Mass Oral Azithromycin for Childhood Mortality: Timing of Death After Distribution in the MORDOR Trial

Travis C Porco, John Hart, Ahmed M Arzika, Jerusha Weaver, Khumbo Kalua, Zakayo Mrango, Sun Y Cotter, Nicole E Stoller, Kieran S O'Brien, Dionna M Fry, Benjamin Vanderschelden, Catherine E Oldenburg, Sheila K West, Robin L Bailey, Jeremy D Keenan, Thomas M Lietman, Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) Study Group, Travis C Porco, John Hart, Ahmed M Arzika, Jerusha Weaver, Khumbo Kalua, Zakayo Mrango, Sun Y Cotter, Nicole E Stoller, Kieran S O'Brien, Dionna M Fry, Benjamin Vanderschelden, Catherine E Oldenburg, Sheila K West, Robin L Bailey, Jeremy D Keenan, Thomas M Lietman, Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) Study Group

Abstract

In a large community-randomized trial, biannual azithromycin distributions significantly reduced postneonatal childhood mortality in sub-Saharan African sites. Here, we present a prespecified secondary analysis showing that much of the protective effect was in the first 3 months postdistribution. Distributing more frequently than biannually could be considered if logistically feasible. Clinical Trials Registration. NCT02047981.

Keywords: azithromycin; childhood mortality; sub-Saharan Africa.

© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America.

Figures

Figure 1.
Figure 1.
Excess mortality in the first 2 months in the control group, compared to the treatment group, is seen in the difference between estimated mortality time density estimates. The horizontal axis depicts time in days from the beginning of each phase. The vertical axis shows the difference between the density of mortality times in the control and treatment groups (smoothed with a Gaussian kernel of bandwidth 0.1 month). Results from Malawi are presented in red, Niger in purple, Tanzania in green, and total in black. Note that this displays the difference between 2 probability distributions, and thus an excess at one time would necessarily be balanced by a deficit at another.

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Source: PubMed

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