{"id":25535,"date":"2024-04-06T04:38:00","date_gmt":"2024-04-05T20:38:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=25535"},"modified":"2024-04-06T06:04:55","modified_gmt":"2024-04-05T22:04:55","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%b8%83%e5%9f%ba%e7%ba%b3%e6%b3%95%e7%b4%a2%e7%be%a4%e4%bd%93%e5%88%86%e5%8f%91%e9%98%bf%e5%a5%87%e9%9c%89%e7%b4%a0%e9%a2%84%e9%98%b2%e5%84%bf","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=25535","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u5e03\u57fa\u7eb3\u6cd5\u7d22\u7fa4\u4f53\u5206\u53d1\u963f\u5947\u9709\u7d20\u9884\u9632\u513f\u7ae5\u6b7b\u4ea1"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

February 13, 2024<\/p>\n\n\n\n

Mass Azithromycin Distribution to Prevent Child Mortality in Burkina Faso: The CHAT Randomized Clinical Trial<\/h1>\n\n\n\n

Catherine E.\u00a0Oldenburg,\u00a0Mamadou\u00a0Ouattara,\u00a0Mamadou\u00a0Bountogo,\u00a0et al<\/h3>\n\n\n\n

JAMA.\u00a0<\/em>2024;331(6):482-490. doi:10.1001\/jama.2023.27393<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  Does twice-annual mass azithromycin distribution prevent all-cause childhood mortality among children in Burkina Faso aged 1 to 59 months in the setting of seasonal malaria chemoprevention distribution?<\/p>\n\n\n\n

Findings<\/strong>  In this randomized trial of twice-yearly mass azithromycin distribution, 498 deaths were recorded over 60\u202f592 person-years (8.2 deaths\/1000 person-years) in the azithromycin group compared with 588 deaths over 58\u202f547 person-years (10.0 deaths\/1000 person-years) in the placebo group. The difference was not statistically significant.<\/p>\n\n\n\n

Meaning<\/strong>  Communities with mass azithromycin distribution had lower child mortality than controls, although the difference was not statistically significant. The study may have been underpowered to detect a clinically relevant difference.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Repeated mass distribution of azithromycin has been shown to reduce childhood mortality by 14% in sub-Saharan Africa. However, the estimated effect varied by location, suggesting that the intervention may not be effective in different geographical areas, time periods, or conditions.<\/p>\n\n\n\n

Objective<\/strong>  To evaluate the efficacy of twice-yearly azithromycin to reduce mortality in children in the presence of seasonal malaria chemoprevention.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This cluster randomized placebo-controlled trial evaluating the efficacy of single-dose azithromycin for prevention of all-cause childhood mortality included 341 communities in the Nouna district in rural northwestern Burkina Faso. Participants were children aged 1 to 59 months living in the study communities.<\/p>\n\n\n\n

Interventions<\/strong>  Communities were randomized in a 1:1 ratio to receive oral azithromycin or placebo distribution. Children aged 1 to 59 months were offered single-dose treatment twice yearly for 3 years (6 distributions) from August 2019 to February 2023.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was all-cause childhood mortality, measured during a twice-yearly enumerative census.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0A total of 34\u202f399 children (mean [SD] age, 25.2 [18] months) in the azithromycin group and 33\u202f847 children (mean [SD] age, 25.6 [18] months) in the placebo group were included. A mean (SD) of 90.1% (16.0%) of the censused children received the scheduled study drug in the azithromycin group and 89.8% (17.1%) received the scheduled study drug in the placebo group. In the azithromycin group, 498 deaths were recorded over 60\u202f592 person-years (8.2 deaths\/1000 person-years). In the placebo group, 588 deaths were recorded over 58\u202f547 person-years (10.0 deaths\/1000 person-years). The incidence rate ratio for mortality was 0.82 (95% CI, 0.67-1.02;\u00a0P<\/em>\u2009=\u2009.07) in the azithromycin group compared with the placebo group. The incidence rate ratio was 0.99 (95% CI, 0.72-1.36) in those aged 1 to 11 months, 0.92 (95% CI, 0.67-1.27) in those aged 12 to 23 months, and 0.73 (95% CI, 0.57-0.94) in those aged 24 to 59 months.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  Mortality in children (aged 1-59 months) was lower with biannual mass azithromycin distribution in a setting in which seasonal malaria chemoprevention was also being distributed, but the difference was not statistically significant. The study may have been underpowered to detect a clinically relevant difference.<\/p>\n\n\n\n

Trial Registration<\/strong>  ClinicalTrials.gov Identifier: NCT03676764<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  February 13, 202 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25535"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25535"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25535\/revisions"}],"predecessor-version":[{"id":25536,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25535\/revisions\/25536"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25535"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25535"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25535"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}