TY - JOUR
T1 - Treating village newcomers and travelers for trachoma
T2 - Results from ASANTE cluster randomized trial
AU - West, Sheila K.
AU - Munoz, Beatriz
AU - Mkocha, Harran
AU - Dize, Laura
AU - Gaydos, Charlotte A.
AU - Swenor, Bonnie
AU - Ervin, Ann Margret
AU - Quinn, Thomas C.
N1 - Publisher Copyright:
© This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
PY - 2017/6
Y1 - 2017/6
N2 - Trial design Trachoma is targeted for global elimination. Infection rates with Chlamydia trachomatis are higher in new arrivals to a community and in travelers who leave for extended periods, suggesting they are sources of re-infection. This community-randomized, clinical trial was designed to determine if a surveillance program that targeted newcomers and travelers, identified weekly, would result in more communities achieving levels of infection of 1%. Methods 52 communities were randomly allocated 1:1 to the control (annual MDA alone if warranted) or intervention arm (annual MDA if warranted, plus a surveillance program to identify and treat newcomers and travelers). In each community, surveys were completed every six months on a random sample of 100 children ages 1±9 years for trachoma and infection. The primary outcome was the proportion of communities in the intervention arm, compared to the control arm, which had a prevalence of infection at 1% by 24 months. Registered: clinicaltrials. gov(NCT01767506). Results Intervention communities experienced an average of 110 surveillance events per month. At 24 months, 7 (27%) of 26 intervention communities achieved a prevalence of infection 1% compared to 4 (15%) of the 26 control communities (odds ratio = 2-6, 95%CI = 0-56±11-9). At 24 months, the average infection prevalence in the intervention communities was 4-8, compared to 6-9 in the control communities (p = -06). Conclusion Despite surveillance programs for community newcomers and travelers, the proportion of intervention communities with a level of infection 1% was lower than expected and not significantly different from control communities.
AB - Trial design Trachoma is targeted for global elimination. Infection rates with Chlamydia trachomatis are higher in new arrivals to a community and in travelers who leave for extended periods, suggesting they are sources of re-infection. This community-randomized, clinical trial was designed to determine if a surveillance program that targeted newcomers and travelers, identified weekly, would result in more communities achieving levels of infection of 1%. Methods 52 communities were randomly allocated 1:1 to the control (annual MDA alone if warranted) or intervention arm (annual MDA if warranted, plus a surveillance program to identify and treat newcomers and travelers). In each community, surveys were completed every six months on a random sample of 100 children ages 1±9 years for trachoma and infection. The primary outcome was the proportion of communities in the intervention arm, compared to the control arm, which had a prevalence of infection at 1% by 24 months. Registered: clinicaltrials. gov(NCT01767506). Results Intervention communities experienced an average of 110 surveillance events per month. At 24 months, 7 (27%) of 26 intervention communities achieved a prevalence of infection 1% compared to 4 (15%) of the 26 control communities (odds ratio = 2-6, 95%CI = 0-56±11-9). At 24 months, the average infection prevalence in the intervention communities was 4-8, compared to 6-9 in the control communities (p = -06). Conclusion Despite surveillance programs for community newcomers and travelers, the proportion of intervention communities with a level of infection 1% was lower than expected and not significantly different from control communities.
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U2 - 10.1371/journal.pone.0178595
DO - 10.1371/journal.pone.0178595
M3 - Article
C2 - 28662043
AN - SCOPUS:85021683960
VL - 12
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 6
M1 - e0178595
ER -