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Optimizing the Number of Child Deaths Averted with Mass Azithromycin Distribution

Catherine E Oldenburg1,2,3, Ahmed M Arzika4, Ramatou Maliki4

  • 1Department of Ophthalmology, University of California, San Francisco, San Francisco, California.

The American Journal of Tropical Medicine and Hygiene
|February 19, 2020
PubMed

Insights

Targeting mass azithromycin distribution to younger children may avert fewer deaths. While antibiotic-sparing strategies are considered, treating all preschool children prevents more deaths than focusing on high-risk infants.

Area of Science:

  • Global Health
  • Infectious Diseases
  • Pediatrics

Background:

  • Biannual mass azithromycin distribution in children under five reduces mortality in sub-Saharan Africa.
  • Antibiotic-sparing strategies, like targeting younger children, are being explored to optimize azithromycin use.

Purpose of the Study:

  • To evaluate the impact of age-targeted azithromycin distribution on averted deaths.
  • To compare the number of deaths averted across different age groups in the Macrolides Oraux pour Réduire le Décès avec un Oeil sur la Résistance study.

Main Methods:

  • Analysis of data from the Macrolides Oraux pour Réduire le Décès avec un Oeil sur la Résistance study.
  • Comparison of deaths averted in three age cohorts: 1-5 months, 1-11 months, and 1-59 months.

Main Results:

  • Mass distribution to children aged 1-59 months averted 729 deaths (95% CI 492 to 966).
  • Targeting children aged 1-11 months averted 297 deaths (95% CI 168 to 427).
  • Focusing on the youngest infants (1-5 months) averted 126 deaths (95% CI 43 to 209).

Conclusions:

  • Limiting azithromycin treatment to higher-risk younger children may result in a lower absolute number of averted deaths.
  • Wider distribution to all preschool children appears more effective in reducing overall mortality compared to targeted approaches.

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