Efficacy of oral azithromycin versus topical tetracycline in mass treatment of endemic trachoma


Fraser-Hurt, N; Bailey, RL; Cousens, S; Mabey, D; Faal, H; Mabey, DC; (2001) Efficacy of oral azithromycin versus topical tetracycline in mass treatment of endemic trachoma. Bulletin of the World Health Organization, 79 (7). pp. 632-40. ISSN 0042-9686

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Abstract

OBJECTIVE: To compare the impact of mass treatment with oral azithromycin and topical tetracycline on the prevalence of active trachoma. METHODS: A total of 1803 inhabitants from 106 households of eight Gambian villages were randomized, in pairs, to receive either three doses of azithromycin at weekly intervals, or daily topical tetracycline over 6 weeks. Ocular examinations were conducted before treatment, and 2, 6 and 12 months after treatment. FINDINGS: Prior to treatment, 16% of the study participants had active trachoma. Two months after treatment, the prevalence of trachoma was 4.6% and 5.1% in the azithromycin and the tetracycline groups, respectively (adjusted odds ratio (OR) = 1.09; 95% confidence interval (CI) = 0.53, 2.02). Subsequently, the prevalence rose to 16% in the tetracycline group, while remaining at 7.7% in the azithromycin group (adjusted OR at 12 months = 0.52; 95% CI = 0.34, 0.80). At 12 months post-treatment, there were fewer new prevalent cases in the azithromycin group, and trachoma resolution was significantly better for this group (adjusted OR = 2.02; 95% CI = 1.42, 3.50). CONCLUSION: Oral azithromycin therefore appears to offer a means for controlling blinding trachoma. It is easy to administer and higher coverages may be possible than have been achieved hitherto.

Item Type: Article
Keywords: Administration, Oral, Administration, Topical, Adolescent, Antibiotics, Macrolide/adverse effects/*therapeutic use, Azithromycin/administration & dosage/*therapeutic use, Child, Child, Preschool, Comparative Study, Drug Evaluation, Endemic Diseases/*prevention & control, Female, Gambia/epidemiology, Human, Infant, Male, Prevalence, Support, Non-U.S. Gov't, Tetracyclines/administration & dosage/*therapeutic use, Trachoma/diagnosis/*drug therapy/epidemiology, Treatment Outcome, Administration, Oral, Administration, Topical, Adolescence, Antibiotics, Macrolide, adverse effects, therapeutic use, Azithromycin, administration & dosage, therapeutic use, Child, Child, Preschool, Comparative Study, Drug Evaluation, Endemic Diseases, prevention & control, Female, Gambia, epidemiology, Human, Infant, Male, Prevalence, Support, Non-U.S. Gov't, Tetracyclines, administration & dosage, therapeutic use, Trachoma, diagnosis, drug therapy, epidemiology, Treatment Outcome
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Tropical Epidemiology Group
Neglected Tropical Diseases Network
PubMed ID: 11477966
Web of Science ID: 169992400007
URI: http://researchonline.lshtm.ac.uk/id/eprint/16470

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