title: Anthropometric indices of Gambian children after one or three annual rounds of mass drug administration with azithromycin for trachoma control.
abstract: BACKGROUND
  Mass drug administration (MDA) with azithromycin, carried out for the control of blinding trachoma, has been linked to reduced mortality in children. While the mechanism behind this reduction is unclear, it may be due, in part, to improved nutritional status via a potential reduction in the community burden of infectious disease. To determine whether MDA with azithromycin improves anthropometric indices at the community level, we measured the heights and weights of children aged 1 to 4 years in communities where one (single MDA arm) or three annual rounds (annual MDA arm) of azithromycin had been distributed.
  
  
  METHODS
  Data collection took place three years after treatment in the single MDA arm and one year after the final round of treatment in the annual MDA arm. Mean height-for-age, weight-for-age and weight-for-height z scores were compared between treatment arms.
  
  
  RESULTS
  No significant differences in mean height-for-age, weight-for-age or weight-for-height z scores were found between the annual MDA and single MDA arms, nor was there a significant reduction in prevalence of stunting, wasting or underweight between arms.
  
  
  CONCLUSIONS
  Our data do not provide evidence that community MDA with azithromycin improved anthropometric outcomes of children in The Gambia. This may suggest reductions in mortality associated with azithromycin MDA are due to a mechanism other than improved nutritional status.
authors.affiliation: Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK. Sarah.Burr@lshtm.ac.uk.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Burr
authors.forename: John
authors.initials: J
authors.lastname: Hart
authors.forename: Tansy
authors.initials: T
authors.lastname: Edwards
authors.forename: Emma M
authors.initials: EM
authors.lastname: Harding-Esch
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Holland
authors.forename: David C W
authors.initials: DC
authors.lastname: Mabey
authors.forename: Ansumana
authors.initials: A
authors.lastname: Sillah
authors.forename: Robin L
authors.initials: RL
authors.lastname: Bailey
mesh_terms: D000886:Anthropometry; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D002662:Child Health Services; D002675:Child, Preschool; D003153:Community Health Services; D005260:Female; D005714:Gambia; D006801:Humans; D007223:Infant; D008297:Male; D009752:Nutritional Status; D015995:Prevalence; D014141:Trachoma / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin