Yearly Mass Treatment C. Trachomatis: When Can We Stop?

每年的大规模治疗沙眼衣原体：我们什么时候可以停止？

• 批准号: 7289229
• 负责人: SHEILA K WEST
• 金额: $ 41.6万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2009-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7289229
• 关键词: Address; Africa; Age; Antibiotic Therapy; Asia; Azithromycin; Child; Chronic; Classification; Clinical; Clinical Markers; Clinical Treatment; Communities; Country; Data; Disease; Dose; Enrollment; Exposure to; Goals; Infection; Institutes; Laboratories; Life; Middle East; Modeling; Monitor; Morocco; Numbers; Personal Communication; Poverty; Predictive Value; Prevalence; Public Health; Rate; Research; Research Personnel; Resources; Rest; Risk; Sampling; School-Age Population; Schools; Sensitivity and Specificity; Sentinel; Surveys; Tanzania; Testing; Time; Trachoma; Work; World Health Organization; base; design; experience; programs; success; virtual; Address; Africa; Age; Antibiotic Therapy; Asia; Azithromycin; Child; Chronic; Classification; Clinical; Clinical Markers; Clinical Treatment; Communities; Country; Data; Disease; Dose; Enrollment; Exposure to; Goals; Infection; Institutes; Laboratories; Life; Middle East; Modeling; Monitor; Morocco; Numbers; Personal Communication; Poverty; Predictive Value; Prevalence; Public Health; Rate; Research; Research Personnel; Resources; Rest; Risk; Sampling; School-Age Population; Schools; Sensitivity and Specificity; Sentinel; Surveys; Tanzania; Testing; Time; Trachoma; Work; World Health Organization; base; design; experience; programs; success; virtual

DESCRIPTION (provided by applicant): Country trachoma control programs are currently mass treating trachoma endemic communities every year using single dose azithromycin, with no evidence base for how long treatment must continue to reach these goals, or the optimal clinical marker with which to monitor progress. The World Health Organization currently suggests using follicular trachoma (TF) for monitoring, but data suggest this is sub-optimal. This application addresses the following critical aims for national programs: first, we determine the prevalence of infection in Tanzanian communities after exposure to mass treatment for 3 to 7 years, and whether an optimal number of yearly rounds can be identified after which mass treatment could be reconsidered. Second, we assess the utility and predictive value of specific combinations of clinical trachoma signs, following rounds of mass treatment that might be used to chart progress and guide decisions to stop mass treatment. Working with the Tanzania National Trachoma Control Program communities, we propose to survey samples within 18 communities in each of five strata, reflecting exposure to 3, 4, 5, 6, and 7 rounds of mass treatment. Within the 90 communities, a random sample of children age 1-7 years will be selected to serve as a sentinel sample of current status of trachoma and infection with ocular C. trachomatis, according to years of exposure to mass treatment. Analyses, using models adjusted for clustering of infection within villages, will determine the prevalence of infection as a function of years of exposure to mass treatment, treatment coverage over time, baseline prevalence of trachoma, and other village level predictors. Within strata of exposure to rounds of mass treatment, the utility of other clinical markers against infection, compared to the WHO-recommended use of TF alone against infection, will be assessed. The results are critical for National Trachoma Programs, who need a better understanding of infection in their communities following several rounds of mass treatment and better clinical markers to guide decisions of when to stop mass treatment.

描述（由申请人提供）：目前使用单剂量阿奇罗霉素每年都在大规模治疗沙丘瘤特有社区，没有证据表明必须继续执行这些目标多长时间的治疗方法，或者使用这些目标来监测进度的最佳临床标记。世界卫生组织目前建议使用滤泡性沙眼（TF）进行监测，但数据表明这是最佳的。该申请涉及以下国家计划的关键目标：首先，我们在3至7年接受大规模治疗后确定坦桑尼亚社区感染的流行，以及是否可以确定可以重新考虑大规模治疗的年度最佳次数。其次，我们评估了临床沙丘瘤体征特定组合的效用和预测价值，此后大量治疗可能用于绘制进度并指导决策以停止群众治疗。与坦桑尼亚国家三血管控制计划社区合作，我们建议调查五个阶层中每个社区中的样本，以反映3、4、5、6和7轮的大规模治疗。在90个社区中，根据大规模治疗的年份，将选择一个随机的1-7岁儿童样本作为沙眼瘤当前状态和眼球梭状芽孢杆菌感染的哨兵样本。分析，使用调整后针对村庄内感染聚类的模型，将确定感染的普遍性，这是多年暴露于大规模治疗，随着时间的时间治疗覆盖率，气管瘤的基线患病率和其他乡村水平预测变量的函数。在暴露于大规模治疗的阶层中，将评估其他临床标志物针对感染的效用，与WHO要求单独使用TF对感染的使用相比。结果对于国家气管疾病计划至关重要，在几轮大规模治疗和更好的临床标记之后，他们需要更好地了解其社区感染，以指导何时停止大规模治疗的决策。