Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2005 Jan;46(1):83-7.
doi: 10.1167/iovs.04-0327.

Mass treatment and the effect on the load of Chlamydia trachomatis infection in a trachoma-hyperendemic community

Emily S West  1 , Beatriz Munoz, Harran Mkocha, Martin J Holland, Aura Aguirre, Anthony W Solomon, Robin Bailey, Allen Foster, David Mabey, Sheila K West
Affiliations

Mass treatment and the effect on the load of Chlamydia trachomatis infection in a trachoma-hyperendemic community

Emily S West et al. Invest Ophthalmol Vis Sci. 2005 Jan.

Abstract

Purpose: Trachoma remains a leading cause of blindness. Determining the most effective antibiotic treatment strategy is essential for the success of country-based trachoma control programs.

Methods: Baseline and 2-month follow-up examinations were performed in a trachoma-hyperendemic village. All residents were offered azithromycin for trachoma after baseline was determined. Infection with Chlamydia trachomatis and chlamydial load were determined by PCR. Clinical trachoma status was evaluated. A high chlamydial load was defined as a higher than median chlamydial load among those with infection. Risk factors were examined in multiple logistic regression models. Associations are presented as odds ratios and 95% confidence intervals.

Results: At baseline, 57% of participants were infected with C. trachomatis. Although clinical trachoma correlated with infection, 23% of participants with high chlamydial loads showed no clinical signs. Adults represented only 10% of the population with high loads. Treatment significantly decreased the proportion positive in the community and the load in the community. However, 27% of individuals with high loads at baseline who received treatment also were infected at 2 months. Of those, 93% with high loads at 2 months were aged < or =10 years.

Conclusions: Although most of the chlamydial load in this community resided in children, 10% of the high load resided in adults, most of whom did not have follicular trachoma and in whom the infection would be missed under treatment strategies that focus on clinical disease or children. These data support a mass treatment strategy for hyperendemic communities, at least as a first approach. In addition, treatment of children age < or =2 years should be reexamined, as >30% with high loads at baseline remained infected at 2 months, despite monitored treatment according to weight.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Distribution of chlamydial load in the total population by age and gender.
See this image and copyright information in PMC

References

    1. Global Elimination of Blinding Trachoma. World Health Organization 51st World Health Assembly. Geneva: WHO; 1998. 51.11.
    1. Negrel AD, Mariotti SP. WHO alliance for the global elimination of blinding trachoma and the potential use of azithromycin. Int J Antimicrob Agents. 1998;10:259–262. - PubMed
    1. West SK, Munoz B, Turner VM, Mmbaga BB, Taylor HR. The epidemiology of trachoma in central Tanzania. Int J Epidemiol. 1991;20:1088–1092. - PubMed
    1. Schachter J, West SK, Mabey D, et al. Azithromycin in control of trachoma. Lancet. 1999;354:630–635. - PubMed
    1. Solomon AW, Holland MJ, Burton MJ, et al. Strategies for control of trachoma: observational study with quantitative PCR. Lancet. 2003;362:198–204. - PubMed

Publication types

MeSH terms