The impact on malaria of biannual treatment with azithromycin in children age less than 5 years: a prospective study
Abstract Background The MORDOR study, a cluster randomized clinical trial, showed that single-dose azithromycin (20 mg/kg) administered biannually for 2 years to preschool children reduced mortality; a study was conducted to determine its effect on clinical symptomatic episodes of malaria as a poten...
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ftdoajarticles:oai:doaj.org/article:1ce4b9fe250b4f13a317140586ae2184 2023-05-15T15:17:47+02:00 The impact on malaria of biannual treatment with azithromycin in children age less than 5 years: a prospective study Evan M. Bloch Beatriz Munoz Zakayo Mrango Jerusha Weaver Leonard E. G. Mboera Tom M. Lietman David J. Sullivan Sheila K. West 2019-08-01T00:00:00Z https://doi.org/10.1186/s12936-019-2914-8 https://doaj.org/article/1ce4b9fe250b4f13a317140586ae2184 EN eng BMC http://link.springer.com/article/10.1186/s12936-019-2914-8 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-019-2914-8 1475-2875 https://doaj.org/article/1ce4b9fe250b4f13a317140586ae2184 Malaria Journal, Vol 18, Iss 1, Pp 1-9 (2019) Malaria Clinical trial Azithromycin Child mortality Tanzania Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2019 ftdoajarticles https://doi.org/10.1186/s12936-019-2914-8 2022-12-31T13:31:44Z Abstract Background The MORDOR study, a cluster randomized clinical trial, showed that single-dose azithromycin (20 mg/kg) administered biannually for 2 years to preschool children reduced mortality; a study was conducted to determine its effect on clinical symptomatic episodes of malaria as a potential mechanism for mortality benefit. Methods A randomized control trial (RCT) was conducted, whereby 30 randomly selected communities in Kilosa District, Tanzania were randomized to receive 6-monthly treatment of children ages 1–59 months with single-dose azithromycin (20 mg/kg) vs. placebo. A prospective cohort study was nested within the RCT: children, aged 1 to 35 months at baseline, were randomly selected in each community and evaluated at 6-monthly intervals for 2 years. At each visit, the children were assessed for recent or ongoing fever and anti-malarial treatment; a rapid diagnostic test (RDT) for malaria was performed. The two major outcomes of interest were prevalence of RDT positivity and clinical malaria. The latter was defined as RDT-positivity with fever at time of evaluation and/or reported fever in the 3 days prior to evaluation. Methods that account for correlations at community level and within individuals over time were used to evaluate associations. Results At baseline, the prevalence rates in the children in the azithromycin and placebo arms were 17.6% vs. 15.5% for RDT positivity (p = 0.76) and 6.1% vs. 4.3% (p = 0.56) for clinical malaria. There was a decline in both RDT-positivity and clinical malaria over time in both arms. The difference by treatment assignment was not significant for clinical malaria; it was significant for RDT-positivity with greater odds of decline in the placebo arm (p = 0.01). Conclusions Lack of evidence for a significant difference in the prevalence of clinical malaria in children at any visit following treatment suggests that the effect of single-dose azithromycin on malaria is at best transient and limited in scope. Chance overrepresentation of non-seasonal ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 18 1 |
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English |
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Malaria Clinical trial Azithromycin Child mortality Tanzania Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Malaria Clinical trial Azithromycin Child mortality Tanzania Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Evan M. Bloch Beatriz Munoz Zakayo Mrango Jerusha Weaver Leonard E. G. Mboera Tom M. Lietman David J. Sullivan Sheila K. West The impact on malaria of biannual treatment with azithromycin in children age less than 5 years: a prospective study |
topic_facet |
Malaria Clinical trial Azithromycin Child mortality Tanzania Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background The MORDOR study, a cluster randomized clinical trial, showed that single-dose azithromycin (20 mg/kg) administered biannually for 2 years to preschool children reduced mortality; a study was conducted to determine its effect on clinical symptomatic episodes of malaria as a potential mechanism for mortality benefit. Methods A randomized control trial (RCT) was conducted, whereby 30 randomly selected communities in Kilosa District, Tanzania were randomized to receive 6-monthly treatment of children ages 1–59 months with single-dose azithromycin (20 mg/kg) vs. placebo. A prospective cohort study was nested within the RCT: children, aged 1 to 35 months at baseline, were randomly selected in each community and evaluated at 6-monthly intervals for 2 years. At each visit, the children were assessed for recent or ongoing fever and anti-malarial treatment; a rapid diagnostic test (RDT) for malaria was performed. The two major outcomes of interest were prevalence of RDT positivity and clinical malaria. The latter was defined as RDT-positivity with fever at time of evaluation and/or reported fever in the 3 days prior to evaluation. Methods that account for correlations at community level and within individuals over time were used to evaluate associations. Results At baseline, the prevalence rates in the children in the azithromycin and placebo arms were 17.6% vs. 15.5% for RDT positivity (p = 0.76) and 6.1% vs. 4.3% (p = 0.56) for clinical malaria. There was a decline in both RDT-positivity and clinical malaria over time in both arms. The difference by treatment assignment was not significant for clinical malaria; it was significant for RDT-positivity with greater odds of decline in the placebo arm (p = 0.01). Conclusions Lack of evidence for a significant difference in the prevalence of clinical malaria in children at any visit following treatment suggests that the effect of single-dose azithromycin on malaria is at best transient and limited in scope. Chance overrepresentation of non-seasonal ... |
format |
Article in Journal/Newspaper |
author |
Evan M. Bloch Beatriz Munoz Zakayo Mrango Jerusha Weaver Leonard E. G. Mboera Tom M. Lietman David J. Sullivan Sheila K. West |
author_facet |
Evan M. Bloch Beatriz Munoz Zakayo Mrango Jerusha Weaver Leonard E. G. Mboera Tom M. Lietman David J. Sullivan Sheila K. West |
author_sort |
Evan M. Bloch |
title |
The impact on malaria of biannual treatment with azithromycin in children age less than 5 years: a prospective study |
title_short |
The impact on malaria of biannual treatment with azithromycin in children age less than 5 years: a prospective study |
title_full |
The impact on malaria of biannual treatment with azithromycin in children age less than 5 years: a prospective study |
title_fullStr |
The impact on malaria of biannual treatment with azithromycin in children age less than 5 years: a prospective study |
title_full_unstemmed |
The impact on malaria of biannual treatment with azithromycin in children age less than 5 years: a prospective study |
title_sort |
impact on malaria of biannual treatment with azithromycin in children age less than 5 years: a prospective study |
publisher |
BMC |
publishDate |
2019 |
url |
https://doi.org/10.1186/s12936-019-2914-8 https://doaj.org/article/1ce4b9fe250b4f13a317140586ae2184 |
geographic |
Arctic |
geographic_facet |
Arctic |
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Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 18, Iss 1, Pp 1-9 (2019) |
op_relation |
http://link.springer.com/article/10.1186/s12936-019-2914-8 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-019-2914-8 1475-2875 https://doaj.org/article/1ce4b9fe250b4f13a317140586ae2184 |
op_doi |
https://doi.org/10.1186/s12936-019-2914-8 |
container_title |
Malaria Journal |
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18 |
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1 |
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1766348021443854336 |