03243nas a2200349   4500000000100000008004100001260001200042653002900054653001300083653002500096653001600121653001800137653001600155100001200171700001300183700001100196700001200207700001300219700001100232700001200243700002200255700001300277700001500290700002000305700001400325245020200339856010900541300000900650490000600659520221400665022001402879       2024                            d  c01/202410aMass drug administration10aChildren10aHigh child-mortality10aFeasibility10aAcceptability10aIntegration1 aDulli L1 aTouré F1 aMama A1 aEvens E1 aMurray K1 aDjè N1 aKoné S1 aSadate-Ngatchou P1 aBovary A1 aEichleay M1 aJean-Baptiste M1 aMéité A00aFeasibility and acceptability of integrating mass distribution of azithromycin to children 1-11 months into a trachoma mass drug administration campaign to reduce child mortality in Côte d'Ivoire.  uhttps://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0003426&type=printable  a1-180 v43 a<p>Evidence suggests that bi-annual mass drug administration (MDA) of single-dose azithromycin to 1-11 month-old children reduces child mortality in high child-mortality settings. Several countries conduct annual MDAs to distribute azithromycin to individuals ages 6 months and older to prevent trachoma infection. This study examined the feasibility and acceptability of reaching 1-11 months-old children during a trachoma MDA in Côte d'Ivoire by extending azithromycin distribution to infants 1-5 months old during the campaign. In November 2020, the study piloted single-dose azithromycin for 1-5 month-olds during a trachoma MDA in one health district. Monitoring data included the number of children reached and occurrences of adverse drug reactions. Feasibility, the extent to which the target population received the intervention (coverage), was assessed through a population-based, household survey with parents/caregivers of eligible children conducted after the MDA. Acceptability was explored through in-depth interviews (IDIs) with parents/caregivers of eligible children, focus group discussions (FGDs) with community drug distributors (CDDs), and IDIs with their supervisors. CDD FGDs and supervisor IDIs also documented implementation challenges and recommendations for scale-up. 1,735 1-5 month-olds received azithromycin during the pilot activity (estimated population coverage of 90.2%). Adverse drug reactions were reported for 1% (n = 18) infants; all were mild and self-limited. The post-MDA coverage survey interviewed 267 parents/caregivers; survey-based intervention coverage was 95.4% of 1-5 month-olds. Qualitative data revealed high intervention acceptability among parents, CDDs, and supervisors. Implementation challenges included the need to weigh babies to calculate dosage for 1-5 month-olds and the need to obtain written informed consent from parents to provide the drug to 1-5 month-olds. CDDs also indicated the need for more information on azithromycin and possible side effects during training. Delivering azithromycin to younger infants appears acceptable to parents and implementers; &gt;90% coverage indicates feasibility to integrate into a trachoma MDA.&nbsp;</p>
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