Ciciriello Allan M, Addiss David G, Teferi Tesfaye, Emerson Paul M, Hooper P J, Seid Mohammed, Tadesse Girma, Seife Fikre, Sormolo Mohammed-Aman Jemal, Kebede Fikreab, Kiflu Genet, West Sheila K, Alemu Menbere, LaCon Genevieve, Gebre Teshome
International Trachoma Initiative, The Task Force for Global Health, Decatur, GA 30030, USA.
Focus Area for Compassion and Ethics, The Task Force for Global Health, Decatur, GA 30030, USA.
Trans R Soc Trop Med Hyg. 2022 Oct 2;116(10):917-923. doi: 10.1093/trstmh/trac006.
The International Trachoma Initiative (ITI) provides azithromycin for mass drug administration (MDA) to eliminate trachoma as a public health problem. Azithromycin is given as tablets for adults and powder for oral suspension (POS) is recommended for children aged <7 y, children <120 cm in height (regardless of age) or anyone who reports difficulty in swallowing tablets. An observational assessment of MDA for trachoma was conducted to determine the frequency with which children aged 6 mo through 14 y received the recommended dose and form of azithromycin according to current dosing guidelines and to assess risk factors for choking and adverse swallowing events (ASEs).
MDA was observed in three regions of Ethiopia and data were collected on azithromycin administration and ASEs.
A total of 6477 azithromycin administrations were observed; 97.9% of children received the exact recommended dose. Of children aged 6 mo to <7 y or <120 cm in height, 99.6% received POS. One child experienced choking and 132 (2%) experienced ≥1 ASEs. Factors significantly associated with ASEs included age 6-11 mo or 1-6 y, non-calm demeanor and requiring coaxing prior to drug administration.
There is a high level of adherence to the revised azithromycin dosing guidelines and low incidence of choking and ASEs.
国际沙眼倡议（ITI）提供阿奇霉素用于大规模药物给药（MDA），以消除沙眼这一公共卫生问题。阿奇霉素给成人服用时为片剂，对于7岁以下儿童、身高低于120厘米的儿童（无论年龄）或任何报告吞咽片剂困难的人，建议使用口服混悬液粉剂（POS）。对沙眼MDA进行了一项观察性评估，以确定6个月至14岁儿童按照当前给药指南接受推荐剂量和剂型阿奇霉素的频率，并评估窒息和不良吞咽事件（ASE）的风险因素。
在埃塞俄比亚的三个地区观察MDA，并收集有关阿奇霉素给药和ASE的数据。
共观察到6477次阿奇霉素给药；97.9%的儿童接受了确切的推荐剂量。在6个月至7岁以下或身高低于120厘米的儿童中，99.6%接受了POS。1名儿童发生窒息，132名（2%）儿童发生≥1次ASE。与ASE显著相关的因素包括6-11个月或1-6岁、行为不平静以及给药前需要哄劝。
对修订后的阿奇霉素给药指南的依从性很高，窒息和ASE的发生率很低。
