Comparison of two azithromycin distribution strategies for controlling trachoma in Nepal

Johns Hopkins University, Baltimore, Maryland, United States
Bulletin of the World Health Organisation (Impact Factor: 5.09). 02/2001; 79(3):194-200. DOI: 10.1590/S0042-96862001000300006
Source: PubMed


The study compares the effectiveness of two strategies for distributing azithromycin in an area with mild-to-moderate active trachoma in Nepal.
The two strategies investigated were the use of azithromycin for 1) mass treatment of all children, or 2) targeted treatment of only those children who were found to be clinically active, as well as all members of their household.
Mass treatment of children was slightly more effective in terms of decreasing the prevalence of clinically active trachoma (estimated by clinical examination) and of chlamydial infection (estimated by DNA amplification tests), although neither result was statistically significant.
Both strategies appeared to be effective in reducing the prevalence of clinically active trachoma and infection six months after the treatment. Antibiotic treatment reduced the prevalence of chlamydial infection more than it did the level of clinically active trachoma.

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    • "All people living in a household containing an individual with active disease (Holm et al. 2001; Burton et al. 2003; Blake et al. 2009). "
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    • "The finding in this setting (and others) of householdclustering suggests control programmes involving delivery of antibiotics may be more cost-effective if they are targeted at households in which active trachoma is found. A randomized trial conducted in Nepal to evaluate this hypothesis suggested that mass treatment of all children was at least as effective and no more expensive than treatment only of children with active disease plus members of their households (Frick et al., 2001; Holm et al., 2001), but such comparisons should be made in other trachoma-endemic areas too. The spatial distribution of active trachoma was also explored in this study. "
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