A Longitudinal Analysis of Chlamydial Infection and Trachomatous Inflammation Following Mass Azithromycin Distribution.

Autor: Morberg DP; a Francis I. Proctor Foundation , University of California , San Francisco , CA , USA., Alemayehu W; b Orbis International , Addis Ababa , Ethiopia., Melese M; b Orbis International , Addis Ababa , Ethiopia., Lakew T; b Orbis International , Addis Ababa , Ethiopia., Sisay A; b Orbis International , Addis Ababa , Ethiopia., Zhou Z; a Francis I. Proctor Foundation , University of California , San Francisco , CA , USA., Cevallos V; a Francis I. Proctor Foundation , University of California , San Francisco , CA , USA., Oldenburg CE; a Francis I. Proctor Foundation , University of California , San Francisco , CA , USA., Porco TC; a Francis I. Proctor Foundation , University of California , San Francisco , CA , USA.; c Department of Ophthalmology , University of California , San Francisco , USA.; d Department of Epidemiology & Biostatistics , University of California , San Francisco , USA.; e Institute for Global Health , University of California , San Francisco , USA., Lietman TM; a Francis I. Proctor Foundation , University of California , San Francisco , CA , USA.; c Department of Ophthalmology , University of California , San Francisco , USA.; d Department of Epidemiology & Biostatistics , University of California , San Francisco , USA.; e Institute for Global Health , University of California , San Francisco , USA., Keenan JD; a Francis I. Proctor Foundation , University of California , San Francisco , CA , USA.; c Department of Ophthalmology , University of California , San Francisco , USA.
Jazyk: angličtina
Zdroj: Ophthalmic epidemiology [Ophthalmic Epidemiol] 2019 Feb; Vol. 26 (1), pp. 19-26. Date of Electronic Publication: 2018 Aug 28.
DOI: 10.1080/09286586.2018.1512635
Abstrakt: Background: Mass azithromycin distributions are effective for clearing ocular strains of Chlamydia trachomatis, yet infection frequently returns in areas with hyperendemic trachoma. A better understanding of the factors associated with chlamydial reinfection could be helpful to plan trachoma elimination strategies.
Methods: This was a prospective cohort study conducted in a trachoma-hyperendemic region of Ethiopia in 2003. As part of a larger cluster-randomized trial, 21 villages were treated with a single mass azithromycin distribution and all children 5 years and younger were monitored for ocular chlamydia and clinically active trachoma at baseline and at 2 and 6 months following the treatment.
Results: In 20 villages with available data, azithromycin treatment coverage was 88.7% (95% confidence interval [CI] 85.7-91.8%). In total, 1005 children tested negative for ocular chlamydia at the 2-month visit, of whom 41 became infected by 6 months (1.0 incident chlamydia infections per 100 person-months, 95%CI 0.7-1.4). The presence of intense trachomatous inflammation (TI) at baseline was associated with incident infection at 6 months (incidence rate ratio 1.91, 95%CI 1.03-3.55). Ocular chlamydia infections clustered more within households than communities: (intraclass correlation coefficient 0.01 for communities and 0.29 for households six months posttreatment). Younger children were more likely to have persistent clinically active trachoma (P = 0.03).
Conclusions: More intensive antibiotic distributions may be warranted for younger children, for children with TI, and for households containing children with ocular chlamydia infections.
Databáze: MEDLINE
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