title: Do infants increase the risk of re-emergent infection in households after mass drug administration for trachoma?
abstract: OBJECTIVE
  Mass treatment with azithromycin for trachoma endemic communities typically excludes infants under age 6 months, whose parents are provided with tubes of tetracycline to administer daily over 4 to 6 weeks. The authors sought to determine whether infants aged <6 months are a source of re-emergent infection in their families after mass treatment in trachoma-endemic communities.
  
  
  METHODS
  In a longitudinal study of all children aged less than 10 years in four communities, the authors identified 91 infants aged <6 months living in 86 of 1241 households. All children aged <ten years in all households were examined for trachoma and ocular infection with C. trachomatis at baseline, and 6 months after mass drug administration.
  
  
  RESULTS
  The prevalence of infection at baseline in the infants was 5.9%. At 6 months post mass drug administration, the rate of infection among children older than 6 months and less than 10 years who resided in households with infants was 6.0% compared with 11.1% in children in households without infants (P = 0.18). After adjustment for age, sex, baseline infection status, and treatment, residing in a household with an infant was not associated with infection at 6 months (odds ratio [95% confidence interval] 0.50 [0.20-1.22]).
  
  
  CONCLUSIONS
  This prospective study did not find evidence that living in a household with an infant increased the risk of infection 6 months post mass drug administration in other children residing in the household.
authors.affiliation: Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland 21287-9019, USA. shwest@jhmi.edu
authors.forename: Sheila K
authors.initials: SK
authors.lastname: West
authors.forename: Dianne
authors.initials: D
authors.lastname: Stare
authors.forename: Harran
authors.initials: H
authors.lastname: Mkocha
authors.forename: Beatriz
authors.initials: B
authors.lastname: Munoz
authors.forename: Charlotte
authors.initials: C
authors.lastname: Gaydos
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
mesh_terms: D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D019353:Endemic Diseases / Q000706:statistics & numerical data*; D005192:Family Health; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D013636:Tanzania / Q000453:epidemiology; D013752:Tetracycline / Q000008:administration & dosage; D014141:Trachoma / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin; D013752:Tetracycline