Mass azithromycin for prevention of child mortality among children with acute malnutrition: A subgroup analysis of a cluster randomized controlled trial.
Children with acute malnutrition are at high risk of morality. Mass azithromycin distribution reduces all-cause mortality among children aged 1-59 months, and effects may be greater in underweight infants. Here, we evaluate the efficacy of azithromycin for reducing all-cause mortality in children ag...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2024-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0003875 |
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| author | Ali Sié Mamadou Ouattara Mamadou Bountogo Valentin Boudo Thierry Ouedraogo Clarisse Dah Guillaume Compaoré Elodie Lebas Huiyu Hu Travis C Porco Benjamin F Arnold Kieran S O'Brien Thomas M Lietman Catherine E Oldenburg |
| author_facet | Ali Sié Mamadou Ouattara Mamadou Bountogo Valentin Boudo Thierry Ouedraogo Clarisse Dah Guillaume Compaoré Elodie Lebas Huiyu Hu Travis C Porco Benjamin F Arnold Kieran S O'Brien Thomas M Lietman Catherine E Oldenburg |
| author_sort | Ali Sié |
| collection | DOAJ |
| description | Children with acute malnutrition are at high risk of morality. Mass azithromycin distribution reduces all-cause mortality among children aged 1-59 months, and effects may be greater in underweight infants. Here, we evaluate the efficacy of azithromycin for reducing all-cause mortality in children aged 6-59 months with acute malnutrition (mid-upper arm circumference, MUAC, < 12.5 cm). Communities in Nouna District, Burkina Faso were 1:1 randomized to biannual mass distribution of single dose azithromycin or placebo to all children aged 1-59 months. Mortality was assessed during each census and treatment round. MUAC measurements were collected for all children. We evaluated the effect of azithromycin on mortality in subgroups of children aged 6-59 months defined by acute malnutrition (MUAC < 12.5 cm versus MUAC ≥ 12.5 cm). In children with MUAC < 12.5 cm, mortality rates were 51% lower among those living in azithromycin communities compared to placebo (incidence rate ratio 0.49, 95% confidence interval, CI, 0.25 to 0.99; incidence rate difference -18.1 deaths per 1,000 person-years, 95% CI -37.0 to -0.01), which was greater than the reduction in mortality among children with MUAC ≥ 12.5 cm (P-value for interaction on the relative scale = 0.09; P-value for interaction of the additive scale = 0.03). Children with acute malnutrition may benefit from single dose azithromycin above and beyond those without acute malnutrition. Trial registration: ClinicalTrials.gov NCT03676764; https://clinicaltrials.gov/study/NCT03676764. |
| format | Article |
| id | doaj-art-7e511bb84e5f4102bde655be8e1ff94c |
| institution | OA Journals |
| issn | 2767-3375 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj-art-7e511bb84e5f4102bde655be8e1ff94c2025-08-20T01:57:40ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752024-01-01410e000387510.1371/journal.pgph.0003875Mass azithromycin for prevention of child mortality among children with acute malnutrition: A subgroup analysis of a cluster randomized controlled trial.Ali SiéMamadou OuattaraMamadou BountogoValentin BoudoThierry OuedraogoClarisse DahGuillaume CompaoréElodie LebasHuiyu HuTravis C PorcoBenjamin F ArnoldKieran S O'BrienThomas M LietmanCatherine E OldenburgChildren with acute malnutrition are at high risk of morality. Mass azithromycin distribution reduces all-cause mortality among children aged 1-59 months, and effects may be greater in underweight infants. Here, we evaluate the efficacy of azithromycin for reducing all-cause mortality in children aged 6-59 months with acute malnutrition (mid-upper arm circumference, MUAC, < 12.5 cm). Communities in Nouna District, Burkina Faso were 1:1 randomized to biannual mass distribution of single dose azithromycin or placebo to all children aged 1-59 months. Mortality was assessed during each census and treatment round. MUAC measurements were collected for all children. We evaluated the effect of azithromycin on mortality in subgroups of children aged 6-59 months defined by acute malnutrition (MUAC < 12.5 cm versus MUAC ≥ 12.5 cm). In children with MUAC < 12.5 cm, mortality rates were 51% lower among those living in azithromycin communities compared to placebo (incidence rate ratio 0.49, 95% confidence interval, CI, 0.25 to 0.99; incidence rate difference -18.1 deaths per 1,000 person-years, 95% CI -37.0 to -0.01), which was greater than the reduction in mortality among children with MUAC ≥ 12.5 cm (P-value for interaction on the relative scale = 0.09; P-value for interaction of the additive scale = 0.03). Children with acute malnutrition may benefit from single dose azithromycin above and beyond those without acute malnutrition. Trial registration: ClinicalTrials.gov NCT03676764; https://clinicaltrials.gov/study/NCT03676764.https://doi.org/10.1371/journal.pgph.0003875 |
| spellingShingle | Ali Sié Mamadou Ouattara Mamadou Bountogo Valentin Boudo Thierry Ouedraogo Clarisse Dah Guillaume Compaoré Elodie Lebas Huiyu Hu Travis C Porco Benjamin F Arnold Kieran S O'Brien Thomas M Lietman Catherine E Oldenburg Mass azithromycin for prevention of child mortality among children with acute malnutrition: A subgroup analysis of a cluster randomized controlled trial. PLOS Global Public Health |
| title | Mass azithromycin for prevention of child mortality among children with acute malnutrition: A subgroup analysis of a cluster randomized controlled trial. |
| title_full | Mass azithromycin for prevention of child mortality among children with acute malnutrition: A subgroup analysis of a cluster randomized controlled trial. |
| title_fullStr | Mass azithromycin for prevention of child mortality among children with acute malnutrition: A subgroup analysis of a cluster randomized controlled trial. |
| title_full_unstemmed | Mass azithromycin for prevention of child mortality among children with acute malnutrition: A subgroup analysis of a cluster randomized controlled trial. |
| title_short | Mass azithromycin for prevention of child mortality among children with acute malnutrition: A subgroup analysis of a cluster randomized controlled trial. |
| title_sort | mass azithromycin for prevention of child mortality among children with acute malnutrition a subgroup analysis of a cluster randomized controlled trial |
| url | https://doi.org/10.1371/journal.pgph.0003875 |
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