Community risk factors for ocular Chlamydia infection in Niger: pre-treatment results from a cluster-randomized trachoma trial

Autor: Amza, Abdou, Kadri, Boubacar, Nassirou, Baido, Stoller, Nicole E, Yu, Sun N, Zhou, Zhaoxia, Chin, Stephanie, West, Sheila K, Bailey, Robin L, Mabey, David CW, Keenan, Jeremy D, Porco, Travis C, Lietman, Thomas M, Gaynor, Bruce D, PRET Partnership
Přispěvatelé: Ngondi, Jeremiah M
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Male
Multivariate analysis
Chlamydia trachomatis
Azithromycin
medicine.disease_cause
Medical and Health Sciences
law.invention
0302 clinical medicine
Randomized controlled trial
law
Risk Factors
Prevalence
Niger
Child
Univariate analysis
Chlamydia
lcsh:Public aspects of medicine
Biological Sciences
3. Good health
Anti-Bacterial Agents
Infectious Diseases
Treatment Outcome
Trachoma
Child
Preschool
Medicine
Female
Infection
medicine.drug
Research Article
Neglected Tropical Diseases
PRET Partnership
medicine.medical_specialty
lcsh:Arctic medicine. Tropical medicine
lcsh:RC955-962
030231 tropical medicine
Clinical Trials and Supportive Activities
Head of Household
03 medical and health sciences
Drug Therapy
Clinical Research
Internal medicine
Tropical Medicine
medicine
Animals
Humans
Preschool
Eye Disease and Disorders of Vision
business.industry
Prevention
Public Health
Environmental and Occupational Health
Infant
Newborn
Infant
lcsh:RA1-1270
medicine.disease
Newborn
Surgery
Ophthalmology
Good Health and Well Being
030221 ophthalmology & optometry
Sexually Transmitted Infections
business
Zdroj: PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases, Vol 6, Iss 4, p e1586 (2012)
PLoS neglected tropical diseases, vol 6, iss 4
ISSN: 1935-2727
Popis: Background Trachoma control programs utilize mass azithromycin distributions to treat ocular Chlamydia trachomatis as part of an effort to eliminate this disease world-wide. But it remains unclear what the community-level risk factors are for infection. Methods This cluster-randomized, controlled trial entered 48 randomly selected communities in a 2×2 factorial design evaluating the effect of different treatment frequencies and treatment coverage levels. A pretreatment census and examination established the prevalence of risk factors for clinical trachoma and ocular chlamydia infection including years of education of household head, distance to primary water source, presence of household latrine, and facial cleanliness (ocular discharge, nasal discharge, and presence of facial flies). Univariate and multivariate associations were tested using linear regression and Bayes model averaging. Findings There were a total of 24,536 participants (4,484 children aged 0–5 years) in 6,235 households in the study. Before treatment in May to July 2010, the community-level prevalence of active trachoma (TF or TI utilizing the World Health Organization [WHO] grading system) was 26.0% (95% CI: 21.9% to 30.0%) and the mean community-level prevalence of chlamydia infection by Amplicor PCR was 20.7% (95% CI: 16.5% to 24.9%) in children aged 0–5 years. Univariate analysis showed that nasal discharge (0.29, 95% CI: 0.04 to 0.54; P = 0.03), presence of flies on the face (0.40, 95% CI: 0.17 to 0.64; P = 0.001), and years of formal education completed by the head of household (0.07, 95% CI: 0.07 to 0.13; P = 0.03) were independent risk factors for chlamydia infection. In multivariate analysis, facial flies (0.26, 95% CI: 0.02 to 0.49; P = 0.03) and years of formal education completed by the head of household (0.06, 95% CI: 0.008 to 0.11; P = 0.02) were associated risk factors for ocular chlamydial infection. Interpretation We have found that the presence of facial flies and years of education of the head of the household are risk factors for chlamydia infection when the analysis is done at the community level. Trial Registration ClinicalTrials.gov NCT00792922
Author Summary Trachoma is one of the most important neglected tropical diseases because it is the leading cause of blindness from an infection in the world. There are about 1.3 million persons blind from the disease and many more at risk of blindness in the future. It is caused by the common bacterium Chlamydia trachomatis and can be treated with mass drug administrations (MDA) of azithromycin. We have begun a clinical trial in Niger, a country with limited resources in Africa, to determine the best treatment strategy. Our study from May to July 2010, which began before MDA's were given, showed that 26% of children aged 0–5 years were infected with the disease. In these children, we found that discharge from the nose, presence of flies on the face, and the number of years of education completed by the head of the household were risk factors for infection in 48 different communities. We hope to use this information about risk factors of infection to help guide future studies for trachoma and also to help with the WHO goal of eliminating the disease worldwide by the year 2020.
Databáze: OpenAIRE
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