title: Mass distribution of azithromycin for trachoma control is associated with short-term reduction in risk of acute lower respiratory infection in young children.
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.
authors.affiliation: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. ccoles@jhsph.edu
authors.forename: Christian L
authors.initials: CL
authors.lastname: Coles
authors.forename: Joshua
authors.initials: J
authors.lastname: Levens
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Seidman
authors.forename: Harran
authors.initials: H
authors.lastname: Mkocha
authors.forename: Beatriz
authors.initials: B
authors.lastname: Munoz
authors.forename: Sheila
authors.initials: S
authors.lastname: West
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D002675:Child, Preschool; D015331:Cohort Studies; D004358:Drug Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000517:prevention & control*; D014141:Trachoma / Q000150:complications / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin