Biannual versus annual mass azithromycin distribution and malaria seroepidemiology among preschool children in Niger: a sub-study of a cluster randomized trial

Malaria Journal

Robin L. Bailey¹  Sheila K. West²  Benjamin F. Arnold³  Philip J. Rosenthal⁴  Gretchen Cooley⁵  Diana L. Martin⁵  Jeremy D. Keenan⁶  Catherine E. Oldenburg⁶  Thomas M. Lietman⁶  Kieran S. O’Brien⁶  Travis C. Porco⁶  Abdou Amza⁷  Beido Nassirou⁷  Boubacar Kadri⁷ 

[1] Clinical Research Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine;Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University;Department of Epidemiology, University of California, Berkeley;Department of Medicine, University of California, San Francisco;Division of Parasitic Diseases and Malaria, Centers for Disease Prevention and Control;Francis I Proctor Foundation, University of California, San Francisco;Programme FSS/Université Abdou Moumouni de Niamey, Programme Nationale des Soins Oculaire;

关键词: Malaria;    Azithromycin;    Niger;    Mass drug administration;   

DOI  :  10.1186/s12936-019-3033-2

来源: DOAJ

【 摘 要 】

Abstract Background Biannual mass azithromycin administration to preschool children reduces all-cause mortality, but the mechanism for the effect is not understood. Azithromycin has activity against malaria parasites, and malaria is a leading cause of child mortality in the Sahel. The effect of biannual versus annual azithromycin distribution for trachoma control on serological response to merozoite surface protein 1 (MSP-119), a surrogate for malaria incidence, was evaluated among children in Niger. Methods Markers of malaria exposure were measured in two arms of a factorial randomized controlled trial designed to evaluate targeted biannual azithromycin distribution to children under 12 years of age compared to annual azithromycin to the entire community for trachoma control (N = 12 communities per arm). Communities were treated for 36 months (6 versus 3 distributions). Dried blood spots were collected at 36 months among children ages 1–5 years, and MSP-119 antibody levels were assessed using a bead-based multiplex assay to measure malaria seroprevalence. Results Antibody results were available for 991 children. MSP-119 seropositivity was 62.7% in the biannual distribution arm compared to 68.7% in the annual arm (prevalence ratio 0.91, 95% CI 0.83 to 1.00). Mean semi-quantitative antibody levels were lower in the biannual distribution arm compared to the annual arm (mean difference − 0.39, 95% CI − 0.05 to − 0.72). Conclusions Targeted biannual azithromycin distribution was associated with lower malaria seroprevalence compared to that in a population that received annual distribution. Trial Registration Clinicaltrials.gov NCT00792922

【 授权许可】

Unknown