1,377 results on '"Bailey, Robin"'
Search Results
2. Exporter a modern legend
- Author
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Bailey, Robin
- Published
- 2006
3. Predicted Impact of COVID-19 on Neglected Tropical Disease Programs and the Opportunity for Innovation
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Toor, Jaspreet, Adams, Emily R, Aliee, Maryam, Amoah, Benjamin, Anderson, Roy M, Ayabina, Diepreye, Bailey, Robin, Basáñez, Maria-Gloria, Blok, David J, Blumberg, Seth, Borlase, Anna, Rivera, Rocio Caja, Castaño, María Soledad, Chitnis, Nakul, Coffeng, Luc E, Crump, Ronald E, Das, Aatreyee, Davis, Christopher N, Davis, Emma L, Deiner, Michael S, Diggle, Peter J, Fronterre, Claudio, Giardina, Federica, Giorgi, Emanuele, Graham, Matthew, Hamley, Jonathan ID, Huang, Ching-I, Kura, Klodeta, Lietman, Thomas M, Lucas, Tim CD, Malizia, Veronica, Medley, Graham F, Meeyai, Aronrag, Michael, Edwin, Porco, Travis C, Prada, Joaquin M, Rock, Kat S, Le Rutte, Epke A, Smith, Morgan E, Spencer, Simon EF, Stolk, Wilma A, Touloupou, Panayiota, Vasconcelos, Andreia, Vegvari, Carolin, de Vlas, Sake J, Walker, Martin, and Hollingsworth, T Déirdre
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Rare Diseases ,Infectious Diseases ,Vector-Borne Diseases ,Orphan Drug ,Infection ,Good Health and Well Being ,COVID-19 ,Humans ,Neglected Diseases ,Pandemics ,SARS-CoV-2 ,Tropical Medicine ,neglected tropical diseases ,coronavirus ,modeling ,Biological Sciences ,Medical and Health Sciences ,Microbiology - Abstract
Due to the COVID-19 pandemic, many key neglected tropical disease (NTD) activities have been postponed. This hindrance comes at a time when the NTDs are progressing towards their ambitious goals for 2030. Mathematical modelling on several NTDs, namely gambiense sleeping sickness, lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases (STH), trachoma, and visceral leishmaniasis, shows that the impact of this disruption will vary across the diseases. Programs face a risk of resurgence, which will be fastest in high-transmission areas. Furthermore, of the mass drug administration diseases, schistosomiasis, STH, and trachoma are likely to encounter faster resurgence. The case-finding diseases (gambiense sleeping sickness and visceral leishmaniasis) are likely to have fewer cases being detected but may face an increasing underlying rate of new infections. However, once programs are able to resume, there are ways to mitigate the impact and accelerate progress towards the 2030 goals.
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- 2021
4. Smooth sailor
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Bailey, Robin
- Published
- 1999
5. Sefton's odyssey
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Bailey, Robin
- Published
- 1999
6. Wild, wet, and down under
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Bailey, Robin
- Published
- 1998
7. Biannual azithromycin distribution and child mortality among malnourished children: A subgroup analysis of the MORDOR cluster-randomized trial in Niger.
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O'Brien, Kieran S, Arzika, Ahmed M, Maliki, Ramatou, Manzo, Farouk, Mamkara, Alio K, Lebas, Elodie, Cook, Catherine, Bailey, Robin L, West, Sheila K, Oldenburg, Catherine E, Porco, Travis C, Arnold, Benjamin, Keenan, Jeremy D, Lietman, Thomas M, and MORDOR Study Group
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MORDOR Study Group ,Humans ,Malaria ,Child Nutrition Disorders ,Body Weight ,Thinness ,Azithromycin ,Anti-Bacterial Agents ,Child Mortality ,Infant Mortality ,Nutritional Status ,Child ,Preschool ,Infant ,Niger ,Female ,Male ,Mass Drug Administration ,Child ,Preschool ,Medical and Health Sciences ,General & Internal Medicine - Abstract
BackgroundBiannual azithromycin distribution has been shown to reduce child mortality as well as increase antimicrobial resistance. Targeting distributions to vulnerable subgroups such as malnourished children is one approach to reaching those at the highest risk of mortality while limiting selection for resistance. The objective of this analysis was to assess whether the effect of azithromycin on mortality differs by nutritional status.Methods and findingsA large simple trial randomized communities in Niger to receive biannual distributions of azithromycin or placebo to children 1-59 months old over a 2-year timeframe. In exploratory subgroup analyses, the effect of azithromycin distribution on child mortality was assessed for underweight subgroups using weight-for-age Z-score (WAZ) thresholds of -2 and -3. Modification of the effect of azithromycin on mortality by underweight status was examined on the additive and multiplicative scale. Between December 2014 and August 2017, 27,222 children 1-11 months of age from 593 communities had weight measured at their first study visit. Overall, the average age among included children was 4.7 months (interquartile range [IQR] 3-6), 49.5% were female, 23% had a WAZ < -2, and 10% had a WAZ < -3. This analysis included 523 deaths in communities assigned to azithromycin and 661 deaths in communities assigned to placebo. The mortality rate was lower in communities assigned to azithromycin than placebo overall, with larger reductions among children with lower WAZ: -12.6 deaths per 1,000 person-years (95% CI -18.5 to -6.9, P < 0.001) overall, -17.0 (95% CI -28.0 to -7.0, P = 0.001) among children with WAZ < -2, and -25.6 (95% CI -42.6 to -9.6, P = 0.003) among children with WAZ < -3. No statistically significant evidence of effect modification was demonstrated by WAZ subgroup on either the additive or multiplicative scale (WAZ < -2, additive: 95% CI -6.4 to 16.8, P = 0.34; WAZ < -2, multiplicative: 95% CI 0.8 to 1.4, P = 0.50, WAZ < -3, additive: 95% CI -2.2 to 31.1, P = 0.14; WAZ < -3, multiplicative: 95% CI 0.9 to 1.7, P = 0.26). The estimated number of deaths averted with azithromycin was 388 (95% CI 214 to 574) overall, 116 (95% CI 48 to 192) among children with WAZ < -2, and 76 (95% CI 27 to 127) among children with WAZ < -3. Limitations include the availability of a single weight measurement on only the youngest children and the lack of power to detect small effect sizes with this rare outcome. Despite the trial's large size, formal tests for effect modification did not reach statistical significance at the 95% confidence level.ConclusionsAlthough mortality rates were higher in the underweight subgroups, this study was unable to demonstrate that nutritional status modified the effect of biannual azithromycin distribution on mortality. Even if the effect were greater among underweight children, a nontargeted intervention would result in the greatest absolute number of deaths averted.Trial registrationThe MORDOR trial is registered at clinicaltrials.gov NCT02047981.
- Published
- 2020
8. Effects of Biannual Azithromycin Mass Drug Administration on Malaria in Malawian Children: A Cluster-Randomized Trial
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Hart, John D, Samikwa, Lyson, Sikina, Feston, Kalua, Khumbo, Keenan, Jeremy D, Lietman, Thomas M, Burr, Sarah E, and Bailey, Robin L
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Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Sciences ,Rare Diseases ,Infectious Diseases ,Vector-Borne Diseases ,Clinical Research ,Malaria ,Pediatric ,Clinical Trials and Supportive Activities ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Infection ,Good Health and Well Being ,Anemia ,Anti-Bacterial Agents ,Azithromycin ,Child Mortality ,Child ,Preschool ,Double-Blind Method ,Female ,Humans ,Infant ,Male ,Mass Drug Administration ,Parasitemia ,Prevalence ,Medical and Health Sciences ,Tropical Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
Reductions in malaria morbidity have been reported following azithromycin mass drug administration (MDA) for trachoma. The recent Macrolides Oraux pour Reduire les Deces avec un Oeil sur la Resistance (MORDOR) trial reported a reduction in child mortality following biannual azithromycin MDA. Here, we investigate the effects of azithromycin MDA on malaria at the MORDOR-Malawi study site. A cluster-randomized double-blind placebo-controlled trial, with 15 clusters per arm, was conducted. House-to-house census was updated biannually, and azithromycin or placebo syrup was distributed to children aged 1-59 months for a total of four biannual distributions. At baseline, 12-month, and 24-month follow-up visits, a random sample of 1,200 children was assessed for malaria with thick and thin blood smears and hemoglobin measurement. In the community-level analysis, there was no difference in the prevalence of parasitemia (1.0% lower in azithromycin-treated communities; 95% CI: -8.2 to 6.1), gametocytemia (0.7% lower in azithromycin-treated communities; 95% CI: -2.8 to 1.5), or anemia (1.7% lower in azithromycin-treated communities; 95% CI: -8.1 to 4.6) between placebo and azithromycin communities. Further interrogation of the data at the individual level, both per-protocol (including only those who received treatment 6 months previously) and by intention-to-treat, did not identify differences in parasitemia between treatment arms. In contrast to several previous reports, this study did not show an effect of azithromycin MDA on malaria parasitemia at the community or individual levels.
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- 2020
9. Cost-Effectiveness of Mass Treatment with Azithromycin for Reducing Child Mortality in Malawi: Secondary Analysis from the MORDOR Trial
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Hart, John D, Kalua, Khumbo, Keenan, Jeremy D, Lietman, Thomas M, and Bailey, Robin L
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Trials and Supportive Activities ,Comparative Effectiveness Research ,Cost Effectiveness Research ,Clinical Research ,Health Services ,Good Health and Well Being ,Anti-Bacterial Agents ,Azithromycin ,Child Mortality ,Child ,Preschool ,Cost-Benefit Analysis ,Female ,Geography ,Humans ,Infant ,Infant Mortality ,Macrolides ,Malawi ,Male ,Mass Drug Administration ,Quality-Adjusted Life Years ,Medical and Health Sciences ,Tropical Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
The recent Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) trial reported a reduction in child mortality following biannual azithromycin mass drug administration (MDA). Here, we investigate the financial costs and cost-effectiveness from the health provider perspective of azithromycin MDA at the MORDOR-Malawi study site. During MORDOR, a cluster-randomized trial involving biannual azithromycin MDA or placebo to children aged 1-59 months, fieldwork-related costs were collected, including personnel, transport, consumables, overheads, training, and supervision. Mortality rates in azithromycin- and placebo-treated clusters were calculated overall and for the five health zones of Mangochi district. These were used to estimate the number needed to treat to avert one death and the costs per death and disability-adjusted life year (DALY) averted. The cost per dose of MDA was $0.74 overall, varying between $0.63 and $0.94 in the five zones. Overall, the number needed to treat to avert one death was 1,213 children; the cost per death averted was $898.47, and the cost per DALY averted was $9.98. In the three zones where mortality was lower in azithromycin-treated clusters, the number needed to treat to avert one death, cost per death averted, and cost per DALY averted, respectively, were as follows: 3,070, $2,899.24, and $32.31 in Monkey Bay zone; 1,530, $1,214.42, and $13.49 in Chilipa zone; and 344, $217.98, and $2.42 in Namwera zone. This study is a preliminary cost-effectiveness analysis that indicates azithromycin MDA for reducing child mortality has the potential to be highly cost-effective in some settings in Malawi, but the reasons for geographical variation in effectiveness require further investigation.
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- 2020
10. Effect of Mass Treatment with Azithromycin on Causes of Death in Children in Malawi: Secondary Analysis from the MORDOR Trial
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Hart, John D, Kalua, Khumbo, Keenan, Jeremy D, Lietman, Thomas M, and Bailey, Robin L
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Public Health ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Clinical Research ,Clinical Trials and Supportive Activities ,Infectious Diseases ,HIV/AIDS ,Lung ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Infection ,Good Health and Well Being ,Acquired Immunodeficiency Syndrome ,Anti-Bacterial Agents ,Autopsy ,Azithromycin ,Cause of Death ,Child Mortality ,Child ,Preschool ,Diarrhea ,Female ,HIV Infections ,Humans ,Infant ,Infant Mortality ,Infant ,Newborn ,Macrolides ,Malawi ,Male ,Mass Drug Administration ,Pneumonia ,Medical and Health Sciences ,Tropical Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
Recent evidence indicates mass drug administration with azithromycin may reduce child mortality. This study uses verbal autopsy (VA) to investigate the causes of individual deaths during the Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) trial in Malawi. Cluster randomization was performed as part of MORDOR. Biannual household visits were conducted to distribute azithromycin or placebo to children aged 1-59 months and update the census to identify deaths for VA. MORDOR was not powered to investigate mortality effects at individual sites, but the available evidence is presented here for hypothesis generation regarding the mechanism through which azithromycin may reduce child mortality. Automated VA analysis was performed to infer the likely cause of death using two major analysis programs, InterVA and SmartVA. A total of 334 communities were randomized to azithromycin or placebo, with more than 130,000 person-years of follow-up. During the study, there were 1,184 deaths, of which 1,131 were followed up with VA. Mortality was 9% lower in azithromycin-treated communities than in placebo communities (rate ratio 0.91 [95% CI: 0.79-1.05]; P = 0.20). The intention-to-treat analysis by cause using InterVA suggested fewer HIV/AIDS deaths in azithromycin-treated communities (rate ratio 0.70 [95% CI: 0.50-0.97]; P = 0.03) and fewer pneumonia deaths (rate ratio 0.82 [95% CI: 0.60-1.12]; P = 0.22). The use of the SmartVA algorithm suggested fewer diarrhea deaths (rate ratio 0.71 [95% CI: 0.51-1.00]; P = 0.05) and fewer pneumonia deaths (rate ratio 0.58 [95% CI: 0.33-1.00]; P = 0.05). Although this study is not able to provide strong evidence, the data suggest that the mortality reduction during MORDOR in Malawi may have been due to effects on pneumonia and diarrhea or HIV/AIDS mortality.
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- 2020
11. Effect Modification by Baseline Mortality in the MORDOR Azithromycin Trial
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Oron, Assaf P, Burstein, Roy, Mercer, Laina D, Arzika, Ahmed M, Kalua, Khumbo, Mrango, Zakayo, West, Sheila K, Bailey, Robin L, Porco, Travis C, and Lietman, Thomas M
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Public Health ,Health Sciences ,Good Health and Well Being ,Anti-Bacterial Agents ,Azithromycin ,Child ,Child Mortality ,Clinical Trials as Topic ,Humans ,Macrolides ,Proportional Hazards Models ,Medical and Health Sciences ,Tropical Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
We examined whether baseline mortality risk, as a function of child age and site, modified the azithromycin mortality-reduction effect in the Macrolide Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) clinical trial. We used the Cox proportional hazards model with an interaction term. Three models were examined representing three sources for the baseline-risk covariate: two using sources external to MORDOR and the third leveraging data within MORDOR. All three models provided moderate evidence for the effect becoming stronger with increasing baseline mortality (P = 0.02, 0.02, and 0.07, respectively) at the rate of approximately 6-12% additional mortality reduction per doubling of baseline mortality. Etiological and programmatic implications of these findings are discussed.
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- 2020
12. Efficacy of Mass Azithromycin Distribution for Reducing Childhood Mortality Across Geographic Regions.
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Porco, Travis C, Oldenburg, Catherine E, Arzika, Ahmed M, Kalua, Khumbo, Mrango, Zakayo, Cook, Catherine, Lebas, Elodie, Bailey, Robin L, West, Sheila K, Oron, Assaf P, Keenan, Jeremy D, Lietman, Thomas M, and For The Mordor Study Group
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Humans ,Azithromycin ,Anti-Bacterial Agents ,Child Mortality ,Infant Mortality ,Child ,Child ,Preschool ,Infant ,Ethiopia ,Tanzania ,Malawi ,Niger ,Mass Drug Administration ,Prevention ,Pediatric ,Good Health and Well Being ,Medical and Health Sciences ,Tropical Medicine - Abstract
Mass azithromycin distribution has been shown to reduce all-cause mortality in preschool children in sub-Saharan Africa. However, substantial heterogeneity in the apparent effect has been noted across geographic settings, suggesting a greater relative benefit in higher mortality settings. Here, we evaluated the relationship between the underlying mortality rate and the efficacy of azithromycin for the prevention of child mortality using data from multiple sites in Ethiopia, Malawi, Niger, and Tanzania. Between regions, we find no strong evidence of effect modification of the efficacy of azithromycin distribution for the prevention of child mortality by the underlying mortality rate (P = 0.12), although a modest effect is consistent with our findings. Higher mortality settings could be prioritized, however, because of the larger number of deaths which could be averted with azithromycin distribution.
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- 2020
13. Erratum to: Trachoma Prevalence After Discontinuation of Mass Azithromycin Distribution
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Godwin, William, Prada, Joaquin M, Emerson, Paul, Hooper, PJ, Bakhtiari, Ana, Deiner, Michael, Porco, Travis C, Mahmud, Hamidah, Landskroner, Emma, Hollingsworth, T Deirdre, Medley, Graham F, Pinsent, Amy, Bailey, Robin, Lietman, Thomas M, and Oldenburg, Catherine E
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Biological Sciences ,Medical and Health Sciences ,Microbiology - Published
- 2020
14. Comparison of anthropometric indicators to predict mortality in a population-based prospective study of children under 5 years in Niger
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O’Brien, Kieran S, Amza, Abdou, Kadri, Boubacar, Nassirou, Beido, Cotter, Sun Y, Stoller, Nicole E, West, Sheila K, Bailey, Robin L, Porco, Travis C, Keenan, Jeremy D, Lietman, Thomas M, and Oldenburg, Catherine E
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Nutrition and Dietetics ,Obesity ,Pediatric ,Clinical Trials and Supportive Activities ,Clinical Research ,Nutrition ,Zero Hunger ,Good Health and Well Being ,Anthropometry ,Arm ,Body Height ,Body Weight ,Child ,Child Mortality ,Child ,Preschool ,Female ,Humans ,Infant ,Longitudinal Studies ,Male ,Malnutrition ,Niger ,Prospective Studies ,Mortality ,Medical and Health Sciences ,Nutrition & Dietetics ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveIn the present study, we aimed to compare anthropometric indicators as predictors of mortality in a community-based setting.DesignWe conducted a population-based longitudinal study nested in a cluster-randomized trial. We assessed weight, height and mid-upper arm circumference (MUAC) on children 12 months after the trial began and used the trial's annual census and monitoring visits to assess mortality over 2 years.SettingNiger.ParticipantsChildren aged 6-60 months during the study.ResultsOf 1023 children included in the study at baseline, height-for-age Z-score, weight-for-age Z-score, weight-for-height Z-score and MUAC classified 777 (76·0 %), 630 (61·6 %), 131 (12·9 %) and eighty (7·8 %) children as moderately to severely malnourished, respectively. Over the 2-year study period, fifty-eight children (5·7 %) died. MUAC had the greatest AUC (0·68, 95 % CI 0·61, 0·75) and had the strongest association with mortality in this sample (hazard ratio = 2·21, 95 % CI 1·26, 3·89, P = 0·006).ConclusionsMUAC appears to be a better predictor of mortality than other anthropometric indicators in this community-based, high-malnutrition setting in Niger.
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- 2020
15. Biannual azithromycin distribution and child mortality among malnourished children: A subgroup analysis of the MORDOR cluster-randomized trial in Niger
- Author
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O’Brien, Kieran S, Arzika, Ahmed M, Maliki, Ramatou, Manzo, Farouk, Mamkara, Alio K, Lebas, Elodie, Cook, Catherine, Bailey, Robin L, West, Sheila K, Oldenburg, Catherine E, Porco, Travis C, Arnold, Benjamin, Keenan, Jeremy D, and Lietman, Thomas M
- Subjects
Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Prevention ,Pediatric ,Clinical Research ,Clinical Trials and Supportive Activities ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Good Health and Well Being ,Anti-Bacterial Agents ,Azithromycin ,Body Weight ,Child Mortality ,Child Nutrition Disorders ,Child ,Preschool ,Female ,Humans ,Infant ,Infant Mortality ,Malaria ,Male ,Mass Drug Administration ,Niger ,Nutritional Status ,Thinness ,MORDOR Study Group ,Medical and Health Sciences ,General & Internal Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundBiannual azithromycin distribution has been shown to reduce child mortality as well as increase antimicrobial resistance. Targeting distributions to vulnerable subgroups such as malnourished children is one approach to reaching those at the highest risk of mortality while limiting selection for resistance. The objective of this analysis was to assess whether the effect of azithromycin on mortality differs by nutritional status.Methods and findingsA large simple trial randomized communities in Niger to receive biannual distributions of azithromycin or placebo to children 1-59 months old over a 2-year timeframe. In exploratory subgroup analyses, the effect of azithromycin distribution on child mortality was assessed for underweight subgroups using weight-for-age Z-score (WAZ) thresholds of -2 and -3. Modification of the effect of azithromycin on mortality by underweight status was examined on the additive and multiplicative scale. Between December 2014 and August 2017, 27,222 children 1-11 months of age from 593 communities had weight measured at their first study visit. Overall, the average age among included children was 4.7 months (interquartile range [IQR] 3-6), 49.5% were female, 23% had a WAZ < -2, and 10% had a WAZ < -3. This analysis included 523 deaths in communities assigned to azithromycin and 661 deaths in communities assigned to placebo. The mortality rate was lower in communities assigned to azithromycin than placebo overall, with larger reductions among children with lower WAZ: -12.6 deaths per 1,000 person-years (95% CI -18.5 to -6.9, P < 0.001) overall, -17.0 (95% CI -28.0 to -7.0, P = 0.001) among children with WAZ < -2, and -25.6 (95% CI -42.6 to -9.6, P = 0.003) among children with WAZ < -3. No statistically significant evidence of effect modification was demonstrated by WAZ subgroup on either the additive or multiplicative scale (WAZ < -2, additive: 95% CI -6.4 to 16.8, P = 0.34; WAZ < -2, multiplicative: 95% CI 0.8 to 1.4, P = 0.50, WAZ < -3, additive: 95% CI -2.2 to 31.1, P = 0.14; WAZ < -3, multiplicative: 95% CI 0.9 to 1.7, P = 0.26). The estimated number of deaths averted with azithromycin was 388 (95% CI 214 to 574) overall, 116 (95% CI 48 to 192) among children with WAZ < -2, and 76 (95% CI 27 to 127) among children with WAZ < -3. Limitations include the availability of a single weight measurement on only the youngest children and the lack of power to detect small effect sizes with this rare outcome. Despite the trial's large size, formal tests for effect modification did not reach statistical significance at the 95% confidence level.ConclusionsAlthough mortality rates were higher in the underweight subgroups, this study was unable to demonstrate that nutritional status modified the effect of biannual azithromycin distribution on mortality. Even if the effect were greater among underweight children, a nontargeted intervention would result in the greatest absolute number of deaths averted.Trial registrationThe MORDOR trial is registered at clinicaltrials.gov NCT02047981.
- Published
- 2020
16. Biannual versus annual mass azithromycin distribution and malaria seroepidemiology among preschool children in Niger: a sub-study of a cluster randomized trial.
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Oldenburg, Catherine E, Amza, Abdou, Cooley, Gretchen, Kadri, Boubacar, Nassirou, Beido, Arnold, Benjamin F, Rosenthal, Philip J, O'Brien, Kieran S, West, Sheila K, Bailey, Robin L, Porco, Travis C, Keenan, Jeremy D, Lietman, Thomas M, and Martin, Diana L
- Subjects
Humans ,Malaria ,Azithromycin ,Merozoite Surface Protein 1 ,Antimalarials ,Prevalence ,Seroepidemiologic Studies ,Time Factors ,Child ,Preschool ,Infant ,Niger ,Female ,Male ,Mass Drug Administration ,Mass drug administration ,Microbiology ,Medical Microbiology ,Public Health and Health Services ,Tropical Medicine - Abstract
BackgroundBiannual mass azithromycin administration to preschool children reduces all-cause mortality, but the mechanism for the effect is not understood. Azithromycin has activity against malaria parasites, and malaria is a leading cause of child mortality in the Sahel. The effect of biannual versus annual azithromycin distribution for trachoma control on serological response to merozoite surface protein 1 (MSP-119), a surrogate for malaria incidence, was evaluated among children in Niger.MethodsMarkers of malaria exposure were measured in two arms of a factorial randomized controlled trial designed to evaluate targeted biannual azithromycin distribution to children under 12 years of age compared to annual azithromycin to the entire community for trachoma control (N = 12 communities per arm). Communities were treated for 36 months (6 versus 3 distributions). Dried blood spots were collected at 36 months among children ages 1-5 years, and MSP-119 antibody levels were assessed using a bead-based multiplex assay to measure malaria seroprevalence.ResultsAntibody results were available for 991 children. MSP-119 seropositivity was 62.7% in the biannual distribution arm compared to 68.7% in the annual arm (prevalence ratio 0.91, 95% CI 0.83 to 1.00). Mean semi-quantitative antibody levels were lower in the biannual distribution arm compared to the annual arm (mean difference - 0.39, 95% CI - 0.05 to - 0.72).ConclusionsTargeted biannual azithromycin distribution was associated with lower malaria seroprevalence compared to that in a population that received annual distribution. Trial Registration Clinicaltrials.gov NCT00792922.
- Published
- 2019
17. Classic turn ; boat with a past
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Bailey, Robin
- Published
- 1991
18. Community-level Association between Clinical Trachoma and Ocular Chlamydia Infection after MASS Azithromycin Distribution in a Mesoendemic Region of Niger
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Amza, Abdou, Kadri, Boubacar, Nassirou, Beido, Cotter, Sun Y, Stoller, Nicole E, West, Sheila K, Bailey, Robin L, Porco, Travis C, Keenan, Jeremy D, Lietman, Thomas M, and Oldenburg, Catherine E
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Eye Disease and Disorders of Vision ,Clinical Research ,Sexually Transmitted Infections ,Infectious Diseases ,Infection ,Good Health and Well Being ,Anti-Bacterial Agents ,Azithromycin ,Child ,Preschool ,Chlamydia Infections ,Chlamydia trachomatis ,Eye Infections ,Parasitic ,Female ,Humans ,Incidence ,Infant ,Infant ,Newborn ,Male ,Mass Drug Administration ,Niger ,Prevalence ,Trachoma ,azithromycin ,mass drug administration ,Opthalmology and Optometry ,Public Health and Health Services ,Epidemiology ,Ophthalmology and optometry ,Public health - Abstract
Purpose: The clinical sign trachomatous inflammation - follicular (TF) is used to monitor indication for and response to mass azithromycin distribution in trachoma-endemic communities. Here, we assess the relationship between TF, trachomatous inflammation - intense (TI), and infection with ocular Chlamydia trachomatis over time during annual mass azithromycin distribution. Methods: We used data from a cluster-randomized trial of mass azithromycin distribution for trachoma control in a mesoendemic region of Niger. This study includes 24 communities that received 3 years of annual mass azithromycin distribution. TF, TI, and ocular chlamydia infection were monitored among children aged 0-5 years. We assessed the correlation between the prevalence of ocular chlamydia infection and 1) TF and 2) TI prevalence over time. Results: At baseline, ocular chlamydia prevalence was 21.2% (95% CI 14.3-28.1%), TF prevalence was 27.7% (95% CI 21.2-34.2%), and TI prevalence was 8.3% (95% CI 5.2-11.5%). The prevalence of all three measures decreased significantly over time (P < 0.001). At baseline, ocular chlamydia infection prevalence was strongly correlated with both TF (rho = 0.78, P < 0.0001) and TI (rho = 0.76, P < 0.0001). The correlation between ocular chlamydia infection and both TF and TI was weak at months 12 and 24. At 36 months, when TF prevalence had dropped below 10%, ocular chlamydia infection and TF were moderately correlated (rho = 0.70, P= 0.0002). Conclusions: Both TF and TI are good indicators of infection prevalence prior to mass azithromycin distribution. However, this relationship may be affected by repeated rounds of mass azithromycin distribution.
- Published
- 2019
19. Biannual mass azithromycin distributions and malaria parasitemia in pre-school children in Niger: A cluster-randomized, placebo-controlled trial.
- Author
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Arzika, Ahmed M, Maliki, Ramatou, Boubacar, Nameywa, Kane, Salissou, Cotter, Sun Y, Lebas, Elodie, Cook, Catherine, Bailey, Robin L, West, Sheila K, Rosenthal, Philip J, Porco, Travis C, Lietman, Thomas M, Keenan, Jeremy D, and MORDOR Study Group
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MORDOR Study Group ,Humans ,Parasitemia ,Malaria ,Azithromycin ,Anti-Bacterial Agents ,Cluster Analysis ,Time Factors ,Child ,Preschool ,Infant ,Niger ,Female ,Male ,Mass Drug Administration ,Child ,Preschool ,General & Internal Medicine ,Medical and Health Sciences - Abstract
BackgroundMass azithromycin distributions have been shown to reduce mortality in preschool children, although the factors mediating this mortality reduction are not clear. This study was performed to determine whether mass distribution of azithromycin, which has modest antimalarial activity, reduces the community burden of malaria.Methods and findingsIn a cluster-randomized trial conducted from 23 November 2014 until 31 July 2017, 30 rural communities in Niger were randomized to 2 years of biannual mass distributions of either azithromycin (20 mg/kg oral suspension) or placebo to children aged 1 to 59 months. Participants, field staff, and investigators were masked to treatment allocation. The primary malaria outcome was the community prevalence of parasitemia on thick blood smear, assessed in a random sample of children from each community at study visits 12 and 24 months after randomization. Analyses were performed in an intention-to-treat fashion. At the baseline visit, a total of 1,695 children were enumerated in the 15 azithromycin communities, and 3,029 children were enumerated in the 15 placebo communities. No communities were lost to follow-up. The mean prevalence of malaria parasitemia at baseline was 8.9% (95% CI 5.1%-15.7%; 52 of 552 children across all communities) in the azithromycin-treated group and 6.7% (95% CI 4.0%-12.6%; 36 of 542 children across all communities) in the placebo-treated group. In the prespecified primary analysis, parasitemia was lower in the azithromycin-treated group at month 12 (mean prevalence 8.8%, 95% CI 5.1%-14.3%; 51 of 551 children across all communities) and month 24 (mean 3.5%, 95% CI 1.9%-5.5%; 21 of 567 children across all communities) than it was in the placebo-treated group at month 12 (mean 15.3%, 95% CI 10.8%-20.6%; 81 of 548 children across all communities) and month 24 (mean 4.8%, 95% CI 3.3%-6.4%; 28 of 592 children across all communities) (P = 0.02). Communities treated with azithromycin had approximately half the odds of parasitemia compared to those treated with placebo (odds ratio [OR] 0.54, 95% CI 0.30 to 0.97). Parasite density was lower in the azithromycin group than the placebo group at 12 and 24 months (square root-transformed outcome; density estimates were 7,540 parasites/μl lower [95% CI -350 to -12,550 parasites/μl; P = 0.02] at a mean parasite density of 17,000, as was observed in the placebo arm). No significant difference in hemoglobin was observed between the 2 treatment groups at 12 and 24 months (mean 0.34 g/dL higher in the azithromycin arm, 95% CI -0.06 to 0.75 g/dL; P = 0.10). No serious adverse events were reported in either group, and among children aged 1 to 5 months, the most commonly reported nonserious adverse events (i.e., diarrhea, vomiting, and rash) were less common in the azithromycin-treated communities. Limitations of the trial include the timing of the treatments and monitoring visits, both of which took place before the peak malaria season, as well as the uncertain generalizability to areas with different malaria transmission dynamics.ConclusionsMass azithromycin distributions were associated with a reduced prevalence of malaria parasitemia in this trial, suggesting one possible mechanism for the mortality benefit observed with this intervention.Trial registrationThe trial was registered on ClinicalTrials.gov (NCT02048007).
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- 2019
20. Mass Oral Azithromycin for Childhood Mortality: Timing of Death After Distribution in the MORDOR Trial
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Porco, Travis C, Hart, John, Arzika, Ahmed M, Weaver, Jerusha, Kalua, Khumbo, Mrango, Zakayo, Cotter, Sun Y, Stoller, Nicole E, O’Brien, Kieran S, Fry, Dionna M, Vanderschelden, Benjamin, Oldenburg, Catherine E, West, Sheila K, Bailey, Robin L, Keenan, Jeremy D, and Lietman, Thomas M
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Clinical Trials and Supportive Activities ,Clinical Research ,Pediatric ,Good Health and Well Being ,Anti-Bacterial Agents ,Azithromycin ,Child Mortality ,Child ,Preschool ,Female ,Humans ,Infant ,Infant Mortality ,Infant ,Newborn ,Male ,Mass Drug Administration ,Time Factors ,Trachoma ,childhood mortality ,azithromycin ,sub-Saharan Africa ,Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance (MORDOR) Study Group ,Biological Sciences ,Medical and Health Sciences ,Microbiology - Abstract
In a large community-randomized trial, biannual azithromycin distributions significantly reduced postneonatal childhood mortality in sub-Saharan African sites. Here, we present a prespecified secondary analysis showing that much of the protective effect was in the first 3 months postdistribution. Distributing more frequently than biannually could be considered if logistically feasible. Clinical Trials Registration. NCT02047981.
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- 2019
21. Mass Azithromycin Distribution to Prevent Childhood Mortality: A Pooled Analysis of Cluster-Randomized Trials.
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Oldenburg, Catherine E, Arzika, Ahmed M, Amza, Abdou, Gebre, Teshome, Kalua, Khumbo, Mrango, Zakayo, Cotter, Sun Y, West, Sheila K, Bailey, Robin L, Emerson, Paul M, O'Brien, Kieran S, Porco, Travis C, Keenan, Jeremy D, and Lietman, Thomas M
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Humans ,Communicable Diseases ,Azithromycin ,Anti-Bacterial Agents ,Administration ,Oral ,Child Mortality ,Infant Mortality ,Communicable Disease Control ,Child ,Preschool ,Infant ,Mass Drug Administration ,Clinical Research ,Pediatric ,Clinical Trials and Supportive Activities ,Prevention ,Good Health and Well Being ,Medical and Health Sciences ,Tropical Medicine - Abstract
Mass drug administration (MDA) with azithromycin may reduce under-5 child mortality (U5M) in sub-Saharan Africa. Here, we conducted a pooled analysis of all published cluster-randomized trials evaluating the effect of azithromycin MDA on child mortality. We pooled data from cluster-randomized trials randomizing communities to azithromycin MDA versus control. We calculated mortality rates in the azithromycin and control arms in each study, and by country for multisite studies including multiple countries. We conducted a two-stage individual community data meta-analysis to estimate the effect of azithromycin for prevention of child mortality. Three randomized controlled trials in four countries (Ethiopia, Malawi, Niger, and Tanzania) were identified. The overall pooled mortality rate was 15.9 per 1,000 person-years (95% confidence interval [CI]: 15.5-16.3). The pooled mortality rate was lower in azithromycin-treated communities than in placebo-treated communities (14.7 deaths per 1,000 person-years, 95% CI: 14.2-15.3 versus 17.2 deaths per 1,000 person-years, 95% CI: 16.5-17.8). There was a 14.4% reduction in all-cause child mortality in communities receiving azithromycin MDA (95% CI: 6.3-21.7% reduction, P = 0.0007). All-cause U5M was lower in communities receiving azithromycin MDA than in control communities, suggesting that azithromycin MDA could be a new tool to reduce child mortality in sub-Saharan Africa. However, heterogeneity in effect estimates suggests that the magnitude of the effect may vary in time and space and is currently not predictable.
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- 2019
22. Community-level chlamydial serology for assessing trachoma elimination in trachoma-endemic Niger.
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Kim, Jessica S, Oldenburg, Catherine E, Cooley, Gretchen, Amza, Abdou, Kadri, Boubacar, Nassirou, Baido, Cotter, Sun Yu, Stoller, Nicole E, West, Sheila K, Bailey, Robin L, Keenan, Jeremy D, Gaynor, Bruce D, Porco, Travis C, Lietman, Thomas M, and Martin, Diana L
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Humans ,Chlamydia trachomatis ,Trachoma ,Azithromycin ,Bacterial Proteins ,DNA ,Bacterial ,Antibodies ,Bacterial ,Antigens ,Bacterial ,Anti-Bacterial Agents ,Endemic Diseases ,Child ,Preschool ,Infant ,Infant ,Newborn ,Niger ,Disease Eradication ,Mass Drug Administration ,DNA ,Bacterial ,Antibodies ,Antigens ,Child ,Preschool ,Newborn ,Biological Sciences ,Medical and Health Sciences ,Tropical Medicine - Abstract
BACKGROUND:Program decision-making for trachoma elimination currently relies on conjunctival clinical signs. Antibody tests may provide additional information on the epidemiology of trachoma, particularly in regions where it is disappearing or elimination targets have been met. METHODS:A cluster-randomized trial of mass azithromycin distribution strategies for trachoma elimination was conducted over three years in a mesoendemic region of Niger. Dried blood spots were collected from a random sample of children aged 1-5 years in each of 24 study communities at 36 months after initiation of the intervention. A multiplex bead assay was used to test for antibodies to two Chlamydia trachomatis antigens, Pgp3 and CT694. We compared seropositivity to either antigen to clinical signs of active trachoma (trachomatous inflammation-follicular [TF] and trachomatous inflammation-intense [TI]) at the individual and cluster level, and to ocular chlamydia prevalence at the community level. RESULTS:Of 988 children with antibody data, TF prevalence was 7.8% (95% CI 6.1 to 9.5) and TI prevalence was 1.6% (95% CI 0.9 to 2.6). The overall prevalence of antibody positivity to Pgp3 was 27.2% (95% CI 24.5 to 30), and to CT694 was 23.7% (95% CI 21 to 26.2). Ocular chlamydia infection prevalence was 5.2% (95% CI 2.8 to 7.6). Seropositivity to Pgp3 and/or CT694 was significantly associated with TF at the individual and community level and with ocular chlamydia infection and TI at the community level. Older children were more likely to be seropositive than younger children. CONCLUSION:Seropositivity to Pgp3 and CT694 correlates with clinical signs and ocular chlamydia infection in a mesoendemic region of Niger. TRIAL REGISTRATION:ClinicalTrials.gov NCT00792922.
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- 2019
23. The utility of serology for elimination surveillance of trachoma
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Pinsent, Amy, Solomon, Anthony W, Bailey, Robin L, Bid, Rhiannon, Cama, Anaseini, Dean, Deborah, Goodhew, Brook, Gwyn, Sarah E, Jack, Kelvin R, Kandel, Ram Prasad, Kama, Mike, Massae, Patrick, Macleod, Colin, Mabey, David CW, Migchelsen, Stephanie, Müller, Andreas, Sandi, Frank, Sokana, Oliver, Taoaba, Raebwebwe, Tekeraoi, Rabebe, Martin, Diana L, and White, Michael T
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Infection ,Good Health and Well Being ,Adolescent ,Adult ,Africa South of the Sahara ,Age Factors ,Child ,Child ,Preschool ,Chlamydia trachomatis ,Female ,Humans ,Infant ,Models ,Statistical ,Nepal ,Pacific Islands ,Public Health Surveillance ,Seroepidemiologic Studies ,Trachoma ,Young Adult - Abstract
Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. Here, we analyse data from nine trachoma-endemic populations and provide operational thresholds for interpretation of serological data in low-transmission and post-elimination settings. Analyses with sero-catalytic and antibody acquisition models provide insights into transmission history within each population. To accurately estimate sero-conversion rates (SCR) for trachoma in populations with high-seroprevalence in adults, the model accounts for secondary exposure to Chlamydia trachomatis due to urogenital infection. We estimate the population half-life of sero-reversion for anti-Pgp3 antibodies to be 26 (95% credible interval (CrI): 21-34) years. We show SCRs below 0.015 (95% confidence interval (CI): 0.0-0.049) per year correspond to a prevalence of trachomatous inflammation-follicular below 5%, the current threshold for elimination of active trachoma as a public health problem. As global trachoma prevalence declines, we may need cross-sectional serological survey data to inform programmatic decisions.
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- 2018
24. Safety of azithromycin in infants under six months of age in Niger: A community randomized trial.
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Oldenburg, Catherine E, Arzika, Ahmed M, Maliki, Ramatou, Kane, Mohamed Salissou, Lebas, Elodie, Ray, Kathryn J, Cook, Catherine, Cotter, Sun Y, Zhou, Zhaoxia, West, Sheila K, Bailey, Robin, Porco, Travis C, Keenan, Jeremy D, Lietman, Thomas M, and MORDOR Study Group
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MORDOR Study Group ,Humans ,Chlamydia trachomatis ,Trachoma ,Azithromycin ,Anti-Bacterial Agents ,Infant Mortality ,Age Factors ,Infant ,Niger ,Female ,Male ,Biological Sciences ,Medical and Health Sciences ,Tropical Medicine - Abstract
BackgroundMass azithromycin distribution reduces under-5 child mortality. Trachoma control programs currently treat infants aged 6 months and older. Here, we report findings from an infant adverse event survey in 1-5 month olds who received azithromycin as part of a large community-randomized trial in Niger.Methods and principal findingsActive surveillance of infants aged 1-5 months at the time of treatment was conducted in 30 randomly selected communities from within a large cluster randomized trial of biannual mass azithromycin distribution compared to placebo to assess the potential impact on child mortality. We compared the distribution of adverse events reported after treatment among azithromycin-treated versus placebo-treated infants. From January 2015 to February 2018, the caregivers of 1,712 infants were surveyed. Approximately one-third of caregivers reported at least one adverse event (azithromycin: 29.6%, placebo: 34.3%, risk ratio [RR] 0.86, 95% confidence interval [CI] 0.68 to 1.10, P = 0.23). The most commonly reported adverse events included diarrhea (azithromycin: 19.3%, placebo: 28.1%, RR 0.68, 95% CI 0.49 to 0.96, P = 0.03), vomiting (azithromycin: 15.9%, placebo: 21.0%, RR 0.76, 95% CI 0.56 to 1.02, P = 0.07), and skin rash (azithromycin: 12.3%, placebo: 13.6%, RR 0.90, 95% CI 0.59 to 1.37, P = 0.63). No cases of infantile hypertrophic pyloric stenosis were reported.ConclusionsAzithromycin given to infants aged 1-5 months appeared to be safe. Inclusion of younger infants in larger azithromycin-based child mortality or trachoma control programs could be considered if deemed effective.Trial registrationClinicalTrials.gov NCT02048007.
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- 2018
25. Childhood Mortality After Mass Distribution of Azithromycin: A Secondary Analysis of the PRET Cluster-randomized Trial in Niger.
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O'Brien, Kieran S, Cotter, Sun Y, Amza, Abdou, Kadri, Boubacar, Nassirou, Beido, Stoller, Nicole E, Zhou, Zhaoxia, West, Sheila K, Bailey, Robin L, Keenan, Jeremy D, Porco, Travis C, and Lietman, Thomas M
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Humans ,Trachoma ,Communicable Diseases ,Azithromycin ,Anti-Bacterial Agents ,Administration ,Oral ,Prevalence ,Child Mortality ,Child ,Child ,Preschool ,Infant ,Niger ,Female ,Male ,Mass Drug Administration ,Clinical Trials and Supportive Activities ,Infectious Diseases ,Pediatric ,Clinical Research ,Comparative Effectiveness Research ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Good Health and Well Being ,azithromycin ,mortality ,mass drug administration ,cluster-randomized trial ,Paediatrics and Reproductive Medicine ,Public Health and Health Services ,Pediatrics - Abstract
BACKGROUND:Mass distributions of azithromycin for trachoma have been associated with secondary benefits, including reductions in child mortality. METHODS:In the Partnership for the Rapid Elimination of Trachoma cluster-randomized trial in Niger, 24 communities were randomized to annual treatment of everyone and 24 communities were randomized to biannual treatment of children under 12 for 3 years (clinicaltrials.gov, NCT00792922). Treatment was a single dose of directly observed oral azithromycin (20 mg/kg up to 1 g in adults). Vital status was assessed during annual census and monitoring visits. In this prespecified secondary analysis, we compared the mortality rate among children 6 months to less than 5 years of age by treatment arm using negative binomial regression. RESULTS:Among children 6 months to less than 5 years of age, 404 deaths occurred during the study period. The mortality rate was 35.6 deaths per 1000 person-years (231 deaths, 95% CI: 30.9-40.9) in the annual arm and 29.0 deaths per 1000 person-years (173 deaths, 95% CI: 24.8-33.8) in the biannual arm. The mortality rate ratio comparing children in the biannual arm to the annual arm was 0.81 (95% CI: 0.66-1.00, P = 0.07; primary outcome). The mortality rate ratio comparing children who died from infectious causes in the biannual arm to the annual arm was 0.73 (95% CI: 0.57-0.94; P = 0.02). No adverse events were reported. CONCLUSIONS:This secondary analysis of a cluster-randomized trial found a nonsignificant 19% decrease in mortality among children 6 months to less than 5 years of age who received biannual azithromycin compared with children who received annual azithromycin. This study was conducted in a high mortality, trachoma-endemic area; thus, results may be specific to this environment only. In addition, the trial was neither designed nor powered to detect a mortality effect, and we cannot rule out the possibility that mortality differences resulted from bias.
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- 2018
26. Impact of azithromycin mass drug administration on the antibiotic-resistant gut microbiome in children: a randomized, controlled trial
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Pickering, Harry, Hart, John D., Burr, Sarah, Stabler, Richard, Maleta, Ken, Kalua, Khumbo, Bailey, Robin L., and Holland, Martin J.
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- 2022
- Full Text
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27. Anthropometry and Malaria among Children in Niger: A Cross-Sectional Study.
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O'Brien, Kieran S, Amza, Abdou, Kadri, Boubacar, Nassirou, Baido, Cotter, Sun Y, Stoller, Nicole E, West, Sheila K, Bailey, Robin L, Porco, Travis C, Gaynor, Bruce D, Lietman, Thomas M, and Oldenburg, Catherine E
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Humans ,Parasitemia ,Malaria ,Body Weight ,Anthropometry ,Body Height ,Odds Ratio ,Risk Factors ,Cross-Sectional Studies ,Nutritional Status ,Pregnancy ,Child ,Child ,Preschool ,Niger ,Female ,Male ,Vector-Borne Diseases ,Clinical Research ,Rare Diseases ,Infectious Diseases ,Infection ,Good Health and Well Being ,Zero Hunger ,Medical and Health Sciences ,Tropical Medicine - Abstract
The complex relationship between malnutrition and malaria affects morbidity and mortality in children younger than 5 years, particularly in parts of sub-Saharan Africa where these conditions occur together seasonally. Previous research on this relationship has been inconclusive. Here, we examine the association between anthropometric indicators and malaria infection in a population-based sample of children younger than 5 years in Niger. This cross-sectional study is a secondary analysis of a cluster-randomized trial comparing treatment strategies for trachoma in Niger. We included children aged 6-60 months residing in the 48 communities enrolled in the trial who completed anthropometric and malaria infection assessments at the final study visit. We evaluated the association between anthropometric indicators, including height-for-age z-score (HAZ) and weight-for-age z-score (WAZ) and indicators of malaria infection, including malaria parasitemia and clinical malaria. In May 2013, we collected data from 1,649 children. Of these, 780 (47.3%) were positive for malaria parasitemia and 401 (24.3%) had clinical malaria. In models of malaria parasitemia, the adjusted odds ratio (aOR) was 1.05 (95% confidence interval [CI]: 1.00-1.10) for HAZ and 1.07 (95% CI: 0.99, 1.15) for WAZ. In models of clinical malaria, the aOR was 1.07 (95% CI: 1.02-1.11) for HAZ and 1.09 (95% CI: 1.01-1.19) for WAZ. Overall, we did not find evidence of an association between most anthropometric indicators and malaria infection. Greater height may be associated with an increased risk of clinical malaria.
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- 2018
28. Annual Versus Biannual Mass Azithromycin Distribution and Malaria Parasitemia During the Peak Transmission Season Among Children in Niger.
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Oldenburg, Catherine E, Amza, Abdou, Kadri, Boubacar, Nassirou, Beido, Cotter, Sun Y, Stoller, Nicole E, West, Sheila K, Bailey, Robin L, Porco, Travis C, Keenan, Jeremy D, Lietman, Thomas M, and Gaynor, Bruce D
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Humans ,Trachoma ,Parasitemia ,Malaria ,Azithromycin ,Anti-Bacterial Agents ,Prevalence ,Cluster Analysis ,Seasons ,Child ,Child ,Preschool ,Infant ,Niger ,Female ,Male ,Mass Drug Administration ,Rare Diseases ,Pediatric ,HIV/AIDS ,Clinical Trials and Supportive Activities ,Clinical Research ,Infectious Diseases ,Vector-Borne Diseases ,Infection ,Good Health and Well Being ,azithromycin ,malaria ,Paediatrics and Reproductive Medicine ,Public Health and Health Services ,Pediatrics - Abstract
BackgroundAzithromycin has modest efficacy against malaria, and previous cluster randomized trials have suggested that mass azithromycin distribution for trachoma control may play a role in malaria control. We evaluated the effect of annual versus biannual mass azithromycin distribution over a 3-year period on malaria prevalence during the peak transmission season in a region with seasonal malaria transmission in Niger.MethodsTwenty-four communities in Matameye, Niger, were randomized to annual mass azithromycin distribution (3 distributions to the entire community during the peak transmission season) or biannual-targeted azithromycin distribution (6 distributions to children
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- 2018
29. Effectiveness of expanding annual mass azithromycin distribution treatment coverage for trachoma in Niger: a cluster randomised trial.
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Amza, Abdou, Kadri, Boubacar, Nassirou, Beido, Cotter, Sun Y, Stoller, Nicole E, West, Sheila K, Bailey, Robin L, Porco, Travis C, Gaynor, Bruce D, Keenan, Jeremy D, Lietman, Thomas M, and Oldenburg, Catherine E
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Humans ,Trachoma ,Azithromycin ,Anti-Bacterial Agents ,Antibiotic Prophylaxis ,Prevalence ,Child ,Preschool ,Infant ,Delivery of Health Care ,Niger ,Female ,Male ,Child Health ,Clinical Trial ,Conjunctiva ,Infection ,Public Health ,Infectious Diseases ,Cost Effectiveness Research ,Eye Disease and Disorders of Vision ,Clinical Trials and Supportive Activities ,Clinical Research ,Good Health and Well Being ,Clinical Sciences ,Opthalmology and Optometry ,Public Health and Health Services ,Ophthalmology & Optometry - Abstract
Background/aimsThe WHO recommends 3-5 years of annual mass azithromycin distribution with at least 80% treatment coverage to districts with active trachoma prevalence over 10% among children. Here, we assess the efficacy of expanding the coverage target to at least 90% for trachoma control in a mesoendemic region of Niger.MethodsTwenty-four communities were randomised to a single day of azithromycin distribution with a coverage target of 80% of the community or up to 4 days of treatment, aiming for greater than 90% coverage. Distributions were annual and individuals above 6 months of age were treated. Children under 5 years of age were monitored for ocular chlamydia infection and active trachoma.ResultsAt baseline, ocular chlamydia prevalence was 20.5% (95% CI 9.8% to 31.2%) in the standard coverage arm and 21.9% (95% CI 11.3% to 32.5%) in the enhanced coverage arm, which reduced to 4.6% (95% CI 0% to 9.5%, p=0.008) and 7.1% (95% CI 2.7% to 11.4%, p
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- 2018
30. Azithromycin to Reduce Childhood Mortality in Sub-Saharan Africa.
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Keenan, Jeremy D, Bailey, Robin L, West, Sheila K, Arzika, Ahmed M, Hart, John, Weaver, Jerusha, Kalua, Khumbo, Mrango, Zakayo, Ray, Kathryn J, Cook, Catherine, Lebas, Elodie, O'Brien, Kieran S, Emerson, Paul M, Porco, Travis C, Lietman, Thomas M, and MORDOR Study Group
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MORDOR Study Group ,Humans ,Communicable Diseases ,Azithromycin ,Anti-Bacterial Agents ,Administration ,Oral ,Child Mortality ,Infant Mortality ,Public Health ,Communicable Disease Control ,Drug Resistance ,Bacterial ,Child ,Preschool ,Infant ,Tanzania ,Malawi ,Niger ,Female ,Male ,Mass Drug Administration ,Infectious Diseases ,Clinical Trials and Supportive Activities ,Pediatric ,Clinical Research ,Prevention ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Good Health and Well Being ,Medical and Health Sciences ,General & Internal Medicine - Abstract
BackgroundWe hypothesized that mass distribution of a broad-spectrum antibiotic agent to preschool children would reduce mortality in areas of sub-Saharan Africa that are currently far from meeting the Sustainable Development Goals of the United Nations.MethodsIn this cluster-randomized trial, we assigned communities in Malawi, Niger, and Tanzania to four twice-yearly mass distributions of either oral azithromycin (approximately 20 mg per kilogram of body weight) or placebo. Children 1 to 59 months of age were identified in twice-yearly censuses and were offered participation in the trial. Vital status was determined at subsequent censuses. The primary outcome was aggregate all-cause mortality; country-specific rates were assessed in prespecified subgroup analyses.ResultsA total of 1533 communities underwent randomization, 190,238 children were identified in the census at baseline, and 323,302 person-years were monitored. The mean (±SD) azithromycin and placebo coverage over the four twice-yearly distributions was 90.4±10.4%. The overall annual mortality rate was 14.6 deaths per 1000 person-years in communities that received azithromycin (9.1 in Malawi, 22.5 in Niger, and 5.4 in Tanzania) and 16.5 deaths per 1000 person-years in communities that received placebo (9.6 in Malawi, 27.5 in Niger, and 5.5 in Tanzania). Mortality was 13.5% lower overall (95% confidence interval [CI], 6.7 to 19.8) in communities that received azithromycin than in communities that received placebo (P
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- 2018
31. Comparison of Mass Azithromycin Coverage Targets of Children in Niger: A Cluster-Randomized Trachoma Trial.
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Oldenburg, Catherine E, Amza, Abdou, Kadri, Boubacar, Nassirou, Beido, Cotter, Sun Y, Stoller, Nicole E, West, Sheila K, Bailey, Robin L, Porco, Travis C, Gaynor, Bruce D, Keenan, Jeremy D, and Lietman, Thomas M
- Subjects
Eye ,Humans ,Chlamydia trachomatis ,Trachoma ,Azithromycin ,Anti-Bacterial Agents ,Treatment Outcome ,Prevalence ,Cluster Analysis ,Polymerase Chain Reaction ,Child ,Preschool ,Infant ,Niger ,Female ,Male ,Eye Disease and Disorders of Vision ,Clinical Trials and Supportive Activities ,Pediatric ,Clinical Research ,Infectious Diseases ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Infection ,Good Health and Well Being ,Medical and Health Sciences ,Tropical Medicine - Abstract
Repeated oral azithromycin distribution targeted only to children has proven effective in reducing the ocular Chlamydia that causes trachoma. Here, we assess whether an enhanced coverage target of at least 90% of children is superior to the World Health Organization recommendation of at least 80%. Twenty-four trachoma-endemic communities in Matamèye, Niger, were randomized to a single day of azithromycin distribution aiming for at least 80% coverage or up to 4 days of treatment and > 90% coverage of children under age 12. All distributions were biannual. Children < 5 years of age and adults > 15 years were monitored for ocular Chlamydia infection by polymerase chain reaction every 6 months for 36 months in children and at baseline and 36 months in adults. Ocular Chlamydia prevalence in children decreased from 24.9% (95% confidence interval [CI] 15.9-33.8%) to 4.4% (95% CI 0.6-8.2%, P < 0.001) at 36 months in the standard coverage arm and from 15.6% (95% CI 10.0-21.2%) to 3.3% (95% CI 1.0-5.5%; P < 0.001) in the enhanced coverage arm. Enhanced coverage reduced ocular Chlamydia prevalence in children more quickly over time compared with standard (P = 0.04). There was no difference between arms at 36 months in children (2.4% lower with enhanced coverage, 95% CI 7.7-12.5%; P = 0.60). No infection was detected in adults at 36 months. Increasing antibiotic coverage among children from 80% to 90% may yield only short term improvements for trachoma control programs. Targeting treatment to children alone may be sufficient for trachoma control in this setting.
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- 2018
32. “It’s a Right Pain in the Pelvis!”: Post-Traumatic Stress and Post-Traumatic Growth in a Sample of Females Experiencing Chronic Pelvic Pain
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Wall, Charlotte Louise, primary, Carson, Jerome, additional, Brown, Gill, additional, and Bailey, Robin, additional
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- 2024
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33. Fecal biomarkers of environmental enteric dysfunction and the gut microbiota of rural Malawian children: An observational study
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Chaima, David, Pickering, Harry, Hart, John D., Burr, Sarah E., Maleta, Kenneth M., Kalua, Khumbo, Bailey, Robin L., and Holland, Martin J.
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- 2021
- Full Text
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34. Metacognition & health anxiety
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Bailey, Robin and Wells, Adrian
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153 ,Metacognition ,Health Anxiety - Abstract
The development, maintenance, and treatment of health anxiety remains an important area in psychological research. The cognitive behavioural therapy (CBT) model has gained popularity, as an evidence-based approach for explaining and treating health anxiety (Barsky & Ahern, 2004; Clark, et al., 1998; Warwick, et al., 1996). However, significant limitations exist, not least because treating illness-related cognitions appears not to confer much advantage over other treatment approaches. An emerging psychological approach, Metacognitive Therapy (Wells & Matthews, 1994), may offer an alternative approach for understanding and treating this disorder. In this thesis the predictions made by the metacognitive model and applied to health anxiety were tested using data from cross sectional, longitudinal and treatment designs. In Chapter 2 a cross sectional study investigated whether metacognition was associated with health anxiety when controlling for other factors (i.e., neuroticism, somatosensory amplification, and illness cognition). Results indicated a strong positive association between metacognition and health anxiety, and demonstrated the predictive potential of specific metacognitions over and above other established correlates of symptoms. In Chapter 3exploratory and confirmatory factor analysis was used to develop a specific metacognitive measure. This resulted in a 14 item, three factor measure, with further analysis suggesting good internal-consistency, incremental, convergent and discriminant validity. Preliminary findings from this study support the assessment of health-anxiety specific metacognitions with this new tool. Chapter 4 expanded the findings of chapter 2 and directly compared key aspects of the metacognitive model (metacognition) with the cognitive model (dysfunctional beliefs). Metacognitive beliefs were found to explain almost half of the variance in health anxiety when controlling for dysfunctional illness beliefs, and emerged as the strongest independent predictors. These data support a key component of the metacognitive model, that metacognition may be more important in health anxiety than symptom/illness-related beliefs. In Chapter 5 & 6 both cross-sectional and longitudinal designs explored the relationship between cognition (catastrophic misinterpretation), and metacognition. Consistent with the metacognitive model the effect of cognition on health anxiety was explained by an interaction with metacognition. The results of these findings add further weight to the idea that metacognition may be more important in both the development and maintenance of health anxiety than cognition. Finally, in Chapter 7 an A-B single case series treatment design (N=4) was used to investigate the effects associated with metacognitive therapy (MCT) applied to health anxiety. The results showed that all four patients treated with MCT demonstrated large and clinically meaningful improvements in health anxiety both at post treatment and follow up. These improvements also corresponded with substantial changes in patients metacognitive beliefs. Overall this case series provides preliminary evidence that MCT can be applied to health anxiety. Collectively the results of this thesis provide new insights into the role played by metacognition in health anxiety. It provides evidence for a role of metacognition in both the development and maintenance of health anxiety, and indicates that targeting metacognition can be applied in treatment of these patients and may bring about a reduction in health anxiety symptoms.
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- 2017
35. Mass drug administration with azithromycin for trachoma elimination and the population structure of Streptococcus pneumoniae in the nasopharynx
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Gladstone, Rebecca A., Bojang, Ebrima, Hart, John, Harding-Esch, Emma M., Mabey, David, Sillah, Ansumana, Bailey, Robin L., Burr, Sarah E., Roca, Anna, Bentley, Stephen D., and Holland, Martin J.
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- 2021
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36. CBT for Panic Disorder
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Bailey, Robin D., primary
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- 2021
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37. Mass Azithromycin and Malaria Parasitemia in Niger: Results from a Community-Randomized Trial
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O'Brien, Kieran S, Cotter, Sun Y, Amza, Abdou, Kadri, Boubacar, Nassirou, Baido, Stoller, Nicole E, Zhou, Zhaoxia, Cotter, Chris, West, Sheila K, Bailey, Robin L, Rosenthal, Philip J, Gaynor, Bruce D, Porco, Travis C, and Lietman, Thomas M
- Subjects
Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Sciences ,Pediatric ,Clinical Research ,Rare Diseases ,HIV/AIDS ,Infectious Diseases ,Malaria ,Vector-Borne Diseases ,Clinical Trials and Supportive Activities ,Infection ,Good Health and Well Being ,Anti-Bacterial Agents ,Azithromycin ,Female ,Humans ,Infant ,Male ,Niger ,Parasitemia ,Trachoma ,Medical and Health Sciences ,Tropical Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
Studies designed to determine the effects of mass administration of azithromycin on trachoma have suggested that mass azithromycin distributions may also reduce the prevalence of malaria. These studies have typically examined the impact of a small number of treatments over short durations. In this prespecified substudy of a cluster-randomized trial for trachoma, we compared malaria parasitemia prevalence in 24 communities in Niger randomized to receive either annual or biannual mass azithromycin distributions over 3 years. The 12 communities randomized to annual azithromycin received three treatments during the high-transmission season, and the 12 communities randomized to biannual azithromycin received a total of six treatments: three during the high-transmission season and three during the low-transmission season. Blood samples were taken to assess malariometric indices among children in all study communities at a single time point during the high-transmission season after 3 years of the intervention. No significant differences were identified in malaria parasitemia, parasite density, or hemoglobin concentration between the annual and biannual treatment arms. When compared with annual mass azithromycin alone, additional mass azithromycin distributions given during the low-transmission season did not significantly reduce the subsequent prevalence of malaria parasitemia or parasite density after 3 years, as measured during the high-transmission season.
- Published
- 2017
38. Genome-wide profiling of humoral immunity and pathogen genes under selection identifies immune evasion tactics of Chlamydia trachomatis during ocular infection.
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Pickering, Harry, Teng, Andy, Faal, Nkoyo, Joof, Hassan, Makalo, Pateh, Cassama, Eunice, Nabicassa, Meno, Last, Anna R, Burr, Sarah E, Rowland-Jones, Sarah L, Thomson, Nicholas R, Roberts, Chrissy H, Mabey, David CW, Bailey, Robin L, Hayward, Richard D, de la Maza, Luis M, and Holland, Martin J
- Subjects
Humans ,Chlamydia trachomatis ,Trachoma ,Antigens ,Bacterial ,Child ,Child ,Preschool ,Gambia ,Guinea-Bissau ,Female ,Male ,Host-Pathogen Interactions ,Selection ,Genetic ,Immunity ,Humoral ,Immune Evasion ,Vaccine Related ,Genetics ,Infectious Diseases ,Clinical Research ,Immunization ,Prevention ,Biotechnology ,Human Genome ,Sexually Transmitted Infections ,Pediatric ,2.1 Biological and endogenous factors ,Infection ,Inflammatory and Immune System ,Antigens ,Bacterial ,Preschool ,Selection ,Genetic ,Immunity ,Humoral ,Biochemistry and Cell Biology ,Other Physical Sciences - Abstract
The frequency and duration of Chlamydia trachomatis (Ct) ocular infections decrease with age, suggesting development of partial immunity. However, there is a lack of clear correlates of immunity to Ct infection in humans. We screened sera from a cohort of Gambian children followed for six-months against a Ct-proteome microarray. At genome sequence level, we detected signatures of selection from a population of ocular Ct isolates from Guinea-Bissau. Together these approaches allowed us to highlight the focus of humoral responses and hypothesise new modes of pathogen immune evasion. Children who were susceptible to frequent and/or prolonged Ct infection had a less focussed antibody response, including preferential recognition of forty-two antigens. There was evidence of positive and purifying selection across the genome, but little balancing selection. In contrast, most antigens that were associated with susceptibility were under neutral selection. These data suggest an evasion strategy in which Ct presents a large panel of irrelevant antigens to the immune system to block or misdirect protective responses. Development of a focused immune response, possibly induced through vaccination, may be an effective strategy to promote protection to Ct infection.
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- 2017
39. Cause-specific mortality of children younger than 5 years in communities receiving biannual mass azithromycin treatment in Niger: verbal autopsy results from a cluster-randomised controlled trial
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Emerson, Paul M, Weaver, Jerusha, West, Sheila K, Bailey, Robin L, Hart, John, Abdou, Amza, Kadri, Boubacar, Beido, Nassirou, Callahan, E Kelly, Stewart, Aisha E, Arzika, Ahmed M, Elh Adamou, Sanoussi, Galo, Nana Fatima, Ibrahim, Fatima, Kane, Salissou, Kiemago, Mariama, Maliki, Ramatou, Cook, Catherine, Cotter, Sun Y, Doan, Thuy, Fry, Dionna M, Keenan, Jeremy D, Lebas, Elodie, Lietman, Thomas M, Lin, Ying, O'Brien, Kieran S, Oldenburg, Catherine E, Porco, Travis C, Ray, Kathryn J, Rosenthal, Philip J, Rutherford, George W, Vanderschelden, Benjamin, Varnado, Nicole E, Zhong, Lina, and Zhou, Zhaoxia
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- 2020
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40. Why health anxiety needs NICE clinical guidelines
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Bailey, Robin, primary
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- 2024
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41. Genomic insights into local scale evolution of ocularChlamydia trachomatisstrains within and between individuals in Gambian trachoma-endemic villages
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Ghasemian, Ehsan, primary, Faal, Nkoyo, additional, Pickering, Harry, additional, Sillah, Ansumana, additional, Breuer, Judith, additional, Bailey, Robin L., additional, Mabey, David, additional, and Holland, Martin J., additional
- Published
- 2023
- Full Text
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42. Tropical Data: Approach and Methodology as Applied to Trachoma Prevalence Surveys
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Harding-Esch, Emma M, primary, Burgert-Brucker, Clara R, additional, Jimenez, Cristina, additional, Bakhtiari, Ana, additional, Willis, Rebecca, additional, Bejiga, Michael Dejene, additional, Mpyet, Caleb, additional, Ngondi, Jeremiah, additional, Boyd, Sarah, additional, Abdala, Mariamo, additional, Abdou, Amza, additional, Adamu, Yilikal, additional, Alemayehu, Addisu, additional, Alemayehu, Wondu, additional, Al-Khatib, Tawfik, additional, Apadinuwe, Sue-Chen, additional, Awaca, Naomie, additional, Awoussi, Marcel S, additional, Baayendag, Gilbert, additional, Badiane, Mouctar Dieng, additional, Bailey, Robin L, additional, Batcho, Wilfrid, additional, Bay, Zulficar, additional, Bella, Assumpta, additional, Beido, Nassirou, additional, Bol, Yak Yak, additional, Bougouma, Clarisse, additional, Brady, Christopher J, additional, Bucumi, Victor, additional, Butcher, Robert, additional, Cakacaka, Risiate, additional, Cama, Anaseini, additional, Camara, Mamoudou, additional, Cassama, Eunice, additional, Chaora, Shorai Grace, additional, Chebbi, Amel Chenaoui, additional, Chisambi, Alvin Blessings, additional, Chu, Brian, additional, Conteh, Abdulai, additional, Coulibaly, Sidi Mohamed, additional, Courtright, Paul, additional, Dalmar, Abdi, additional, Dat, Tran Minh, additional, Davids, Thully, additional, Djaker, Mohamed El Amine, additional, de Fátima Costa Lopes, Maria, additional, Dézoumbé, Djore, additional, Dodson, Sarity, additional, Downs, Philip, additional, Eckman, Stephanie, additional, Elshafie, Bilghis Elkhair, additional, Elmezoghi, Mourad, additional, Elvis, Ange Aba, additional, Emerson, Paul, additional, Epée, Emilienne EE, additional, Faktaufon, Daniel, additional, Fall, Mawo, additional, Fassinou, Aréty, additional, Fleming, Fiona, additional, Flueckiger, Rebecca, additional, Gamael, Koizan Kadjo, additional, Garae, Mackline, additional, Garap, Jambi, additional, Gass, Katie, additional, Gebru, Genet, additional, Gichangi, Michael M, additional, Giorgi, Emanuele, additional, Goépogui, André, additional, Gómez, Daniela Vaz Ferreira, additional, Gómez Forero, Diana Paola, additional, Gower, Emily W, additional, Harte, Anna, additional, Henry, Rob, additional, Honorio-Morales, Harvy Alberto, additional, Ilako, Dunera R, additional, Issifou, Amadou Alfa Bio, additional, Jones, Ellen, additional, Kabona, George, additional, Kabore, Martin, additional, Kadri, Boubacar, additional, Kalua, Khumbo, additional, Kanyi, Sarjo Kebba, additional, Kebede, Shambel, additional, Kebede, Fikreab, additional, Keenan, Jeremy D, additional, Kello, Amir B, additional, Khan, Asad Aslam, additional, Khelifi, Houria, additional, Kilangalanga, Janvier, additional, Kim, Sung Hye, additional, Ko, Robert, additional, Lewallen, Susan, additional, Lietman, Thomas, additional, Logora, Makoy Samuel Yibi, additional, Lopez, Yuri A, additional, MacArthur, Chad, additional, Macleod, Colin, additional, Makangila, Felix, additional, Mariko, Brehima, additional, Martin, Diana L, additional, Masika, Michael, additional, Massae, Patrick, additional, Massangaie, Marilia, additional, Matendechero, Hadley S, additional, Mathewos, Tsedeke, additional, McCullagh, Siobhain, additional, Meite, Aboulaye, additional, Mendes, Elsa Palma, additional, Abdi, Hirpa M, additional, Miller, Hollman, additional, Minnih, Abdellahi, additional, Mishra, Sailesh Kumar, additional, Molefi, Tuduetso, additional, Mosher, Aryc, additional, M’Po, Nerkoua, additional, Mugume, Francis, additional, Mukwiza, Robson, additional, Mwale, Consity, additional, Mwatha, Stephen, additional, Mwingira, Upendo, additional, Nash, Scott D, additional, Nassa, Christophe, additional, Negussu, Nebiyu, additional, Nieba, Cece, additional, Noah Noah, Jean Claude, additional, Nwosu, Christian O, additional, Olobio, Nicholas, additional, Opon, Rapheal, additional, Pavluck, Alexandre, additional, Phiri, Isaac, additional, Rainima-Qaniuci, Merelesita, additional, Renneker, Kristen K, additional, Saboyá-Díaz, Martha Idalí, additional, Sakho, Fatoumata, additional, Sanha, Salimato, additional, Sarah, Virginia, additional, Sarr, Boubacar, additional, Szwarcwald, Celia L, additional, Shah Salam, Ahmad, additional, Sharma, Shekhar, additional, Seife, Fikre, additional, Serrano Chavez, Gloria Marina, additional, Sissoko, Mactar, additional, Sitoe, Henis Mior, additional, Sokana, Oliver, additional, Tadesse, Fentahun, additional, Taleo, Fasiah, additional, Talero, Sandra Liliana, additional, Tarfani, Youcef, additional, Tefera, Amsayaw, additional, Tekeraoi, Rabebe, additional, Tesfazion, Andeberhan, additional, Traina, Abubaker, additional, Traoré, Lamine, additional, Trujillo-Trujillo, Julián, additional, Tukahebwa, Edridah M, additional, Vashist, Praveen, additional, Wanyama, Ernest B, additional, Warusavithana, Supriya D.P., additional, Watitu, Titus K, additional, West, Sheila, additional, Win, Ye, additional, Woods, Geordie, additional, Yajima, Aya, additional, Yaya, Georges, additional, Zecarias, Alem, additional, Zewengiel, Solomon, additional, Zoumanigui, Akoi, additional, Hooper, Pamela J, additional, Millar, Tom, additional, Rotondo, Lisa, additional, and Solomon, Anthony W, additional
- Published
- 2023
- Full Text
- View/download PDF
43. Power-law stratigraphy
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Bailey, Robin J., primary
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- 2023
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44. Short-term forecasting of the prevalence of clinical trachoma: utility of including delayed recovery and tests for infection
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Liu, Fengchen, Porco, Travis C, Amza, Abdou, Kadri, Boubacar, Nassirou, Baido, West, Sheila K, Bailey, Robin L, Keenan, Jeremy D, and Lietman, Thomas M
- Subjects
Paediatrics ,Biomedical and Clinical Sciences ,Prevention ,Good Health and Well Being ,Humans ,Models ,Theoretical ,Niger ,Prevalence ,Trachoma ,World Health Organization ,Model ,Mass drug administration ,Forecast ,Prediction ,Medical Microbiology ,Public Health and Health Services ,Mycology & Parasitology ,Tropical Medicine ,Microbiology ,Medical microbiology - Abstract
BackgroundThe World Health Organization aims to control blinding trachoma by 2020. Decisions on whether to start and stop mass treatments and when to declare that control has been achieved are currently based on clinical examination data generated in population-based surveys. Thresholds are based on the district-level prevalence of trachomatous inflammation-follicular (TF) in children aged 1-9 years. Forecasts of which districts may and may not meet TF control goals by the 2020 target date could affect resource allocation in the next few years.MethodsWe constructed a hidden Markov model fit to the prevalence of two clinical signs of trachoma and PCR data in 24 communities from the recent PRET-Niger trial. The prevalence of TF in children in each community at 36 months was forecast given data from earlier time points. Forecasts were scored by the likelihood of the observed results. We assessed whether use of TF with additional TI and PCR data rather than just the use of TF alone improves forecasts, and separately whether incorporating a delay in TF recovery is beneficial.ResultsIncluding TI and PCR data did not significantly improve forecasts of TF. Forecasts of TF prevalence at 36 months by the model with the delay in TF recovery were significantly better than forecasts by the model without the delay in TF recovery (p = 0.003). A zero-inflated truncated normal observation model was better than a truncated normal observation model, and better than a sensitivity-specificity observation model.ConclusionThe results in this study suggest that future studies could consider using just TF data for forecasting, and should include a delay in TF recovery.Trial registrationClinicaltrials.gov NCT00792922.
- Published
- 2015
45. The Effect of Antibiotic Selection Pressure on the Nasopharyngeal Macrolide Resistome : A Cluster-randomized Trial
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Partnership for the Rapid Elimination of Trachoma (PRET) Study Group, Keenan, Jeremy D., Chin, Stephanie A., Amza, Abdou, Kadri, Boubacar, Nassirou, Baido, Cevallos, Vicky, Cotter, Sun Y., Zhou, Zhaoxia, West, Sheila K., Bailey, Robin L., Porco, Travis C., and Lietman, Thomas M.
- Published
- 2018
46. Predictors of aetiology and outcomes of acute gastrointestinal illness in returning travellers: a retrospective cohort analysis
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Lever, Robert A., Tapper, Louis, Skarbek, Sophie, Chiodini, Peter L., Armstrong, Margaret, and Bailey, Robin L.
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- 2021
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47. Short-term Forecasting of the Prevalence of Trachoma: Expert Opinion, Statistical Regression, versus Transmission Models.
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Liu, Fengchen, Porco, Travis C, Amza, Abdou, Kadri, Boubacar, Nassirou, Baido, West, Sheila K, Bailey, Robin L, Keenan, Jeremy D, Solomon, Anthony W, Emerson, Paul M, Gambhir, Manoj, and Lietman, Thomas M
- Subjects
Humans ,Trachoma ,Anti-Bacterial Agents ,Prevalence ,Regression Analysis ,Endemic Diseases ,Models ,Biological ,Forecasting ,Expert Testimony ,Child ,Child ,Preschool ,Infant ,Niger ,Randomized Controlled Trials as Topic ,Models ,Biological ,Preschool ,Tropical Medicine ,Biological Sciences ,Medical and Health Sciences - Abstract
BackgroundTrachoma programs rely on guidelines made in large part using expert opinion of what will happen with and without intervention. Large community-randomized trials offer an opportunity to actually compare forecasting methods in a masked fashion.MethodsThe Program for the Rapid Elimination of Trachoma trials estimated longitudinal prevalence of ocular chlamydial infection from 24 communities treated annually with mass azithromycin. Given antibiotic coverage and biannual assessments from baseline through 30 months, forecasts of the prevalence of infection in each of the 24 communities at 36 months were made by three methods: the sum of 15 experts' opinion, statistical regression of the square-root-transformed prevalence, and a stochastic hidden Markov model of infection transmission (Susceptible-Infectious-Susceptible, or SIS model). All forecasters were masked to the 36-month results and to the other forecasts. Forecasts of the 24 communities were scored by the likelihood of the observed results and compared using Wilcoxon's signed-rank statistic.FindingsRegression and SIS hidden Markov models had significantly better likelihood than community expert opinion (p = 0.004 and p = 0.01, respectively). All forecasts scored better when perturbed to decrease Fisher's information. Each individual expert's forecast was poorer than the sum of experts.InterpretationRegression and SIS models performed significantly better than expert opinion, although all forecasts were overly confident. Further model refinements may score better, although would need to be tested and compared in new masked studies. Construction of guidelines that rely on forecasting future prevalence could consider use of mathematical and statistical models.Trial registrationClinicaltrials.gov NCT00792922.
- Published
- 2015
48. Impact of Mass Azithromycin Distribution on Malaria Parasitemia during the Low-Transmission Season in Niger: A Cluster-Randomized Trial
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Gaynor, Bruce D, Amza, Abdou, Kadri, Boubacar, Nassirou, Baido, Lawan, Ousmane, Maman, Laouali, Stoller, Nicole E, Yu, Sun N, Chin, Stephanie A, West, Sheila K, Bailey, Robin L, Rosenthal, Philip J, Keenan, Jeremy D, Porco, Travis C, and Lietman, Thomas M
- Subjects
Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Trials and Supportive Activities ,Rare Diseases ,Clinical Research ,Vector-Borne Diseases ,Malaria ,Prevention ,Infectious Diseases ,6.1 Pharmaceuticals ,2.2 Factors relating to the physical environment ,Infection ,Good Health and Well Being ,Azithromycin ,Child ,Child ,Preschool ,Cluster Analysis ,DNA ,Protozoan ,Female ,Humans ,Infant ,Logistic Models ,Male ,Niger ,Parasitemia ,Prevalence ,Seasons ,Treatment Outcome ,Medical and Health Sciences ,Tropical Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
We assessed the effect of mass azithromycin treatment on malaria parasitemia in a trachoma trial in Niger. Twenty-four study communities received treatment during the wet, high-transmission season. Twelve of the 24 communities were randomized to receive an additional treatment during the dry, low-transmission season. Outcome measurements were conducted at the community-level in children < 1-72 months of age in May-June 2011. Parasitemia was higher in the 12 once-treated communities (29.8%, 95% confidence interval [CI] = 21.5-40.0%) than in the 12 twice-treated communities (19.5%, 95% CI = 13.0-26.5%, P = 0.03). Parasite density was higher in once-treated communities (354 parasites/μL, 95% CI = 117-528 parasites/μL) than in twice-treated communities (74 parasites/μL, 95% CI = 41-202 parasites/μL, P = 0.03). Mass distribution of azithromycin reduced malaria parasitemia 4-5 months after the intervention. The results suggest that drugs with antimalaria activity can have long-lasting impacts on malaria during periods of low transmission.
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- 2014
49. Longitudinal changes in tear cytokines and antimicrobial proteins in trachomatous disease
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Barton, Amber, primary, Faal, Nkoyo, additional, Ramadhani, Athumani, additional, Derrick, Tamsyn, additional, Mafuru, Elias, additional, Mtuy, Tara, additional, Massae, Patrick, additional, Malissa, Aiweda, additional, Joof, Hassan, additional, Makalo, Pateh, additional, Sillah, Ansumana, additional, Harte, Anna, additional, Pickering, Harry, additional, Bailey, Robin, additional, Mabey, David CW, additional, Burton, Matthew J., additional, and Holland, Martin J., additional
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- 2023
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50. Synonymous Myocilin mutations break their silence in a Zambian population attending selected referral eye health facilities
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Muma, Kangwa I. M., primary, Bailey, Robin, additional, Nyalazi, Jessie I. M., additional, Zulu, George, additional, Malisawa, Tyness S. Mumba, additional, Musonda, Lillian M. L. Chinama, additional, Muma, Kachikonyo Sibande, additional, Simulundu, Edgar, additional, and Kaonga, Patrick, additional
- Published
- 2023
- Full Text
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