The Lancet. Microbe, 2022, Volume: 3, Issue:2
Azithromycin mass drug administration (MDA) could reduce child mortality. However, macrolide resistance, which has generally been reported to develop after whole-community MDA for trachoma control, is a concern, and it has less commonly been studied in the context of treating children to reduce mortality. Here, we report on macrolide resistance after biannual azithromycin MDA at the Malawi site of the MORDOR study.. In the MORDOR cluster-randomised trial in Malawi, 30 communities in Mangochi District were randomly selected. Communities were randomly assigned to receive azithromycin or placebo by simple randomisation without stratification. Children aged 1-59 months were administered azithromycin 20 mg/kg or placebo as an oral suspension biannually for a total of four treatments in 2015-17. 1200 children (40 children per community) were randomly selected for nasopharyngeal swabs at baseline, 12 months (6 months after the second treatment visit), and 24 months (6 months after the fourth treatment visit). Samples were processed to culture. These findings support previous evidence from trachoma MDA programmes and suggest that monitoring of macrolide resistance should remain a key component of azithromycin interventions for reducing child mortality.. Bill & Melinda Gates Foundation.. Our results indicate that non-invasive local LIPUS therapy attenuated heart fibrosis and dysfunction in diabetic mice and the effect could be largely preserved at least 12 weeks after suspending LIPUS stimulation. LIPUS ameliorated diabetic heart fibrosis by inhibiting ACE-mediated NOX4-associated oxidative stress and NLRP3 inflammasome activation in cardiac fibroblasts. Our study may provide a novel therapeutic approach to hamper the progression of diabetic heart fibrosis. Topics: Acoustics; Adsorption; Angiotensin II; Animals; Anti-Bacterial Agents; Azithromycin; Calcium; Carbon; Charcoal; Child; Chlorides; Copper; Diabetes Mellitus, Experimental; Diabetic Cardiomyopathies; Dopamine; Dopamine Plasma Membrane Transport Proteins; Drug Resistance, Bacterial; Ecosystem; Epigenesis, Genetic; Female; Fibroblasts; Fibrosis; Gallium Radioisotopes; Heterozygote; Hot Temperature; Humans; Hydrogen-Ion Concentration; Inflammasomes; Inflammation; Kinetics; Macrolides; Magnetic Resonance Imaging; Malawi; Male; Mass Drug Administration; Methylene Blue; Mice; Neuroendocrine Tumors; NLR Family, Pyrin Domain-Containing 3 Protein; Octreotide; Organometallic Compounds; Oxidative Stress; Phenotype; Positron-Emission Tomography; Prevalence; Prognosis; Rats; Receptors, Somatostatin; Retrospective Studies; Rivers; Streptococcus pneumoniae; Trachoma; Water Pollutants, Chemical; Zinc Compounds | 2022 |