Surveillance and Azithromycin Treatment for Newcomers and Travelers Evaluation (ASANTE) Trial: Design and Baseline Characteristics.
Immigrants and travelers may be sources of re-emergent infection in trachoma-endemic communities close to trachoma elimination. The primary objective of the A Surveillance and Azithromycin Treatment for Newcomers and Travelers Evaluation (ASANTE) trial was to determine whether a newcomer and traveler surveillance and treatment program in addition to annual mass drug administration (MDA) would reduce Chlamydia trachomatis infection when compared to MDA alone.



ASANTE was a randomized controlled trial in 52 communities in Kongwa, Tanzania. In 26 intervention communities, monitors treated everyone in new households, in-coming children and guardians in existing households, and all persons in households who had traveled between annual MDA events. A total of 26 usual practice communities received MDA only. Surveys of 100 1-9-year-olds from each community were conducted at baseline and every 6 months up to 2 years to assess clinical trachoma and C. trachomatis infection. Data on demographics and environmental factors were also collected.



Mean prevalences of trachomatous inflammation - follicular (TF) and C. trachomatis were equivalent between the two arms (5.2% and 3.7% in intervention, and 4.9% and 3.6% in usual practice communities, respectively). Of 318 children with TF, 36.5% tested positive for C. trachomatis. TF prevalence was higher among households without a bicycle (p = 0.03) and lower with increasing child's age (p < 0.001). Infection prevalence was higher among households >30 minutes from water (p = 0.015). TF and infection prevalence decreased with increasing years of education (p = 0.004 and p = 0.002, respectively).



The ASANTE trial will inform guidance on the surveillance and treatment of persons traveling or newly arriving to communities hypo-endemic for trachoma.
a Dana Center for Preventive Ophthalmology, Wilmer Eye Institute , Johns Hopkins University , Baltimore , MD , USA.|b Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
Ann-Margret
AM
Ervin
c Kongwa Trachoma Project , Kongwa , Tanzania.
Harran
H
Mkocha
a Dana Center for Preventive Ophthalmology, Wilmer Eye Institute , Johns Hopkins University , Baltimore , MD , USA.
Beatriz
B
Munoz
a Dana Center for Preventive Ophthalmology, Wilmer Eye Institute , Johns Hopkins University , Baltimore , MD , USA.
Kurt
K
Dreger
d International Chlamydia Laboratory, Department of Medicine , Johns Hopkins University , Baltimore , MD , USA.
Laura
L
Dize
d International Chlamydia Laboratory, Department of Medicine , Johns Hopkins University , Baltimore , MD , USA.
Charlotte
C
Gaydos
d International Chlamydia Laboratory, Department of Medicine , Johns Hopkins University , Baltimore , MD , USA.|e National Institute of Allergy and Infectious Diseases, National Institutes of Health , Bethesda , MD , USA.
Thomas C
TC
Quinn
a Dana Center for Preventive Ophthalmology, Wilmer Eye Institute , Johns Hopkins University , Baltimore , MD , USA.
Sheila K
SK
West
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D058069:Neglected Diseases / Q000188:drug therapy / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D013636:Tanzania / Q000453:epidemiology; D014141:Trachoma / Q000188:drug therapy* / Q000453:epidemiology*
D000900:Anti-Bacterial Agents; D017963:Azithromycin
Chlamydia trachomatis; Tanzania; community-based; randomized controlled trial; surveillance; trachoma