Trial reportBulletin of the World Health Organization2014
Mass administration of azithromycin and Streptococcus pneumoniae carriage: cross-sectional surveys in the Gambia.
Trial report in Bulletin of the World Health Organization, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Improving antibiotic utilization in West Africa: enhancing interventions through systematic review and evidence synthesis.Antimicrobial resistance and infection control · 2025Pooled it
- β-Lactam-Resistant Streptococcus pneumoniae Dynamics Following Treatment: A Dose-Response Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Pooled it
- Secondary Effects from Mass Azithromycin Administration: A Systematic Review and Meta-analysis.The American journal of tropical medicine and hygiene · 2022Pooled it
- Antibiotics for trachoma.The Cochrane database of systematic reviews · 2019Pooled it
- Weekly azithromycin for 48 weeks impacts nasopharyngeal microbial prevalence and Streptococcus pneumoniae serotypes in children with HIV-associated chronic lung disease.Scientific reports · 2025Trial
- Prevalence of nasopharyngealThe Lancet. Microbe · 2022Trial
- Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial.Frontiers in public health · 2022Trial
- Trial
- Genomic investigation of Staphylococcus aureus recovered from Gambian women and newborns following an oral dose of intra-partum azithromycin.The Journal of antimicrobial chemotherapy · 2019Trial
- Randomized Trial of Community Treatment With Azithromycin and Ivermectin Mass Drug Administration for Control of Scabies and Impetigo.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Trial
- Long-term Impact of Oral Azithromycin Taken by Gambian Women During Labor on Prevalence and Antibiotic Susceptibility of Streptococcus pneumoniae and Staphylococcus aureus in Their Infants: Follow-up of a Randomized Clinical Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Trial
- [Clinical effect of Saccharomyces boulardii powder combined with azithromycin sequential therapy in treatment of children with diarrhea secondary to Mycoplasma pneumoniae pneumonia].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2018Trial
- Oral azithromycin given during labour decreases bacterial carriage in the mothers and their offspring: a double-blind randomized trial.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2016Trial
- Nasopharyngeal Pneumococcal Serotypes Before and After Mass Azithromycin Distributions for Trachoma.Journal of the Pediatric Infectious Diseases Society · 2016Trial
- Prevention of bacterial infections in the newborn by pre-delivery administration of azithromycin: Study protocol of a randomized efficacy trial.BMC pregnancy and childbirth · 2015Trial
- Impact of intermittent preventive treatment in pregnancy with azithromycin-containing regimens on maternal nasopharyngeal carriage and antibiotic sensitivity of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus: a cross-sectional survey at delivery.Journal of clinical microbiology · 2015Trial
- Azithromycin mass drug administration to reduce childhood mortality in humanitarian crises.PLOS global public health · 2026Review
- Community-level Monitoring of Antimicrobial Resistance following Mass Administration of Azithromycin to Reduce Child Mortality in Côte d'Ivoire: Results from Two Rounds of Surveillance.Gates open research · 2026Article
- Feasibility and acceptability of integrating mass distribution of azithromycin to children 1-11 months into a trachoma mass drug administration campaign to reduce child mortality in Côte d'Ivoire.PLOS global public health · 2024Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo evaluate the effect of repeated mass drug administration (MDA) of azithromycin in the Gambia on the nasopharyngeal carriage of Streptococcus pneumoniae and on the emergence of antibiotic-resistant strains.
methodsThis study involved villages that participated in a cluster randomized trial comparing the effect of one versus three azithromycin MDA rounds on the prevalence of trachoma. Only villages in which most children received 7-valent pneumococcal conjugate vaccine were included. Three cross-sectional surveys were performed in two villages that received three annual MDA rounds: the first immediately before the third MDA round and the second and third, 1 and 6 months, respectively, after the third MDA round. The third survey also covered six villages that had received one MDA round 30 months previously. Pneumococcal carriage was assessed using nasopharyngeal swabs and azithromycin resistance was detected using the Etest.
findingsThe prevalence of pneumococcal carriage decreased from 43.4% to 19.2% between the first and second surveys (P < 0.001) but rebounded by the third survey (45.8%; P = 0.591). Being a carrier at the first survey was a risk factor for being a carrier at the second (odds ratio: 3.71; P < 0.001). At the third survey, the prevalence of carriage was similar after one and three MDA rounds (50.3% versus 45.8%, respectively; P = 0.170), as was the prevalence of azithromycin resistance (0.3% versus 0.9%, respectively; P = 0.340).
conclusionThree azithromycin MDA rounds did not increase the prevalence of nasopharyngeal carriage of azithromycin-resistant S. pneumoniae strains compared with one round.
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Registered trials
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