Department of Pediatrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Academic Division of Child Health, University of Nottingham, Derbyshire Children's Hospital, Derby, United Kingdom.
Am J Trop Med Hyg. 2022 Aug 15;107(4):904-911. doi: 10.4269/ajtmh.22-0134. Print 2022 Oct 12.
The effects of azithromycin mass drug administration (MDA) on trachoma and yaws have been addressed. However, the secondary effects of azithromycin MDA remain unclear. This study aimed to explore the secondary effects of azithromycin MDA. PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched from conception to January 5, 2022. Studies on secondary effects of azithromycin MDA were included. A total of 34 studies were included. Six of them reported on child mortality, 10 on malaria, and 20 on general morbidity and condition. Azithromycin MDA reduced child mortality, and quarterly MDA may be most beneficial for reducing child mortality. The effect of azithromycin MDA on malaria was weak. No association was observed between azithromycin MDA and malaria parasitemia (rate ratio: 0.71, 95% confidence interval: 0.43-1.15). Azithromycin MDA was associated with a lower risk of respiratory tract infections and diarrhea. Additionally, it was associated with a lower risk of fever, vomiting, and headache. The carriage of pathogenic organisms such as Streptococcus pneumoniae and gut Campylobacter species was reduced. However, these secondary effects of azithromycin MDA appeared to last only a few weeks. Moreover, no association was observed between azithromycin MDA and nutritional improvement in children. In conclusion, azithromycin MDA had favorable secondary effects on child mortality and morbidity. However, the effects were short term.
阿奇霉素大规模药物管理（MDA）对沙眼和雅司病的影响已经得到解决。然而，阿奇霉素 MDA 的次要影响仍不清楚。本研究旨在探讨阿奇霉素 MDA 的次要影响。从概念到 2022 年 1 月 5 日，检索了 PubMed、Embase、Cochrane Library、Web of Science 和 ClinicalTrials.gov。纳入了阿奇霉素 MDA 次要影响的研究。共纳入 34 项研究。其中 6 项报告了儿童死亡率，10 项报告了疟疾，20 项报告了一般发病率和病情。阿奇霉素 MDA 降低了儿童死亡率，每季度 MDA 可能最有利于降低儿童死亡率。阿奇霉素 MDA 对疟疾的影响较弱。阿奇霉素 MDA 与疟疾寄生虫血症之间无关联（率比：0.71，95%置信区间：0.43-1.15）。阿奇霉素 MDA 与呼吸道感染和腹泻的风险降低相关。此外，它还与发热、呕吐和头痛的风险降低相关。携带肺炎链球菌和肠道弯曲杆菌等病原体的风险降低。然而，这些阿奇霉素 MDA 的次要影响似乎只持续几周。此外，阿奇霉素 MDA 与儿童营养改善之间没有关联。总之，阿奇霉素 MDA 对儿童死亡率和发病率有有利的次要影响。然而，这些影响是短期的。
