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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Mass treatment with single-dose azithromycin for trachoma
New England Journal of Medicine, Volume 351, No. 19, Year 2004
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Description
BACKGROUND: Trachoma, caused by repeated ocular infection with Chlamydia trachomatis, is an important cause of blindness. Current recommended dosing intervals for mass azithromycin treatment for trachoma are based on a mathematical model. METHODS: We collected conjunctival swabs for quantitative polymerase-chain-reaction assay of C. trachomatis before and 2, 6, 12, 18, and 24 months after mass treatment with azithromycin in a Tanzanian community in which trachoma was endemic. For ethical reasons, at 6, 12, and 18 months, we gave tetracycline eye ointment to residents who had clinically active trachoma. RESULTS: At baseline, 956 of 978 residents (97.8 percent) received either one oral dose of azithromycin or (if azithromycin was contraindicated) a course of tetracycline eye ointment. The prevalence of infection fell from 9.5 percent before mass treatment to 2.1 percent at 2 months and 0.1 percent at 24 months. The quantitative burden of ocular C. trachomatis infection in the community was 13.9 percent of the pretreatment level at 2 months and 0.8 percent at 24 months. At each time point after baseline, over 90 percent of the total community burden of C. trachomatis infection was found among subjects who had been positive the previous time they were tested. CONCLUSIONS: The prevalence and intensity of infection fell dramatically and remained low for two years after treatment. One round of very-high-coverage mass treatment with azithromycin, perhaps aided by subsequent periodic use of tetracycline eye ointment for persons with active disease, can interrupt the transmission of ocular C. trachomatis infection. Copyright © 2004 Massachusetts Medical Society.
Authors & Co-Authors
Solomon, Anthony W.
Unknown Affiliation
Holland, Martin J.
Unknown Affiliation
Alexander, Neal Douglas Edward
Unknown Affiliation
Massae, Patrick A.
Unknown Affiliation
Aguirre, Aura
Unknown Affiliation
Natividad-Sancho, Angels
Unknown Affiliation
Molina, Sandra
Unknown Affiliation
Safari, S.
Unknown Affiliation
Shao, John F.
Unknown Affiliation
Courtright, Paul D.
Unknown Affiliation
Peeling, Rosanna Wai Wan
Unknown Affiliation
Vos, Theo K.
Unknown Affiliation
Bailey, Robin L.
Unknown Affiliation
Foster, Allen
Unknown Affiliation
Mabey, David C.W.
Unknown Affiliation
Statistics
Citations: 261
Authors: 15
Affiliations: 8
Identifiers
Doi:
10.1056/NEJMoa040979
ISSN:
00284793
Research Areas
Health System And Policy
Study Design
Cross Sectional Study
Study Approach
Quantitative