Effectiveness of azithromycin mass drug administration on trachoma: a systematic review.
10.1097/CM9.0000000000001717
- Author:
Tao XIONG
1
;
Yan YUE
2
;
Wen-Xing LI
1
;
Imti CHOONARA
3
;
Shamim QAZI
4
;
Hong-Ju CHEN
1
;
Jun TANG
1
;
Jing SHI
1
;
Hua WANG
1
;
Li-Nan ZENG
5
;
Bin XIA
1
;
Li-Na QIAO
1
;
Yi QU
1
;
De-Zhi MU
2
Author Information
1. 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 610041, China.
2. Key Laboratory of Obstetrics & Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China.
3. Academic Division of Child Health, University of Nottingham, Derbyshire Children's Hospital, Derby, UK.
4. Department of Maternal Newborn Child and Adolescent Health, World Health Organization, Geneva, Switzerland.
5. Department of Pharmacy, Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, Chengdu, Sichuan 610041, China.
- Publication Type:Systematic Review
- MeSH:
Anti-Bacterial Agents/therapeutic use*;
Azithromycin/therapeutic use*;
Humans;
Infant;
Mass Drug Administration;
Prevalence;
Trachoma/epidemiology*
- From:
Chinese Medical Journal
2021;134(24):2944-2953
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDS:Azithromycin mass drug administration (MDA) is a key part of the strategy for controlling trachoma. This systematic review aimed to comprehensively summarize the present studies of azithromycin MDA on trachoma; provide an overview of the impact of azithromycin MDA on trachoma in different districts; and explore the possible methods to enhance the effectiveness of azithromycin MDA in hyperendemic districts.
METHODS:PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials.gov were searched up to February 2021 with no language restriction. Studies reporting the effect of azithromycin MDA on trachoma were included. Mathematical modeling studies, animal studies, case reports, and reviews were excluded. The trachomatous inflammation-follicular (TF) <5.0% was used to judge the effect of azithromycin MDA on eliminating trachoma as a public health problem. Two researchers independently conducted the selection process and risk of bias assessment.
RESULTS:A total of 1543 studies were screened, of which 67 studies including 13 cluster-randomized controlled trials and 54 non-randomized studies were included. The effect of azithromycin MDA on trachoma was closely related to the baseline prevalence in districts. For the districts with baseline prevalence between 5.0% and 9.9%, a single round of MDA achieved a TF <5.0%. For the districts with baseline between 10.0% and 29.9%, annual MDA for 3 to 5 years reduced TF <5.0%. However, for the districts with high level of baseline prevalence (TF >30.0%), especially with baseline TF >50.0%, annual MDA was unable to achieve the TF <5.0% even after 5 to 7 years of treatment. Quarterly MDA is more effective in controlling trachoma in these hyperendemic districts.
CONCLUSIONS:Azithromycin MDA for controlling trachoma depends on the baseline prevalence. The recommendation by the World Health Organization that annual MDA for 3 to 5 years in the districts with TF baseline >10.0% is not appropriate for all eligible districts.
