ArticlePLoS neglected tropical diseases2015
Mass drug administration for trachoma: how long is not long enough?
Article in PLoS neglected tropical diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Trachoma.BMJ clinical evidence · 2016Pooled it
- Article
- Comparison of metrics for assessing face washing behaviour for trachoma control.PLoS neglected tropical diseases · 2024Article
- Potential mitigating role of ivermectin on the spread of Chlamydia trachomatis by Musca sorbens.PLoS neglected tropical diseases · 2023Article
- Review
- Implementer and recipient perspectives of community-wide mass drug administration for soil-transmitted helminths in Kwale County, Kenya.PLoS neglected tropical diseases · 2020Article
- Effectiveness and safety of azithromycin 1.5% eye drops for mass treatment of active trachoma in a highly endemic district in Cameroon.BMJ open ophthalmology · 2020Article
- Associations between Water, Sanitation and Hygiene (WASH) and trachoma clustering at aggregate spatial scales, Amhara, Ethiopia.Parasites & vectors · 2019Article
- Selecting behaviour change priorities for trachoma 'F' and 'E' interventions: A formative research study in Oromia, Ethiopia.PLoS neglected tropical diseases · 2019Article
- Ocular Chlamydia trachomatis infection: elimination with mass drug administration.Expert review of anti-infective therapy · 2019Review
- Insights from mathematical modelling and quantitative analysis on the proposed 2030 goals for trachoma.Gates open research · 2019Article
- Optimising sampling regimes and data collection to inform surveillance for trachoma control.PLoS neglected tropical diseases · 2018Article
- The impact of a single round of community mass treatment with azithromycin on disease severity and ocular Chlamydia trachomatis load in treatment-naïve trachoma-endemic island communities in West Africa.Parasites & vectors · 2017Article
- Increased Epithelial Expression of CTGF and S100A7 with Elevated Subepithelial Expression of IL-1β in Trachomatous Trichiasis.PLoS neglected tropical diseases · 2016Article
- Article
- Inverse relationship between microRNA-155 and -184 expression with increasing conjunctival inflammation during ocular Chlamydia trachomatis infection.BMC infectious diseases · 2016Article
- Short-term forecasting of the prevalence of clinical trachoma: utility of including delayed recovery and tests for infection.Parasites & vectors · 2015Article
- Trachoma and Ocular Chlamydial Infection in the Era of Genomics.Mediators of inflammation · 2015Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBlinding trachoma is targeted for elimination by 2020 using the SAFE strategy (Surgery, Antibiotics, Facial cleanliness, and Environmental improvements). Annual mass drug administration (MDA) with azithromycin is a cornerstone of this strategy. If baseline prevalence of clinical signs of trachomatous inflammation - follicular among 1-9 year-olds (TF1-9) is ≥ 10% but <30%, the World Health Organization guidelines are for at least 3 annual MDAs; if ≥ 30%, 5. We assessed the likelihood of achieving the global elimination target of TF1-9 <5% at 3 and 5 year evaluations using program reports. METHODOLOGY/PRINCIPAL
findingsWe used the International Trachoma Initiative's prevalence and treatment database. Of 283 cross-sectional survey pairs with baseline and follow-up data, MDA was conducted in 170 districts. Linear and logistic regression modeling was applied to these to investigate the effect of MDA on baseline prevalence. Reduction to <5% was less likely, though not impossible, at higher baseline TF1-9 prevalences. Increased number of annual MDAs, as well as no skipped MDAs, were significant predictors of reduced TF1-9 at follow-up. The probability of achieving the <5% target was <50% for areas with ≥ 30% TF1-9 prevalence at baseline, even with 7 or more continuous annual MDAs.
conclusionsNumber of annual MDAs alone appears insufficient to predict program progress; more information on the effects of baseline prevalence, coverage, and underlying environmental and hygienic conditions is needed. Programs should not skip MDAs, and at prevalences >30%, 7 or more annual MDAs may be required to achieve the target. There are five years left before the 2020 deadline to eliminate blinding trachoma. Low endemic settings are poised to succeed in their elimination goals. However, newly-identified high prevalence districts warrant immediate inclusion in the global program. Intensified application of the SAFE strategy is needed in order to guarantee blinding trachoma elimination by 2020.
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