Importance of coverage and endemicity on the return of infectious trachoma after a single mass antibiotic distribution.
As part of the SAFE strategy, mass antibiotic treatments are useful in controlling the ocular strains of chlamydia that cause trachoma. The World Health Organization recommends treating at least 80% of individuals per community. However, the role of antibiotic coverage for trachoma control has been...
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ftdoajarticles:oai:doaj.org/article:caf5042acdcd47eebfa1a651391114bf 2023-05-15T15:13:37+02:00 Importance of coverage and endemicity on the return of infectious trachoma after a single mass antibiotic distribution. Takele Lakew Wondu Alemayehu Muluken Melese Elizabeth Yi Jenafir I House Kevin C Hong Zhaoxia Zhou Kathryn J Ray Travis C Porco Bruce D Gaynor Thomas M Lietman Jeremy D Keenan 2009-08-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0000507 https://doaj.org/article/caf5042acdcd47eebfa1a651391114bf EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC2724711?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000507 https://doaj.org/article/caf5042acdcd47eebfa1a651391114bf PLoS Neglected Tropical Diseases, Vol 3, Iss 8, p e507 (2009) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2009 ftdoajarticles https://doi.org/10.1371/journal.pntd.0000507 2022-12-31T00:20:12Z As part of the SAFE strategy, mass antibiotic treatments are useful in controlling the ocular strains of chlamydia that cause trachoma. The World Health Organization recommends treating at least 80% of individuals per community. However, the role of antibiotic coverage for trachoma control has been poorly characterized.In a collection of cluster-randomized clinical trials, mass oral azithromycin was administered to 40 villages in Ethiopia. The village prevalence of ocular chlamydia was determined before treatment, and at two and six months post-treatment. The mean prevalence of ocular chlamydia was 48.9% (95% CI 42.8 to 55.0%) before mass treatments, decreased to 5.4% (95% CI 3.9 to 7.0%) at two months after treatments (p<0.0001), and returned to 7.9% (95% CI 5.4 to 10.4%) by six months after treatment (p = 0.03). Antibiotic coverage ranged from 73.9% to 100%, with a mean of 90.6%. In multivariate regression models, chlamydial prevalence two months after treatment was associated with baseline infection (p<0.0001) and antibiotic coverage (p = 0.007). However, by six months after treatment, chlamydial prevalence was associated only with baseline infection (p<0.0001), but not coverage (p = 0.31).In post-hoc analyses of a large clinical trial, the amount of endemic chlamydial infection was a strong predictor of chlamydial infection after mass antibiotic treatments. Antibiotic coverage was an important short-term predictor of chlamydial infection, but no longer predicted infection by six months after mass antibiotic treatments. A wider range of antibiotic coverage than found in this study might allow an assessment of a more subtle association. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 3 8 e507 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Takele Lakew Wondu Alemayehu Muluken Melese Elizabeth Yi Jenafir I House Kevin C Hong Zhaoxia Zhou Kathryn J Ray Travis C Porco Bruce D Gaynor Thomas M Lietman Jeremy D Keenan Importance of coverage and endemicity on the return of infectious trachoma after a single mass antibiotic distribution. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
As part of the SAFE strategy, mass antibiotic treatments are useful in controlling the ocular strains of chlamydia that cause trachoma. The World Health Organization recommends treating at least 80% of individuals per community. However, the role of antibiotic coverage for trachoma control has been poorly characterized.In a collection of cluster-randomized clinical trials, mass oral azithromycin was administered to 40 villages in Ethiopia. The village prevalence of ocular chlamydia was determined before treatment, and at two and six months post-treatment. The mean prevalence of ocular chlamydia was 48.9% (95% CI 42.8 to 55.0%) before mass treatments, decreased to 5.4% (95% CI 3.9 to 7.0%) at two months after treatments (p<0.0001), and returned to 7.9% (95% CI 5.4 to 10.4%) by six months after treatment (p = 0.03). Antibiotic coverage ranged from 73.9% to 100%, with a mean of 90.6%. In multivariate regression models, chlamydial prevalence two months after treatment was associated with baseline infection (p<0.0001) and antibiotic coverage (p = 0.007). However, by six months after treatment, chlamydial prevalence was associated only with baseline infection (p<0.0001), but not coverage (p = 0.31).In post-hoc analyses of a large clinical trial, the amount of endemic chlamydial infection was a strong predictor of chlamydial infection after mass antibiotic treatments. Antibiotic coverage was an important short-term predictor of chlamydial infection, but no longer predicted infection by six months after mass antibiotic treatments. A wider range of antibiotic coverage than found in this study might allow an assessment of a more subtle association. |
format |
Article in Journal/Newspaper |
author |
Takele Lakew Wondu Alemayehu Muluken Melese Elizabeth Yi Jenafir I House Kevin C Hong Zhaoxia Zhou Kathryn J Ray Travis C Porco Bruce D Gaynor Thomas M Lietman Jeremy D Keenan |
author_facet |
Takele Lakew Wondu Alemayehu Muluken Melese Elizabeth Yi Jenafir I House Kevin C Hong Zhaoxia Zhou Kathryn J Ray Travis C Porco Bruce D Gaynor Thomas M Lietman Jeremy D Keenan |
author_sort |
Takele Lakew |
title |
Importance of coverage and endemicity on the return of infectious trachoma after a single mass antibiotic distribution. |
title_short |
Importance of coverage and endemicity on the return of infectious trachoma after a single mass antibiotic distribution. |
title_full |
Importance of coverage and endemicity on the return of infectious trachoma after a single mass antibiotic distribution. |
title_fullStr |
Importance of coverage and endemicity on the return of infectious trachoma after a single mass antibiotic distribution. |
title_full_unstemmed |
Importance of coverage and endemicity on the return of infectious trachoma after a single mass antibiotic distribution. |
title_sort |
importance of coverage and endemicity on the return of infectious trachoma after a single mass antibiotic distribution. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2009 |
url |
https://doi.org/10.1371/journal.pntd.0000507 https://doaj.org/article/caf5042acdcd47eebfa1a651391114bf |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 3, Iss 8, p e507 (2009) |
op_relation |
http://europepmc.org/articles/PMC2724711?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000507 https://doaj.org/article/caf5042acdcd47eebfa1a651391114bf |
op_doi |
https://doi.org/10.1371/journal.pntd.0000507 |
container_title |
PLoS Neglected Tropical Diseases |
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3 |
container_issue |
8 |
container_start_page |
e507 |
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1766344148893302784 |