Azithromycin Reduction to Reach Elimination of Trachoma

减少阿奇霉素以消除沙眼

• 批准号: 10616840
• 负责人: THOMAS M LIETMAN
• 金额: $ 7.34万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10616840
• 关键词: Age; Antibiotics; Area; Azithromycin; Blindness; Child; Chlamydia; Chlamydia Infections; Chlamydia trachomatis; Clinical; Communities; Confidence Intervals; Country; Data; Decision Making; Diagnostic tests; Drops; Early treatment; Europe; Funding; Gambia; Ghana; Goals; Guidelines; Hygiene; Individual; Infection; Inflammation; Intervention; Laos; Lead; Low Prevalence; Macrolides; Measures; Mexico; Nepal; Niger; Prevalence; Public Health; Randomized; Randomized Controlled Trials; Recrudescences; Residual state; Resources; Sanitation; Savings; Seroprevalences; Surveys; Testing; Trachoma; Uganda; Uveitis; Water; World Health Organization; base; discontinuation trial; isoniazid; markov model; population based; programs; randomized placebo controlled trial; response; serological marker; tool; transmission process; treatment response

PROJECT SUMMARY/ABSTRACT Annual mass azithromycin distribution dramatically reduces the prevalence of the ocular strains of Chlamydia trachomatis that lead to blinding trachoma. Current World Health Organization guidelines indicate that annual mass azithromycin distribution should be continued until district-level prevalence of the clinical sign of trachoma, trachomatous inflammation-follicular (TF), drops below 5%. However, TF does not correlate well with infection after multiple rounds of azithromycin treatment. Specifically, any decrease in TF lags well behind the decrease in infection. Thus the TF threshold may lead to overuse of antibiotics and depletion of scarce resources. Here, we propose a community randomized controlled trial and diagnostic test study to evaluate whether 1) azithromycin distribution can be discontinued in communities with TF prevalence up to 20%, and 2) alternative indicators of trachoma transmission can better measure true infection. We anticipate that results will provide evidence to support discontinuation of azithromycin treatment earlier, and evidence of that true local elimination of infection can be achieved, altering the goal of the trachoma program from control to eradication.

项目摘要/摘要 年度质量阿奇霉素分布大大降低了衣原体的眼部菌株的流行率 气管瘤，导致盲目沙眼瘤。当前的世界卫生组织指南表明年度 质量阿奇霉素的分布应继续，直到临床症状的地区级别的患病率 沙眼炎性炎症 - 炎症（TF）下降到5％以下。但是，TF的相关性不佳 多发阿奇霉素治疗后感染。具体而言，TF滞后的任何减少 感染的减少。因此，TF阈值可能导致抗生素过度使用和稀缺 资源。在这里，我们提出了一个社区随机对照试验和诊断测试研究以评估 1）在TF患病率高达20％和2的社区中，阿奇霉素的分布是否可以停止 沙眼传播的替代指标可以更好地衡量真正的感染。我们预计结果将会 提供证据以支持较早的阿奇霉素治疗的停用，并证明这是真正局部的证据 可以消除感染，从而将沙眼计划的目标从控制到根除。