Abstract
.Studies designed to determine the effects of mass administration of azithromycin on trachoma have suggested that mass azithromycin distributions may also reduce the prevalence of malaria. These studies have typically examined the impact of a small number of treatments over short durations. In this prespecified substudy of a cluster-randomized trial for trachoma, we compared malaria parasitemia prevalence in 24 communities in Niger randomized to receive either annual or biannual mass azithromycin distributions over 3 years. The 12 communities randomized to annual azithromycin received three treatments during the high-transmission season, and the 12 communities randomized to biannual azithromycin received a total of six treatments: three during the high-transmission season and three during the low-transmission season. Blood samples were taken to assess malariometric indices among children in all study communities at a single time point during the high-transmission season after 3 years of the intervention. No significant differences were identified in malaria parasitemia, parasite density, or hemoglobin concentration between the annual and biannual treatment arms. When compared with annual mass azithromycin alone, additional mass azithromycin distributions given during the low-transmission season did not significantly reduce the subsequent prevalence of malaria parasitemia or parasite density after 3 years, as measured during the high-transmission season.
Highlights
This study suggested that an additional mass distribution during the low-transmission season contributed to the lower prevalence found after 1 year of treatment.[11]
The 12 communities randomized to annual mass azithromycin had a mean of 138 children and the 12 biannually treated communities had a mean of 125 children 6–60 months of age (Figure 1)
In this cluster-randomized trial, we were unable to demonstrate a difference in malaria parasitemia, parasite density, or hemoglobin concentration between children who received annual or biannual treatment with azithromycin after 3 years of the intervention
Summary
Mass distributions of oral azithromycin are currently used to control ocular strains of Chlamydia in trachoma-endemic areas. Studies have identified potential secondary benefits of mass azithromycin given for trachoma among children, including reductions in the prevalence of malaria and its sequelae.[11,12,13,14] These prior trachoma studies examined the short-term effects of a small number of mass distributions of azithromycin on malaria. Trachoma programs typically give multiple rounds of azithromycin over the course of several years, and the longer term effects of these mass distributions on malaria are unclear
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