| Mphatso Dennis Phiri, Matthew Cairns, Issaka Zongo, Frederic Nikiema, Modibo Diarra, Rakiswendé Serge Yerbanga, Amadou Barry, Amadou Tapily, Samba Coumare, Ismaila Thera, Irene Kuepfer, Paul Milligan, Halidou Tinto, Alassane Dicko, Jean Bosco Ouédraogo, Brian Greenwood, Daniel Chandramohan, Issaka Sagara The duration of protection from azithromycin against malaria, acute respiratory, gastrointestinal, and skin infections when given alongside seasonal malaria chemoprevention: Secondary analyses of data from a clinical trial in houndé, Burkina Faso, and bougouni, Mali (Journal Article) In: Clin. Infect. Dis., vol. 73, no. 7, pp. e2379–e2386, 2021, ISSN: 1537-6591 1058-4838, (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.
PMID: 33417683
PMCID: PMC8492219). @article{Phiri2021-oy,
title = {The duration of protection from azithromycin against malaria, acute respiratory, gastrointestinal, and skin infections when given alongside seasonal malaria chemoprevention: Secondary analyses of data from a clinical trial in hound\'{e}, Burkina Faso, and bougouni, Mali},
author = {Mphatso Dennis Phiri and Matthew Cairns and Issaka Zongo and Frederic Nikiema and Modibo Diarra and Rakiswend\'{e} Serge Yerbanga and Amadou Barry and Amadou Tapily and Samba Coumare and Ismaila Thera and Irene Kuepfer and Paul Milligan and Halidou Tinto and Alassane Dicko and Jean Bosco Ou\'{e}draogo and Brian Greenwood and Daniel Chandramohan and Issaka Sagara},
doi = {10.1093/cid/ciaa1905},
issn = {1537-6591 1058-4838},
year = {2021},
date = {2021-10-01},
urldate = {2021-10-01},
journal = {Clin. Infect. Dis.},
volume = {73},
number = {7},
pages = {e2379--e2386},
publisher = {Oxford University Press (OUP)},
abstract = {BACKGROUND: Mass drug administration (MDA) with azithromycin
(AZ) is being considered as a strategy to promote child survival
in sub-Saharan Africa, but the mechanism by which AZ reduces
mortality is unclear. To better understand the nature and extent
of protection provided by AZ, we explored the profile of
protection by time since administration, using data from a
household-randomized, placebo-controlled trial in Burkina Faso
and Mali. METHODS: Between 2014 and 2016, 30 977 children aged
3-59 months received seasonal malaria chemoprevention (SMC) with
sulfadoxine-pyrimethamine plus amodiaquine and either AZ or
placebo monthly, on 4 occasions each year. Poisson regression
with gamma-distributed random effects, accounting for the
household randomization and within-individual clustering of
illness episodes, was used to compare incidence of prespecified
outcomes between SMC+AZ versus SMC+placebo groups in fixed time
strata post-treatment. The likelihood ratio test was used to
assess evidence for a time-treatment group interaction. RESULTS:
Relative to SMC+placebo, there was no evidence of protection
from SMC+AZ against hospital admissions and deaths. Additional
protection from SMC+AZ against malaria was confined to the first
2 weeks post-administration (protective efficacy (PE): 24.2%
[95% CI: 17.8%, 30.1%]). Gastroenteritis and pneumonia were
reduced by 29.9% [21.7; 37.3%], and 34.3% [14.9; 49.3%],
respectively, in the first 2 weeks postadministration.
Protection against nonmalaria fevers with a skin condition
persisted up to 28 days: PE: 46.3% [35.1; 55.6%]. CONCLUSIONS:
The benefits of AZ-MDA are broad-ranging but short-lived. To
maximize impact, timing of AZ-MDA must address the challenge of
targeting asynchronous morbidity and mortality peaks from
different causes.},
note = {© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.
PMID: 33417683
PMCID: PMC8492219},
keywords = {Antimalarials/therapeutic use, Azithromycin, Azithromycin/therapeutic use, Burkina Faso/epidemiology, Chemoprevention, Child, child mortality, Drug Combinations, duration of protection, Humans, Infant, Malaria/drug therapy/epidemiology/prevention \& control, Mali/epidemiology, Preschool, Sahel, seasonal malaria chemoprevention, Seasons},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Mass drug administration (MDA) with azithromycin
(AZ) is being considered as a strategy to promote child survival
in sub-Saharan Africa, but the mechanism by which AZ reduces
mortality is unclear. To better understand the nature and extent
of protection provided by AZ, we explored the profile of
protection by time since administration, using data from a
household-randomized, placebo-controlled trial in Burkina Faso
and Mali. METHODS: Between 2014 and 2016, 30 977 children aged
3-59 months received seasonal malaria chemoprevention (SMC) with
sulfadoxine-pyrimethamine plus amodiaquine and either AZ or
placebo monthly, on 4 occasions each year. Poisson regression
with gamma-distributed random effects, accounting for the
household randomization and within-individual clustering of
illness episodes, was used to compare incidence of prespecified
outcomes between SMC+AZ versus SMC+placebo groups in fixed time
strata post-treatment. The likelihood ratio test was used to
assess evidence for a time-treatment group interaction. RESULTS:
Relative to SMC+placebo, there was no evidence of protection
from SMC+AZ against hospital admissions and deaths. Additional
protection from SMC+AZ against malaria was confined to the first
2 weeks post-administration (protective efficacy (PE): 24.2%
[95% CI: 17.8%, 30.1%]). Gastroenteritis and pneumonia were
reduced by 29.9% [21.7; 37.3%], and 34.3% [14.9; 49.3%],
respectively, in the first 2 weeks postadministration.
Protection against nonmalaria fevers with a skin condition
persisted up to 28 days: PE: 46.3% [35.1; 55.6%]. CONCLUSIONS:
The benefits of AZ-MDA are broad-ranging but short-lived. To
maximize impact, timing of AZ-MDA must address the challenge of
targeting asynchronous morbidity and mortality peaks from
different causes. |
| Navideh Noori, Karim Derra, Innocent Valea, Assaf P Oron, Aminata Welgo, Toussaint Rouamba, Palwende Romuald Boua, Athanase M Somé, Eli Rouamba, Edward Wenger, Hermann Sorgho, Halidou Tinto, Andre Lin Ouédraogo Patterns of child mortality in rural area of Burkina Faso: evidence from the Nanoro health and demographic surveillance system (HDSS) (Journal Article) In: BMC Public Health, vol. 21, no. 1, pp. 1425, 2021, ISSN: 1471-2458, (© 2021. The Author(s).
PMID: 34281547
PMCID: PMC8287796). @article{Noori2021-te,
title = {Patterns of child mortality in rural area of Burkina Faso: evidence from the Nanoro health and demographic surveillance system (HDSS)},
author = {Navideh Noori and Karim Derra and Innocent Valea and Assaf P Oron and Aminata Welgo and Toussaint Rouamba and Palwende Romuald Boua and Athanase M Som\'{e} and Eli Rouamba and Edward Wenger and Hermann Sorgho and Halidou Tinto and Andre Lin Ou\'{e}draogo},
doi = {10.1186/s12889-021-11483-4},
issn = {1471-2458},
year = {2021},
date = {2021-07-19},
urldate = {2021-07-19},
journal = {BMC Public Health},
volume = {21},
number = {1},
pages = {1425},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: Half of global child deaths occur in sub-Saharan
Africa. Understanding child mortality patterns and risk factors
will help inform interventions to reduce this heavy toll. The
Nanoro Health and Demographic Surveillance System (HDSS),
Burkina Faso was described previously, but patterns and
potential drivers of heterogeneity in child mortality in the
district had not been studied. Similar studies in other
districts indicated proximity to health facilities as a risk
factor, usually without distinction between facility types.
METHODS: Using Nanoro HDSS data from 2009 to 2013, we estimated
the association between under-5 mortality and proximity to
inpatient and outpatient health facilities, seasonality of
death, age group, and standard demographic risk factors.
RESULTS: Living in homes 40-60 min and \> 60 min travel time from
an inpatient facility was associated with 1.52 (95% CI:
1.13-2.06) and 1.74 (95% CI: 1.27-2.40) greater hazard of
under-5 mortality, respectively, than living in homes \< 20 min
from an inpatient facility. No such association was found for
outpatient facilities. The wet season (July-November) was
associated with 1.28 (95% CI: 1.07, 1.53) higher under-5
mortality than the dry season (December-June), likely reflecting
the malaria season. CONCLUSIONS: Our results emphasize the
importance of geographical proximity to health care, distinguish
between inpatient and outpatient facilities, and also show a
seasonal effect, probably driven by malaria.},
note = {© 2021. The Author(s).
PMID: 34281547
PMCID: PMC8287796},
keywords = {Burkina Faso, Burkina Faso/epidemiology, child mortality, ChildHealth Facilities, Children under 5, Demographic surveillance, HDSS, Humans, Infant, Malaria, Nanoro, Spatial analysis, Travel},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Half of global child deaths occur in sub-Saharan
Africa. Understanding child mortality patterns and risk factors
will help inform interventions to reduce this heavy toll. The
Nanoro Health and Demographic Surveillance System (HDSS),
Burkina Faso was described previously, but patterns and
potential drivers of heterogeneity in child mortality in the
district had not been studied. Similar studies in other
districts indicated proximity to health facilities as a risk
factor, usually without distinction between facility types.
METHODS: Using Nanoro HDSS data from 2009 to 2013, we estimated
the association between under-5 mortality and proximity to
inpatient and outpatient health facilities, seasonality of
death, age group, and standard demographic risk factors.
RESULTS: Living in homes 40-60 min and > 60 min travel time from
an inpatient facility was associated with 1.52 (95% CI:
1.13-2.06) and 1.74 (95% CI: 1.27-2.40) greater hazard of
under-5 mortality, respectively, than living in homes < 20 min
from an inpatient facility. No such association was found for
outpatient facilities. The wet season (July-November) was
associated with 1.28 (95% CI: 1.07, 1.53) higher under-5
mortality than the dry season (December-June), likely reflecting
the malaria season. CONCLUSIONS: Our results emphasize the
importance of geographical proximity to health care, distinguish
between inpatient and outpatient facilities, and also show a
seasonal effect, probably driven by malaria. |