Abstract
Purpose: 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%. Methods: 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. Results: Comparison of baseline and 12-month follow-up showed no significant difference in the overall TF 1-9 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). Conclusion: These data suggest that a single round of MDA may not be sufficient to decrease TF levels below 5% when TF 1-9 is between 5 and 9.9% at baseline.
Original language | English (US) |
---|---|
Pages (from-to) | 1-6 |
Number of pages | 6 |
Journal | Ophthalmic Epidemiology |
Volume | 26 |
Issue number | 1 |
DOIs | |
State | Published - Jan 2 2019 |
Keywords
- Antibody
- chlamydia
- mass drug administration
- trachoma
- trachomatis
ASJC Scopus subject areas
- Epidemiology
- Ophthalmology