Wang, Yi Qu, and Dezhi Mu, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China, E-mails: firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, and email@example.com. Imti Choonara, University of Nottingham, Derbyshire Children’s Hospital, Derby, United Kingdom, E-mail: firstname.lastname@example.org. Shamim Qazi, Department of Maternal Newborn Child and Adolescent Health, World Health Organization, Geneva, Switzerland, E-mail: email@example.com.