title: Impact of mass azithromycin distribution on malaria parasitemia during the low-transmission season in Niger: a cluster-randomized trial.
abstract: We assessed the effect of mass azithromycin treatment on malaria parasitemia in a trachoma trial in Niger. Twenty-four study communities received treatment during the wet, high-transmission season. Twelve of the 24 communities were randomized to receive an additional treatment during the dry, low-transmission season. Outcome measurements were conducted at the community-level in children < 1-72 months of age in May-June 2011. Parasitemia was higher in the 12 once-treated communities (29.8%, 95% confidence interval [CI] = 21.5-40.0%) than in the 12 twice-treated communities (19.5%, 95% CI = 13.0-26.5%, P = 0.03). Parasite density was higher in once-treated communities (354 parasites/μL, 95% CI = 117-528 parasites/μL) than in twice-treated communities (74 parasites/μL, 95% CI = 41-202 parasites/μL, P = 0.03). Mass distribution of azithromycin reduced malaria parasitemia 4-5 months after the intervention. The results suggest that drugs with antimalaria activity can have long-lasting impacts on malaria during periods of low transmission.
authors.affiliation: F.I. Proctor Foundation, Department of Ophthalmology, Department of Epidemiology and Biostatistics, Institute for Global Health, Department of Medicine, University of California, San Francisco, California; Programme National de Lutte Contre la Cecité Niamey, Niger; Zinder Hospital, Zinder, Niger; Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland; Clinical Research Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Gaynor
authors.forename: Abdou
authors.initials: A
authors.lastname: Amza
authors.forename: Boubacar
authors.initials: B
authors.lastname: Kadri
authors.forename: Baido
authors.initials: B
authors.lastname: Nassirou
authors.forename: Ousmane
authors.initials: O
authors.lastname: Lawan
authors.forename: Laouali
authors.initials: L
authors.lastname: Maman
authors.forename: Nicole E
authors.initials: NE
authors.lastname: Stoller
authors.forename: Sun N
authors.initials: SN
authors.lastname: Yu
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Chin
authors.forename: Sheila K
authors.initials: SK
authors.lastname: West
authors.forename: Robin L
authors.initials: RL
authors.lastname: Bailey
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Rosenthal
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Keenan
authors.forename: Travis C
authors.initials: TC
authors.lastname: Porco
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Lietman
mesh_terms: D017963:Azithromycin / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D016054:DNA, Protozoan / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008288:Malaria / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D009548:Niger / Q000453:epidemiology; D018512:Parasitemia / Q000188:drug therapy* / Q000453:epidemiology; D015995:Prevalence; D012621:Seasons; D016896:Treatment Outcome
chemical_list: D016054:DNA, Protozoan; D017963:Azithromycin