title: Does mass azithromycin distribution impact child growth and nutrition in Niger? A cluster-randomized trial.
abstract: BACKGROUND
  Antibiotic use on animals demonstrates improved growth regardless of whether or not there is clinical evidence of infectious disease. Antibiotics used for trachoma control may play an unintended benefit of improving child growth.
  
  
  METHODS
  In this sub-study of a larger randomized controlled trial, we assess anthropometry of pre-school children in a community-randomized trial of mass oral azithromycin distributions for trachoma in Niger. We measured height, weight, and mid-upper arm circumference (MUAC) in 12 communities randomized to receive annual mass azithromycin treatment of everyone versus 12 communities randomized to receive biannual mass azithromycin treatments for children, 3 years after the initial mass treatment. We collected measurements in 1,034 children aged 6-60 months of age.
  
  
  RESULTS
  We found no difference in the prevalence of wasting among children in the 12 annually treated communities that received three mass azithromycin distributions compared to the 12 biannually treated communities that received six mass azithromycin distributions (odds ratio = 0.88, 95% confidence interval = 0.53 to 1.49).
  
  
  CONCLUSIONS
  We were unable to demonstrate a statistically significant difference in stunting, underweight, and low MUAC of pre-school children in communities randomized to annual mass azithromycin treatment or biannual mass azithromycin treatment. The role of antibiotics on child growth and nutrition remains unclear, but larger studies and longitudinal trials may help determine any association.
authors.affiliation: Programme FSS/Université Abdou Moumouni de Niamey, Programme National de Santé Oculaire, Niamey, Niger.
authors.forename: Abdou
authors.initials: A
authors.lastname: Amza
authors.affiliation: F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Sun N
authors.initials: SN
authors.lastname: Yu
authors.affiliation: Programme FSS/Université Abdou Moumouni de Niamey, Programme National de Santé Oculaire, Niamey, Niger.
authors.forename: Boubacar
authors.initials: B
authors.lastname: Kadri
authors.affiliation: Programme FSS/Université Abdou Moumouni de Niamey, Programme National de Santé Oculaire, Niamey, Niger.
authors.forename: Baido
authors.initials: B
authors.lastname: Nassirou
authors.affiliation: F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Nicole E
authors.initials: NE
authors.lastname: Stoller
authors.affiliation: F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Zhaoxia
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Sheila K
authors.initials: SK
authors.lastname: West
authors.affiliation: Clinical Research Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Robin L
authors.initials: RL
authors.lastname: Bailey
authors.affiliation: F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, United States of America; Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Gaynor
authors.affiliation: F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, United States of America; Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Keenan
authors.affiliation: F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, United States of America; Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, United States of America; Institute for Global Health, University of California, San Francisco, California, United States of America.
authors.forename: Travis C
authors.initials: TC
authors.lastname: Porco
authors.affiliation: F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, United States of America; Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States of America; Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, United States of America; Institute for Global Health, University of California, San Francisco, California, United States of America.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Lietman
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017963:Azithromycin / Q000008:administration & dosage / Q000627:therapeutic use*; D001835:Body Weight; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D016000:Cluster Analysis; D003141:Communicable Diseases / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009548:Niger / Q000453:epidemiology; D009752:Nutritional Status; D013851:Thinness; D014141:Trachoma / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin