Mass distribution of azithromycin for trachoma control is associated with short-term reduction in risk of acute lower respiratory infection in young children

Christian L. Coles, Joshua Levens, Jessica C. Seidman, Harran Mkocha, Beatriz Munoz, Sheila K West

Research output: Contribution to journalArticle

Abstract

Background: We evaluated the effect of a single mass distribution of azithromycin for trachoma on the risk of acute lower respiratory infection (ALRI) during a 6-month period among young children living in 8 communities in rural Tanzania. Methods: In 8 communities, a cohort of randomly selected children (n = 1036) was followed for incidence of ALRI episodes. Mass treatment for trachoma using a single dose of oral azithromycin was provided in 4 of the 8 communities where trachoma prevalence was >10%. All children were followed with biweekly surveillance at home for 6 months. Incidence of ALRI episodes was calculated for 0 to 1 month, 1 to 3 months, and 3 to 6 months posttreatment and in comparable time points in the nontreated villages. Results: In the multivariate analysis, living in a MDA village was associated with a 38% (rate ratio 5 0.62, 95% confidence interval [CI] = 0.43-0.91) decreased risk of ALRI in the 0-to 1-month follow-up period as compared with those in the untreated communities after adjusting for covariates and clustering. There were no significant differences in ALRI incidence by exposure status in the 1-to 3-month (rate ratio = 0.91, 95% CI = 0.69-1.20) and in the 3-to 6-month (rate ratio = 1.00, 95% CI = 0.76-1.30) follow-up periods. Conclusions: Mass distribution of a single dose of oral azithromycin for trachoma is associated with a significant short-term reduction in ALRI morbidity among young children.

Original languageEnglish (US)
Pages (from-to)341-346
Number of pages6
JournalPediatric Infectious Disease Journal
Volume31
Issue number4
DOIs
StatePublished - Apr 2012

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Trachoma
Azithromycin
Risk Reduction Behavior
Respiratory Tract Infections
Confidence Intervals
Incidence
Tanzania
Rural Population
Cluster Analysis
Multivariate Analysis
Morbidity

Keywords

  • acute lower respiratory infection
  • Africa
  • azithromycin
  • children
  • trachoma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases
  • Microbiology (medical)

Cite this

Mass distribution of azithromycin for trachoma control is associated with short-term reduction in risk of acute lower respiratory infection in young children. / Coles, Christian L.; Levens, Joshua; Seidman, Jessica C.; Mkocha, Harran; Munoz, Beatriz; West, Sheila K.

In: Pediatric Infectious Disease Journal, Vol. 31, No. 4, 04.2012, p. 341-346.

Research output: Contribution to journalArticle

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abstract = "Background: We evaluated the effect of a single mass distribution of azithromycin for trachoma on the risk of acute lower respiratory infection (ALRI) during a 6-month period among young children living in 8 communities in rural Tanzania. Methods: In 8 communities, a cohort of randomly selected children (n = 1036) was followed for incidence of ALRI episodes. Mass treatment for trachoma using a single dose of oral azithromycin was provided in 4 of the 8 communities where trachoma prevalence was >10{\%}. All children were followed with biweekly surveillance at home for 6 months. Incidence of ALRI episodes was calculated for 0 to 1 month, 1 to 3 months, and 3 to 6 months posttreatment and in comparable time points in the nontreated villages. Results: In the multivariate analysis, living in a MDA village was associated with a 38{\%} (rate ratio 5 0.62, 95{\%} confidence interval [CI] = 0.43-0.91) decreased risk of ALRI in the 0-to 1-month follow-up period as compared with those in the untreated communities after adjusting for covariates and clustering. There were no significant differences in ALRI incidence by exposure status in the 1-to 3-month (rate ratio = 0.91, 95{\%} CI = 0.69-1.20) and in the 3-to 6-month (rate ratio = 1.00, 95{\%} CI = 0.76-1.30) follow-up periods. Conclusions: Mass distribution of a single dose of oral azithromycin for trachoma is associated with a significant short-term reduction in ALRI morbidity among young children.",
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