Abstract
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.
| Original language | English (US) |
|---|---|
| Article number | e0178595 |
| Journal | PLoS One |
| Volume | 12 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1 2017 |
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ASJC Scopus subject areas
- Medicine(all)
- Biochemistry, Genetics and Molecular Biology(all)
- Agricultural and Biological Sciences(all)
Cite this
Treating village newcomers and travelers for trachoma : Results from ASANTE cluster randomized trial. / West, Sheila K; Munoz, Beatriz; Mkocha, Harran; Dize, Laura; Gaydos, Charlotte A; Swenor, Bonnielin; Ervin, Ann Margret; Quinn, Thomas C.
In: PLoS One, Vol. 12, No. 6, e0178595, 01.06.2017.Research output: Contribution to journal › Article
}
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, Bonnielin
AU - Ervin, Ann Margret
AU - Quinn, Thomas C
PY - 2017/6/1
Y1 - 2017/6/1
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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UR - http://www.scopus.com/inward/citedby.url?scp=85021683960&partnerID=8YFLogxK
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 -