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Effect of biannual azithromycin distribution on antibody responses to malaria, bacterial, and protozoan pathogens in Niger

Author

Listed:
  • Ahmed M. Arzika

    (The Carter Center)

  • Ramatou Maliki

    (The Carter Center)

  • E. Brook Goodhew

    (Centers for Disease Control and Prevention)

  • Eric Rogier

    (Centers for Disease Control and Prevention)

  • Jeffrey W. Priest

    (Centers for Disease Control and Prevention)

  • Elodie Lebas

    (University of California)

  • Kieran S. O’Brien

    (University of California
    University of California)

  • Victoria Le

    (University of California)

  • Catherine E. Oldenburg

    (University of California
    University of California
    University of California)

  • Thuy Doan

    (University of California
    University of California)

  • Travis C. Porco

    (University of California
    University of California
    University of California)

  • Jeremy D. Keenan

    (University of California
    University of California)

  • Thomas M. Lietman

    (University of California
    University of California
    University of California)

  • Diana L. Martin

    (Centers for Disease Control and Prevention)

  • Benjamin F. Arnold

    (University of California
    University of California)

Abstract

The MORDOR trial in Niger, Malawi, and Tanzania found that biannual mass distribution of azithromycin to children younger than 5 years led to a 13.5% reduction in all-cause mortality (NCT02048007). To help elucidate the mechanism for mortality reduction, we report IgG responses to 11 malaria, bacterial, and protozoan pathogens using a multiplex bead assay in pre-specified substudy of 30 communities in the rural Niger placebo-controlled trial over a three-year period (n = 5642 blood specimens, n = 3814 children ages 1–59 months). Mass azithromycin reduces Campylobacter spp. force of infection by 29% (hazard ratio = 0.71, 95% CI: 0.56, 0.89; P = 0.004) but serological measures show no significant differences between groups for other pathogens against a backdrop of high transmission. Results align with a recent microbiome study in the communities. Given significant sequelae of Campylobacter infection among preschool aged children, our results support an important mechanism through which biannual mass distribution of azithromycin likely reduces mortality in Niger.

Suggested Citation

  • Ahmed M. Arzika & Ramatou Maliki & E. Brook Goodhew & Eric Rogier & Jeffrey W. Priest & Elodie Lebas & Kieran S. O’Brien & Victoria Le & Catherine E. Oldenburg & Thuy Doan & Travis C. Porco & Jeremy D, 2022. "Effect of biannual azithromycin distribution on antibody responses to malaria, bacterial, and protozoan pathogens in Niger," Nature Communications, Nature, vol. 13(1), pages 1-11, December.
    • Handle: RePEc:nat:natcom:v:13:y:2022:i:1:d:10.1038_s41467-022-28565-5
    DOI: 10.1038/s41467-022-28565-5
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    References listed on IDEAS

    as
    1. Ruppert,David & Wand,M. P. & Carroll,R. J., 2003. "Semiparametric Regression," Cambridge Books, Cambridge University Press, number 9780521780506.
    2. Regina Nuzzo, 2015. "How scientists fool themselves – and how they can stop," Nature, Nature, vol. 526(7572), pages 182-185, October.
    3. Ruppert,David & Wand,M. P. & Carroll,R. J., 2003. "Semiparametric Regression," Cambridge Books, Cambridge University Press, number 9780521785167.
    4. Inyoung Kim & Noah D. Cohen & Raymond J. Carroll, 2003. "Semiparametric Regression Splines in Matched Case-Control Studies," Biometrics, The International Biometric Society, vol. 59(4), pages 1158-1169, December.
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    Cited by:

    1. Christine Tedijanto & Anthony W. Solomon & Diana L. Martin & Scott D. Nash & Jeremy D. Keenan & Thomas M. Lietman & Patrick J. Lammie & Kristen Aiemjoy & Abdou Amza & Solomon Aragie & Ahmed M. Arzika , 2023. "Monitoring transmission intensity of trachoma with serology," Nature Communications, Nature, vol. 14(1), pages 1-12, December.
    2. Camelia Herman & Colleen M. Leonard & Perpetua Uhomoibhi & Mark Maire & Delynn Moss & Uwem Inyang & Ado Abubakar & Abiodun Ogunniyi & Nwando Mba & Stacie M. Greby & McPaul I. Okoye & Nnaemeka C. Iriem, 2023. "Non-falciparum malaria infection and IgG seroprevalence among children under 15 years in Nigeria, 2018," Nature Communications, Nature, vol. 14(1), pages 1-13, December.

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