Short-term malaria reduction by single-dose azithromycin during mass drug administration for trachoma, Tanzania

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

Research output: Contribution to journalArticle

Abstract

Single-dose mass drug administration of azithromycin (AZT) is underway to eliminate trachoma worldwide. Studies in Ethiopia showed a reduction in all-cause childhood deaths after administration. To examine the effect of singledose AZ MDA on prevalent malaria infections in a large prospective cohort of children and parents in Dodoma Province, Tanzania, we quantified the temporal prevalence of malaria parasitemia by real-time PCR for 6 months after single-dose AZT. In the first month after treatment but not in subsequent months, Plasmodium falciparum infections were reduced by 73% (95% CI 43%-89%) in treatment versus control villages and differences remained significant (p = 0.00497) in multivariate models with village-level random effects. Genetic sequencing of P. falciparum ribosomal L4 protein showed no mutations associated with AZT resistance. AZT mass drug administration caused a transient, 1-month antimalarial effect without selecting for P. falciparum ribosomal L4 resistance mutations in a region with a 10-year history of treating trachoma with this drug.

Original languageEnglish (US)
Pages (from-to)941-949
Number of pages9
JournalEmerging infectious diseases
Volume20
Issue number6
DOIs
StatePublished - Jun 2014

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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