title: Trachoma:  an update on prevention, diagnosis, and treatment.
abstract: OBJECTIVE
  To review recent clinical and epidemiological studies regarding the prevention, diagnosis, and treatment of trachoma.
  
  
  RESULTS
  Newer studies propose novel diagnostic tests that appear sensitive for the detection of ocular chlamydial infection. For example, recent studies with ribosomal RNA-based nucleic acid amplification tests (NAATs) have demonstrated improved sensitivities compared to DNA-based NAATs; and the progression of scarring has now been characterized with confocal microscopy. Immunologic studies have further explored the etiology of clinical sequelae, suggesting that chronic inflammation can lead to progressive scarring even in the absence of Chlamydia. Mass oral azithromycin distributions remain a mainstay of treatment; studies have assessed the appropriate frequency and duration of treatment programs. Current studies have also explored ancillary effects of azithromycin distribution on mortality and bacterial infections.
  
  
  CONCLUSIONS
  Trachoma programs have had remarkable success at reducing chlamydial infection and clinical signs of trachoma. Recent work suggests improved methods to monitor infection and scarring, and better ways to distribute treatment. Whereas studies continue to demonstrate reduction in infection in hyperendemic areas, more work is necessary to achieve elimination of this blinding disease.
authors.affiliation: F. I Proctor Foundation and Department of Ophthalmology, University of California-San Francisco, 513 Parnassus Ave, San Francisco, CA 94143, USA.
authors.forename: Satasuk Joy
authors.initials: SJ
authors.lastname: Bhosai
authors.forename: Robin L
authors.initials: RL
authors.lastname: Bailey
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Gaynor
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Lietman
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D002690:Chlamydia Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D002692:Chlamydia trachomatis / Q000235:genetics; D006801:Humans; D021141:Nucleic Acid Amplification Techniques; D012335:RNA, Ribosomal / Q000235:genetics; D014141:Trachoma / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D012335:RNA, Ribosomal; D017963:Azithromycin