Question

How is the treatment (azithromycin) for a non-lethal ocular disease (trachoma) affecting mortality in children? Discuss why this affect could be seen?

Answer 1

Treatment of non-lethal ocular disease trachoma using azithromycin has reduced the mortality rates in children. According to a recent report in lancet infectious disease june 2018 , overall mortality rates of children over a period of two years was 13.5% lower in case of those who received treatment for trachoma using azithromycin compared to those who received a placebo.

According to WHO trachoma is a blindness of the eyes caused by infection by Chlamydia trachomatis. Infection can spread through direct contact or through flies that have come in contact with bodily discharges from a person infected with this disease. In the recent years this reduction in child mortality rates could be seen due strategy of mass distribution of azithromycin to cohort that is in danger of facing infection. Improvement in surgery techniques, introduction of facial cleanliness strategies and overall improvement of the environment of the population that is susceptible to the disease in addition to distribution of antibiotics has led to a striking decrease in the mortality rates. This reduction of mortality rates in population receiving azithromycin treatment can also be due to the efficiency of azithromycin in controlling other diseases like respiratory infection, diarrhoea and malaria. This led to an overall decrease in exposure to body discharges and affects subpatent infection, carriers and transmission. Previously azithromycin treatment was given to children above 6 months age. Recent studies also include children in the range of 1 to 5 months thus increasing the total number in the cohort that is receiving treatment. The most significant attraction of this mass distribution of antibiotic is that non development of resistance. Azithromycin has also been used to treat gonorrhoea. Thus mass non specific use provides advantage over loss of efficacy. It is also important to keep in mind that azithromycin shows longer tissue half life and works against intracellular microorganisms like Chlamydia trachomatis . Azithromycin also do not show symptoms of vomiting and abdominal pain associated with other routinely used antibiotics. Thus the affect of treating a non lethal occular disease using Azithromycin could be seen in the recent years.