Effect of biannual azithromycin on respiratory pathogens among symptomatic children: results from the randomised Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) I trial
Introduction Biannual (ie, every 6 months) mass drug administration of azithromycin has reduced childhood mortality in Niger, but its effects on specific respiratory pathogens are not fully elucidated.Methods Across 2 years of the Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistanc...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/10/2/e016043.full |
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| author | Jie Liu Thomas M Lietman Jeremy D Keenan Kieran S O'Brien Elodie Lebas Amza Abdou Benjamin F Arnold James A Platts-Mills Eric R Houpt Stephanie A Brennhofer Elizabeth T Rogawski McQuade Ramatou Maliki Jixian Zhang Suzanne Stroup Suporn Pholwat Ahmed M Arzika |
| author_facet | Jie Liu Thomas M Lietman Jeremy D Keenan Kieran S O'Brien Elodie Lebas Amza Abdou Benjamin F Arnold James A Platts-Mills Eric R Houpt Stephanie A Brennhofer Elizabeth T Rogawski McQuade Ramatou Maliki Jixian Zhang Suzanne Stroup Suporn Pholwat Ahmed M Arzika |
| author_sort | Jie Liu |
| collection | DOAJ |
| description | Introduction Biannual (ie, every 6 months) mass drug administration of azithromycin has reduced childhood mortality in Niger, but its effects on specific respiratory pathogens are not fully elucidated.Methods Across 2 years of the Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) study in Niger, we evaluated 1468 nasopharyngeal swabs from children who presented for care with respiratory symptoms. Swabs were tested by quantitative PCR using a customised TaqMan Array Card that included assays for 19 respiratory pathogens.Results Nasopharyngeal detection of Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae was common in both azithromycin and placebo communities. The prevalence was reduced in children from azithromycin communities for just two pathogens: Bordetella pertussis and H. influenzae type b (Hib). These children had a 49% and 65% reduction in the prevalence of B. pertussis and Hib in nasopharyngeal swabs, respectively, compared with children from the control communities (prevalence ratios 0.51, 95% CI 0.35, 0.75; and 0.35, 95% CI 0.17, 0.71).Conclusions Biannual administration of azithromycin to communities in Niger was associated with lower prevalence of B. pertussis and Hib compared with placebo. These reductions may explain some of the childhood mortality benefit of azithromycin.Trial registration number NCT02048007. |
| format | Article |
| id | doaj-art-46bfabd1c23b4211bf7584c6f3ea7ff5 |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-46bfabd1c23b4211bf7584c6f3ea7ff52025-02-11T09:30:11ZengBMJ Publishing GroupBMJ Global Health2059-79082025-02-0110210.1136/bmjgh-2024-016043Effect of biannual azithromycin on respiratory pathogens among symptomatic children: results from the randomised Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) I trialJie Liu0Thomas M Lietman1Jeremy D Keenan2Kieran S O'Brien3Elodie Lebas4Amza Abdou5Benjamin F Arnold6James A Platts-Mills7Eric R Houpt8Stephanie A Brennhofer9Elizabeth T Rogawski McQuade10Ramatou Maliki11Jixian Zhang12Suzanne Stroup13Suporn Pholwat14Ahmed M Arzika15School of Public Health, Qingdao University, Qingdao, Shandong, ChinaFrancis I Proctor Foundation, University of California San Francisco, San Francisco, California, USAFrancis I Proctor Foundation, University of California San Francisco, San Francisco, California, USAFrancis I Proctor Foundation, University of California San Francisco, San Francisco, California, USAFrancis I Proctor Foundation, University of California San Francisco, San Francisco, California, USAProgramme Nationale de Santé Oculaire, Niamey, NigerFrancis I Proctor Foundation, University of California San Francisco, San Francisco, California, USADivision of Infectious Diseases & International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USADivision of Infectious Diseases & International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USADivision of Infectious Diseases & International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USADepartment of Epidemiology, Emory University, Atlanta, Georgia, USACarter Center, Niamey, NigerDivision of Infectious Diseases & International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USADivision of Infectious Diseases & International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USADivision of Infectious Diseases & International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USACentre de Recherche et Interventions en Sante Publique, Niamey, NigerIntroduction Biannual (ie, every 6 months) mass drug administration of azithromycin has reduced childhood mortality in Niger, but its effects on specific respiratory pathogens are not fully elucidated.Methods Across 2 years of the Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) study in Niger, we evaluated 1468 nasopharyngeal swabs from children who presented for care with respiratory symptoms. Swabs were tested by quantitative PCR using a customised TaqMan Array Card that included assays for 19 respiratory pathogens.Results Nasopharyngeal detection of Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae was common in both azithromycin and placebo communities. The prevalence was reduced in children from azithromycin communities for just two pathogens: Bordetella pertussis and H. influenzae type b (Hib). These children had a 49% and 65% reduction in the prevalence of B. pertussis and Hib in nasopharyngeal swabs, respectively, compared with children from the control communities (prevalence ratios 0.51, 95% CI 0.35, 0.75; and 0.35, 95% CI 0.17, 0.71).Conclusions Biannual administration of azithromycin to communities in Niger was associated with lower prevalence of B. pertussis and Hib compared with placebo. These reductions may explain some of the childhood mortality benefit of azithromycin.Trial registration number NCT02048007.https://gh.bmj.com/content/10/2/e016043.full |
| spellingShingle | Jie Liu Thomas M Lietman Jeremy D Keenan Kieran S O'Brien Elodie Lebas Amza Abdou Benjamin F Arnold James A Platts-Mills Eric R Houpt Stephanie A Brennhofer Elizabeth T Rogawski McQuade Ramatou Maliki Jixian Zhang Suzanne Stroup Suporn Pholwat Ahmed M Arzika Effect of biannual azithromycin on respiratory pathogens among symptomatic children: results from the randomised Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) I trial BMJ Global Health |
| title | Effect of biannual azithromycin on respiratory pathogens among symptomatic children: results from the randomised Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) I trial |
| title_full | Effect of biannual azithromycin on respiratory pathogens among symptomatic children: results from the randomised Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) I trial |
| title_fullStr | Effect of biannual azithromycin on respiratory pathogens among symptomatic children: results from the randomised Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) I trial |
| title_full_unstemmed | Effect of biannual azithromycin on respiratory pathogens among symptomatic children: results from the randomised Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) I trial |
| title_short | Effect of biannual azithromycin on respiratory pathogens among symptomatic children: results from the randomised Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) I trial |
| title_sort | effect of biannual azithromycin on respiratory pathogens among symptomatic children results from the randomised macrolides oraux pour reduire les deces avec un oeil sur la resistance mordor i trial |
| url | https://gh.bmj.com/content/10/2/e016043.full |
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