Mass treatment with single-dose azithromycin for trachoma.


Solomon, AW; Holland, MJ; Alexander, ND; Massae, PA; Aguirre, A; Natividad-Sancho, A; Molina, S; Safari, S; Shao, JF; Courtright, P; Peeling, RW; West, SK; Bailey, RL; Foster, A; Mabey, DC; (2004) Mass treatment with single-dose azithromycin for trachoma. The New England journal of medicine, 351 (19). pp. 1962-71. ISSN 0028-4793 DOI: 10.1056/NEJMoa040979

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Abstract

: 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.<br/> : 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.<br/> : 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.<br/> : 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.<br/>

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Neglected Tropical Diseases Network
Tropical Epidemiology Group
The International Centre for Evidence in Disability
International Centre for Eye Health
PubMed ID: 15525721
Web of Science ID: 224851300008
URI: http://researchonline.lshtm.ac.uk/id/eprint/14167

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