Self-Reported Side Effects following Mass Administration of Azithromycin to Eliminate Trachoma in Amhara, Ethiopia: Results from a Region-Wide Population-Based Survey.

Tigist Astale,Gedefaw Ayenew,Melsew Chanyalew,Zerihun Tadesse,Bizuayehu Gashaw,Elizabeth Kelly Callahan,Eshetu Sata,Scott D Nash,Zebene Ayele,Mulat Zerihun,Demelash Gessese,Berhanu Melak,Aisha E P Stewart,Andrew W Nute

doi:10.4269/ajtmh.18-0781

Abstract

.A region-wide population-based post–mass drug administration (MDA) coverage survey was conducted 3 weeks following the 2016 trachoma MDA in Amhara, Ethiopia. The prevalence of self-reported side effects was assessed among those who self-reported receiving azithromycin. A total of 16,773 individuals from 5,129 households reported taking azithromycin during the 2016 MDA in Amhara. The regional prevalence of any self-reported side effect was 9.6% (95% CI: 8.3–11.2%) and ranged from 3.9% to 12.4% among the 10 zones. The most common reported side effects were abdominal pain (53.1%), nausea (21.7%), vomiting (12.8%), and diarrhea (12.5%). Side-effect prevalence among female members was higher than in male members (11.6% versus 7.6%; P < 0.001) and increased with age. After an average of 8 years of annual MDA, the prevalence of self-reported side effects was less than 10% in this population.

Highlights

A fear of side effects has been identified by community members as a reason for not participating in neglected tropical disease Mass drug administration (MDA), including trachoma.[4,5,6,7,8]
Despite the excellent safety profile of azithromycin, a clearer understanding of the magnitude of reported side effects of azithromycin would be useful to guide trachoma control programs in designing specific strategies aimed at overcoming this barrier to high coverage.[9]
This survey estimated the prevalence of self-reported side effects from a population-based sample following a trachoma MDA in Amhara, a region with a mature trachoma control program

Summary

Introduction

High coverage is important for the success of an MDA program, key structural and behavioral barriers often exist which can hamper the effectiveness of this intervention.[3,4] A fear of side effects has been identified by community members as a reason for not participating in neglected tropical disease MDAs, including trachoma.[4,5,6,7,8] Despite the excellent safety profile of azithromycin, a clearer understanding of the magnitude of reported side effects of azithromycin would be useful to guide trachoma control programs in designing specific strategies aimed at overcoming this barrier to high coverage.[9]. After an average of 8 years of annual MDA, the prevalence of self-reported side effects was less than 10% in this population.

Results

Conclusion