title: Clinical activity and polymerase chain reaction evidence of chlamydial infection after repeated mass antibiotic treatments for trachoma.
abstract: It is unclear how the prevalence of clinically active trachoma correlates with the prevalence of ocular chlamydial infection at the community level. In 24 villages from a cluster-randomized clinical trial of mass azithromycin distributions in Ethiopia, the correlation between the prevalence of clinical activity (on examination) and chlamydial infection (by polymerase chain reaction) was moderately strong before mass antibiotic treatments (Pearson's correlation coefficient r = 0.75, 95% confidence interval [CI] = 0.52-0.87), but decreased at each time point during four biannual treatments (at 24 months, r = 0.15, 95% CI = -0.14-0.41). One year after the final treatment, the correlation coefficient had increased, but not to the pre-treatment level (r = 0.55, 95% CI = 0.30-0.73). In a region with hyperendemic trachoma, conjunctival examination was a useful indicator of the prevalence of chlamydial infection before treatments, less useful during mass treatments, but regained utility by one year after treatments had stopped.
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, CA, USA.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Keenan
authors.forename: Takele
authors.initials: T
authors.lastname: Lakew
authors.forename: Wondu
authors.initials: W
authors.lastname: Alemayehu
authors.forename: Muluken
authors.initials: M
authors.lastname: Melese
authors.forename: Travis C
authors.initials: TC
authors.lastname: Porco
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Yi
authors.forename: Jenafir I
authors.initials: JI
authors.lastname: House
authors.forename: Zhaoxia
authors.initials: Z
authors.lastname: Zhou
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Ray
authors.forename: Nisha R
authors.initials: NR
authors.lastname: Acharya
authors.forename: John P
authors.initials: JP
authors.lastname: Whitcher
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Gaynor
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Lietman
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016133:Polymerase Chain Reaction; D015995:Prevalence; D014141:Trachoma / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin