Evaluation of a Single Dose of Azithromycin for Trachoma in Low-Prevalence Communities

Details

• Alternative Title:
  Ophthalmic Epidemiol
• Personal Author:
  Wilson, Nana ; Goodhew, Brook ; Mkocha, Harran ; Joseph, Kahaliah ; Bandea, Claudiu ; Black, Carolyn ; Igietseme, Joseph ; Munoz, Beatriz ; West, Sheila K. ; Lammie, Patrick ; Kasubi, Mabula ; Martin, Diana L.
• Description:
  Trachoma, caused by repeated ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide and is targeted for elimination as a public health problem. We sought to determine whether a one-time azithromycin mass treatment would reduce trachomatous inflammation-follicular (TF) levels below the elimination threshold of 5% in communities with disease prevalence between 5 and 9.9%.|The study was conducted in 96 sub-village units (balozis) in the Kongwa district of Tanzania which were predicted from prior prevalence surveys to have TF between 5 and 9.9%. Balozis were randomly assigned to the intervention and control arms. The intervention arm received a single mass drug administration of azithromycin. At baseline and 12-month follow-up, ocular exams for trachoma, ocular swabs for detection of chlamydial DNA, and finger prick blood for analysis of anti-chlamydial antibody were taken.|Comparison of baseline and 12-month follow-up showed no significant difference in the overall TF| prevalence by balozi between control and treatment arms. In the treatment arm there was a significant reduction of ocular infection 12 months after treatment (p = 0.004) but no change in the control arm. No change in Pgp3-specific antibody responses were observed after treatment in the control or treatment arms. Anti-CT694 responses increased in both study arms (p = 0.009 for control arm and p = 0.04 for treatment arm).|These data suggest that a single round of MDA may not be sufficient to decrease TF levels below 5% when TF| is between 5 and 9.9% at baseline.
• Subjects:
  Anti-Bacterial Agents Azithromycin Child Child, Preschool Chlamydia Trachomatis DNA, Bacterial Dose-Response Relationship, Drug Eye Infections, Bacterial Female Follow-Up Studies Humans Infant Male Original Articles Prevalence Time Factors Trachoma Treatment Outcome

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• Source:
  Ophthalmic Epidemiol. 2019; 26(1):1-6
• Pubmed ID:
  30543311
• Pubmed Central ID:
  PMC6352373
• Document Type:
  Journal Article
• Place as Subject:
  Tanzania
• Volume:
  26
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:89a480bc3c990e1ab38bb688c8de6eb2f3f473e499244f8cee33df29bdf03953
• Download URL:
  https://stacks.cdc.gov/view/cdc/77759/cdc_77759_DS1.pdf
• File Type:
  [PDF - 550.09 KB ]