Single-dose azithromycin for child growth in Burkina Faso: a randomized controlled trial

Sié, Ali; Coulibaly, Boubacar; Dah, Clarisse; Bountogo, Mamadou; Ouattara, Mamadou; Compaoré, Guillaume; Brogdon, Jessica; Godwin, William W; Lebas, Elodie; Doan, Thuy; Arnold, Benjamin F.; Porco, Travis C.; Lietman, Thomas M.; Oldenburg, Catherine E.

doi:10.1186/s12887-021-02601-7

Cited by 7 publications

(11 citation statements)

References 30 publications

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“…A randomized trial 18 in Malawi found that antibiotics improved childhood growth and decreased mortality when given in the setting of severe acute malnutrition, although other similar trials 19 , 20 have found no benefit. A randomized trial 21 from Burkina Faso found greater weight gain among children administered a single dose of azithromycin at 14 days but not at 6 months.…”

Section: Discussionmentioning

confidence: 99%

Effect of Mass Azithromycin Distributions on Childhood Growth in Niger

et al. 2021

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IMPORTANCEMass azithromycin distributions may decrease childhood mortality, although the causal pathway is unclear. The potential for antibiotics to function as growth promoters may explain some of the mortality benefit. OBJECTIVE To investigate whether biannual mass azithromycin distributions are associated with increased childhood growth. DESIGN, SETTING, AND PARTICIPANTS This cluster-randomized trial was performed from December 2014 until March 2020 among 30 rural communities in Boboye and Loga departments in Niger, Africa, with populations from 200 to 2000 individuals. Communities were randomized in a 1:1 ratio to biannual mass distributions of azithromycin or placebo for children ages 1 to 59 months. Participants, field-workers, and study personnel were masked to treatment allocation. Height and weight changes from baseline to follow-up at 4 years were compared between groups. Data were analyzed from June through November 2021. INTERVENTIONS Participants received azithromycin at 20 mg/kg using height-based approximation or by weight for children unable to stand every 6 months at the participants' households. Placebo contained the vehicle of the azithromycin suspension. MAIN OUTCOMES AND MEASURES Longitudinal anthropometric assessments were performed on a random sample of children before the first treatment and then annually for 5 years. Height and weight were the prespecified primary outcomes. RESULTS Among 3936 children enrolled from 30 communities, baseline characteristics were similar between 1299 children in the azithromycin group and 2637 children in the placebo group (mean 48.2% [95% CI, 45.5% to 50.8%] girls vs 48.0% [95% CI, 45.7% to 50.3%] girls; mean age, 30.8 months [95% CI, 29.5 to 32.0 months] vs 30.6 months [95% CI, 29.2 to 31.6 months]). Baseline anthropometric assessments were performed among 2230 children, including 985 children in the azithromycin group and 1245 children in the placebo group, of whom follow-up measurements were available for 789 children (80.1%) and 1063 children (85.4%), respectively. At the prespecified 4-yearfollow-up visit, children in the azithromycin group gained a mean 6.7 cm (95% CI, 6.5 to 6.8 cm) in height and 1.7 kg (95% CI, 1.7 to 1.8 kg) in weight per year and children in the placebo group gained a mean 6.6 cm (95% CI, 6.4 to 6.7 cm) in height and 1.7 kg (95% CI, 1.7 to 1.8 kg) in weight per year.Height at 4 years was not statistically significantly different between groups when adjusted for baseline height (0.08 cm [95% CI, −0.12 to 0.28 cm] greater in the azithromycin group; P = .45), and neither was weight when adjusted for height and baseline weight (0.02 kg [95% CI, −0.10 to 0.06 kg] less in the azithromycin group; P = .64). However, among children in the shortest quartile of (continued) Key Points Question Do biannual mass azithromycin distributions, which have been shown to decrease child mortality in sub-Saharan Africa, promote child growth? Findings In this placebo-controlled cluster-randomized trial with longitudinal anthropometric monitoring among 22...

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Section: Discussionmentioning

confidence: 99%

Effect of Mass Azithromycin Distributions on Childhood Growth in Niger

et al. 2021

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“…Physiological criteria, including body and thymus weight, were determined following the methods described by Farhangi et al ( 2017 ) and Kong et al ( 2018 ). The weight gain velocity (Sié et al, 2021 ; Stahr et al, 2021 ) was calculated with the formula below: when: N > 2, M = N ‐2; N = 1, M = 0,

…”

Section: Methodsmentioning

confidence: 99%

“…Physiological criteria, including body and thymus weight, were determined following the methods described by Farhangi et al (2017) and Kong et al (2018). The weight gain velocity (Sié et al, 2021; Stahr et al, 2021) was calculated with the formula below: when: N > 2, M = N ‐2; N = 1, M = 0,

weight gain velocity goodbreak= \frac{weight at N weeks - weight at M weeks}{weight at M weeks} goodbreak\times 100 % .

…”

Section: Methodsmentioning

confidence: 99%

Donkey whey protein and peptides regulate gut microbiota community and physiological functions of D‐galactose‐induced aging mice

Zhou

Tian

Li³

et al. 2022

Food Science & Nutrition

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The prolongation of life span has attracted more and more attention in the current world. Gut microbiota is considered one of the most critical elements and is essential in regulating life span and quality. The effects of donkey whey protein (DWP) and donkey whey hydrolysate (DWPP) on physiological functions and gut microbiota of D‐galactose‐induced aging mice were investigated to find new strategies for resisting aging. Our results showed that DWP and DWPP could increase the body weight gain velocity, superoxide dismutase (SOD) activity, and thymus index, whereas decrease the level of reactive oxygen species (ROS) and malondialdehyde (MDA), and improve the aging of the body in the liver congestion, oozy draw focal sclerosis of chronic inflammation. The effects of medium and high concentrations of DWP and low and medium concentrations of DWPP were the same as the vitamin C (Vc)‐positive control group. It was found that both DWP and DWPP could change α‐diversity; the relative abundance of Lactobacillus increased, whereas the relative abundance of Helicobacter and Stenotrophomonas decreased after being treated with DWP and DWPP. The correlation between intestinal microflora and physiological indexes showed that chao1, ACE, and observed species indexes in the α index were positively correlated with weight gain velocity, SOD activity, and thymus index. The relative abundance of Lactobacillus was positively correlated with SOD and thymus index but negatively correlated with MDA. The relative abundance of Stenotrophomonas was opposite to that of Lactobacillus . The Anaerobiospirillum , Fusobacterium , and Dubosiella had a significant positive correlation with the weight gain velocity. The study provided a deeper more profound understanding of the potential use of DWP and DWPP in senescence delays.

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“…Specific antibiotics within these classes, such as azithromycin and Ceftiofur Crystalline Free Acid (CCFA), can be given as a single dose or abbreviated course and offers refinement options for veterinarians as one‐time dosing or abbreviated courses may be utilized. Reports in the literature have shown that a single, high‐dose azithromycin for the treatment of shigellosis in children resulted in increased weight and survivability 11 . In human medicine, a 5‐day tapering dose of azithromycin, also known by brand names Zithromax™ and Z‐Pak™, can be used for a variety of clinical diseases due to its wide spectrum of activity 12 .…”

Section: Introductionmentioning

confidence: 99%

“…Reports in the literature have shown that a single, high‐dose azithromycin for the treatment of shigellosis in children resulted in increased weight and survivability. 11 In human medicine, a 5‐day tapering dose of azithromycin, also known by brand names Zithromax™ and Z‐Pak™, can be used for a variety of clinical diseases due to its wide spectrum of activity. 12 Additionally, CCFA, a fourth generation cephalosporin, has been demonstrated to reach therapeutic concentrations in macaques for at least 7 days when given as a one‐time convenient dose.…”

Section: Introductionmentioning

confidence: 99%

A comparison of different antibiotic regimens for the treatment of naturally acquired shigellosis in rhesus and pigtailed macaques (Macaca mulatta and nemestrina)

Maxwell

Herrod

Hutchinson

2022

J of Medical Primatology

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Shigella spp. are non-spore forming, facultatively anaerobic, gramnegative rods that are transmitted fecal-orally and a major causative agent of dysentery in humans and non-human primates. 1,2 Shigella remains an important pathogen worldwide and is a major cause of morbidity among humans, particularly in children under the age of 5. 2 In the United States alone, it accounts for an estimated 450 000 infections per year. 2 Based on biochemical and serological properties, Shigella can be separated into four serotypes, which include sonnei, boydii, dysenteriae, and flexneri. All four serotypes are important causes of morbidity and mortality in humans particularly in low-resource areas. 2 Captive non-human primates may acquire shigellosis due to their close contact with humans or from conspecifics in endemically infected colonies, with S. flexneri being the most frequent serotype isolated. [1][2][3] The symptoms of shigellosis range from acute life threatening disease to subclinical carrier states. 1,4 Acute cases often present as severe dysentery with bloody mucoid diarrhea, anorexia, weight loss, and secondary dehydration resulting in rapid decline and potentially death. 1,4 The development of disease relies on invasion of bacteria into the colonic epithelial cells resulting in mucosal inflammation, hemorrhage, and necrosis. 5 While subclinical carriers appear clinically healthy, they remain an important source of infection to conspecifics and laboratory animal workers. 1 Animals may also develop non-enteric forms of the disease including reactive arthritis,

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Single-dose azithromycin for child growth in Burkina Faso: a randomized controlled trial

Cited by 7 publications

References 30 publications

Effect of Mass Azithromycin Distributions on Childhood Growth in Niger

Effect of Mass Azithromycin Distributions on Childhood Growth in Niger

Donkey whey protein and peptides regulate gut microbiota community and physiological functions of D‐galactose‐induced aging mice

A comparison of different antibiotic regimens for the treatment of naturally acquired shigellosis in rhesus and pigtailed macaques (Macaca mulatta and nemestrina)

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