Short-Term Malaria Reduction by Single-Dose Azithromycin during Mass Drug Administration for Trachoma,Tanzania |
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| Authors: | Stephen E. Schachterle George Mtove Joshua P. Levens Emily Clemens Lirong Shi Amrita Raj J. Stephen Dumler Beatriz Munoz Shelia West David J. Sullivan |
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| Affiliation: | Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (S.E. Schachterle, L. Shi, A. Raj, D.J. Sullivan); ;National Institute for Medical Research, Ubwari, Tanzania (G. Mtove); ; Johns Hopkins University School of Medicine, Baltimore (J.P. Levens, E. Clemens, J.S. Dumler, B. Munoz, S. West) |
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| Abstract: | Single-dose mass drug administration of azithromycin (AZT) is underway to eliminate trachoma worldwide. Studies in Ethiopia showed a reduction in all-cause childhood deaths after administration. To examine the effect of single-dose AZ MDA on prevalent malaria infections in a large prospective cohort of children and parents in Dodoma Province, Tanzania, we quantified the temporal prevalence of malaria parasitemia by real-time PCR for 6 months after single-dose AZT. In the first month after treatment but not in subsequent months, Plasmodium falciparum infections were reduced by 73% (95% CI 43%–89%) in treatment versus control villages and differences remained significant (p = 0.00497) in multivariate models with village-level random effects. Genetic sequencing of P. falciparum ribosomal L4 protein showed no mutations associated with AZT resistance. AZT mass drug administration caused a transient, 1-month antimalarial effect without selecting for P. falciparum ribosomal L4 resistance mutations in a region with a 10-year history of treating trachoma with this drug. |
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| Keywords: | malaria parasites azithromycin mass drug administration single dose prospective cohort study trachoma Tanzania |
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