Evidence map›Paper›PMID 34559801›Full record

Trial reportPloS one2021

Causes of death after biannual azithromycin treatment: A community-level randomized clinical trial.

Evan M Bloch, Zakayo Mrango, Jerusha Weaver, Beatriz Munoz, Thomas M Lietman, Sheila K West

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02048007 (Evaluating Impact of Azithromycin Mass Drug Administrations on All-cause Mortality and Antibiotic Resistance), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT02048007 phase4completednot on this map

Evaluating Impact of Azithromycin Mass Drug Administrations on All-cause Mortality and Antibiotic Resistance: Morbidity Study

TypeinterventionalSponsorUniversity of California, San FranciscoRan2014 to 2020Enrolled72,000ConditionsChildhood MortalityArmsAzithromycin, Placebo
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Evan M BlochDepartment of pathology, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.ORCID 0000-0001-8181-9517
Zakayo MrangoNational Institute for Medical Research, Kilosa, Tanzania.
Jerusha WeaverDana Center for Preventive Ophthalmology, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.ORCID 0000-0001-5960-5475
Beatriz MunozDana Center for Preventive Ophthalmology, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
Thomas M LietmanFrancis I Proctor Foundation, University of California, San Francisco, San Francisco, CA, United States of America.
Sheila K WestDana Center for Preventive Ophthalmology, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The MORDOR study, a masked, community-level randomized clinical trial conducted in Niger, Malawi and Tanzania (2015 to 2017), showed that biannual administration of single-dose azithromycin to preschool children reduced all-cause mortality. We sought to evaluate its impact on causes of death in children aged 1-59 months in Tanzania. A random sampling of 614 communities was conducted in Kilosa District, Tanzania, with simple random assignment of communities to receive either azithromycin or placebo. In these communities, a census was carried out every 6 months and children aged 1-59 months received biannual (every 6 months), single-dose azithromycin (~20mg/kg) or placebo depending on community assignment, over a 2-year period. Mortality was determined at the time of the biannual census. For child deaths, a verbal autopsy was performed to ascertain the cause using a standardized diagnostic classification. A total of 190- (0.58 /100 person-years) and 200 deaths (0.59/100 person-years) were reported in the azithromycin and placebo arms, respectively. Malaria, pneumonia and diarrhea, accounted for 71% and 68% of deaths in the respective arms. Overall, the mortality was not different by treatment arm, nor were the distribution of causes of death after adjusting for community clustering. The cause-specific mortality for diarrhea/pneumonia was no different over time. In children aged 1-5 months, 32 deaths occurred in the placebo arm and 25 deaths occurred in the azithromycin arm; 20 (62.5%) deaths in the placebo- and 10 (40%) in the azithromycin arm were attributed to diarrhea or pneumonia. Neither differences in the number of deaths nor the diarrhea/pneumonia attribution was statistically significant after adjusting for community clustering. In conclusion, azithromycin was not associated with a significant decline in deaths by specific causes compared to placebo. The non-significant lower rates of diarrhea or pneumonia in children <6 months who received azithromycin merit further investigation in high-mortality settings. Trial registration: NCT02048007.

Indexed as

Anti-Bacterial AgentsAntibiotic ProphylaxisAzithromycinCause of DeathChild, PreschoolDiarrheaDose-Response Relationship, DrugDouble-Blind MethodFemaleHumansInfantInfant, NewbornMalariaMalawiMaleNigerAnti-Bacterial AgentsAzithromycin

Identifiers

PMID34559801
PMCPMC8462712

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.