A targeted, single-dose azithromycin strategy for trachoma

Med J Aust. 2000 Feb 21;172(4):163-6.

Abstract

Objective: To evaluate the impact of treating children with acute trachoma and their contacts with oral azithromycin.

Design: Open, uncontrolled, prospective evaluation of a community-based treatment strategy.

Setting: Central Australian semi-desert Aboriginal community (1995-1996).

Participants: 216 school- and pre-schoolchildren aged 6 months and up to 15 years.

Intervention: All children with acute trachoma and their contacts (co-resident siblings aged between 6 months and 15 years) received single-dose oral azithromycin suspension (20 mg/kg, to a maximum of 1000 mg).

Main outcome measure: Prevalence of acute trachoma (World Health Organization trachoma diagnostic criteria).

Results: Trachoma prevalence at baseline was 42% (71/169) and 55% (18/33) for schoolchildren and pre-schoolchildren, respectively: 103 schoolchildren and 21 pre-schoolchildren, comprising 77 with follicular trachoma and their 47 contacts, were treated with azithromycin over an 8-week period. Acute trachoma prevalence in schoolchildren fell to 22% at 6-8 months (P < 0.0001) and was 31% at 12 months (P < 0.05 compared with baseline). Pre-schoolchildren were followed up for 6 months after treatment, and their trachoma prevalence fell from 55% to 25% (P < 0.05). Further treatment was given to children with trachoma at 12 months, and the point prevalence of trachoma for schoolchildren at 24 months was 34%.

Conclusions: In contrast to mass-treatment strategies, significant reductions in trachoma prevalence at 6 months were achieved by screening 35% of community members (216) and treating 20% (124). The subsequent prevalence increases support the need for more comprehensive treatment programs, including health promotion and efforts to improve living conditions.

MeSH terms

  • Acute Disease
  • Administration, Oral
  • Adolescent
  • Anti-Bacterial Agents / administration & dosage*
  • Azithromycin / administration & dosage*
  • Child
  • Child, Preschool
  • Humans
  • Infant
  • Northern Territory / epidemiology
  • Oceanic Ancestry Group* / statistics & numerical data
  • Population Surveillance
  • Prevalence
  • Prospective Studies
  • Rural Health / statistics & numerical data
  • School Health Services
  • Trachoma / drug therapy*
  • Trachoma / ethnology
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Azithromycin