ArticlePLoS neglected tropical diseases2009
When can antibiotic treatments for trachoma be discontinued? Graduating communities in three African countries.
Article in PLoS neglected tropical diseases, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Epidemiology and control of trachoma: systematic review.Tropical medicine & international health : TM & IH · 2010Pooled it
- Prolonged mass azithromycin distributions and macrolide resistance determinants among preschool children in Niger: A sub-study of a cluster-randomized trial (MORDOR).PLoS medicine · 2024Trial
- The efficacy of oral azithromycin in clearing ocular chlamydia: mathematical modeling from a community-randomized trachoma trial.Epidemics · 2014Trial
- District-Level Forecast of Achieving Trachoma Elimination as a Public Health Problem By 2030: An Ensemble Modelling Approach.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Review
- Modeling the "F" in "SAFE": The dynamic game of facial cleanliness in trachoma prevention.PloS one · 2023Article
- Mass drug administration: the importance of synchrony.Mathematical medicine and biology : a journal of the IMA · 2017Article
- Probabilistic forecasts of trachoma transmission at the district level: A statistical model comparison.Epidemics · 2017Article
- Improving our forecasts for trachoma elimination: What else do we need to know?PLoS neglected tropical diseases · 2017Article
- Basic Reproduction Number and Transmission Dynamics of Common Serogroups of Enterohemorrhagic Escherichia coli.Applied and environmental microbiology · 2016Article
- Article
- Serological Measures of Trachoma Transmission Intensity.Scientific reports · 2015Article
- Short-term forecasting of the prevalence of clinical trachoma: utility of including delayed recovery and tests for infection.Parasites & vectors · 2015Article
- Short-term Forecasting of the Prevalence of Trachoma: Expert Opinion, Statistical Regression, versus Transmission Models.PLoS neglected tropical diseases · 2015Article
- The distribution of the prevalence of ocular chlamydial infection in communities where trachoma is disappearing.Epidemics · 2015Article
- Control of trachoma in Australia: a model based evaluation of current interventions.PLoS neglected tropical diseases · 2015Article
- The distribution of ocular Chlamydia prevalence across Tanzanian communities where trachoma is declining.PLoS neglected tropical diseases · 2015Article
- Prevalence of trachoma at sub-district level in ethiopia: determining when to stop mass azithromycin distribution.PLoS neglected tropical diseases · 2014Article
- Assessment of transmission in trachoma programs over time suggests no short-term loss of immunity.PLoS neglected tropical diseases · 2013Article
- Number of years of annual mass treatment with azithromycin needed to control trachoma in hyper-endemic communities in Tanzania.The Journal of infectious diseases · 2011Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundRepeated mass azithromycin distributions are effective in controlling the ocular strains of chlamydia that cause trachoma. However, it is unclear when treatments can be discontinued. Investigators have proposed graduating communities when the prevalence of infection identified in children decreases below a threshold. While this can be tested empirically, results will not be available for years. Here we use a mathematical model to predict results with different graduation strategies in three African countries.
methodsA stochastic model of trachoma transmission was constructed, using the parameters with the maximum likelihood of obtaining results observed from studies in Tanzania (with 16% infection in children pre-treatment), The Gambia (9%), and Ethiopia (64%). The expected prevalence of infection at 3 years was obtained, given different thresholds for graduation and varying the characteristics of the diagnostic test.
resultsThe model projects that three annual treatments at 80% coverage would reduce the mean prevalence of infection to 0.03% in Tanzanian, 2.4% in Gambian, and 12.9% in the Ethiopian communities. If communities graduate when the prevalence of infection falls below 5%, then the mean prevalence at 3 years with the new strategy would be 0.3%, 3.9%, and 14.4%, respectively. Graduations reduced antibiotic usage by 63% in Tanzania, 56% in The Gambia, and 11% in Ethiopia.
conclusionModels suggest that graduating communities from a program when the infection is reduced to 5% is a reasonable strategy and could reduce the amount of antibiotic distributed in some areas by more than 2-fold.
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