Evidence map›Paper›PMID 33674869›Full record

Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021

Targeted Antibiotics for Trachoma: A Cluster-Randomized Trial.

Jason S Melo, Solomon Aragie, Ambahun Chernet, Zerihun Tadesse, Adane Dagnew, Dagnachew Hailu, Mahteme Haile, Tàye Zeru, Dionna M Wittberg, Scott D Nash and 5 more

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.4field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 11 citations in OpenAlex.

  1. Targeted Mass Azithromycin Distribution for Trachoma: A Community-Randomized Trial (TANA II).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023
    Trial
  2. Trial
  3. Trial
  4. Efficacy of Single-Dose Azithromycin for Ocular Chlamydial Infection: A Longitudinal Study.The American journal of tropical medicine and hygiene · 2024
    Article
  5. Article
  6. Monitoring transmission intensity of trachoma with serology.medRxiv : the preprint server for health sciences · 2023
    Article
  7. Article
  8. Trachoma.Nature reviews. Disease primers · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 2 countries.

Jason S MeloFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Solomon AragieThe Carter Center Ethiopia, Addis Ababa, Ethiopia.
Ambahun ChernetThe Carter Center Ethiopia, Addis Ababa, Ethiopia.
Zerihun TadesseThe Carter Center Ethiopia, Addis Ababa, Ethiopia.
Adane DagnewThe Carter Center Ethiopia, Addis Ababa, Ethiopia.
Dagnachew HailuThe Carter Center Ethiopia, Addis Ababa, Ethiopia.
Mahteme HaileAmhara Public Health Institute, Bahir Dar, Ethiopia.
Tàye ZeruAmhara Public Health Institute, Bahir Dar, Ethiopia.
Dionna M WittbergFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Scott D NashThe Carter Center, Atlanta, Georgia, USA.
E Kelly CallahanThe Carter Center, Atlanta, Georgia, USA.
Benjamin F ArnoldFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Travis C PorcoFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Thomas M LietmanFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Jeremy D KeenanFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
San Francisco Foundation · USThe Carter Center · ETCarter Center · USEthiopian Public Health Institute · ETUniversity of California, San Francisco · US

Funding

Sanitation, Water, and Instruction in face-washing for trachoma II (SWIFT II)UG1EY023939 · NEI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KEENAN, JEREMY DAVID · 2019 to 2023
$4.1M
Sanitation, Water, and Instruction in Face-washing for TrachomaU10EY023939 · NEI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KEENAN, JEREMY DAVID · 2014 to 2018
$2.7M
NEI NIH HHS U10 EY023939NEI NIH HHS UG1 EY023939
6 · The paper itself

Abstract

backgroundCurrent guidelines recommend community-wide mass azithromycin for trachoma, but a targeted treatment strategy could reduce the volume of antibiotics required.

methodsIn total, 48 Ethiopian communities were randomized to mass, targeted, or delayed azithromycin distributions. In the targeted arm, only children aged 6 months to 5 years with evidence of ocular chlamydia received azithromycin, distributed thrice over the following year. The primary outcome was ocular chlamydia at months 12 and 24, comparing the targeted and delayed arms (0-5 year-olds, superiority analysis) and the targeted and mass azithromycin arms (8-12 year-olds, noninferiority analysis, 10% noninferiority margin).

resultsAt baseline, the mean prevalence of ocular chlamydia in the 3 arms ranged from 7% to 9% among 0-5 year-olds and from 3% to 9% among 8-12 year-olds. Averaged across months 12-24, the mean prevalence of ocular chlamydia among 0-5 year-olds was 16.7% (95% confidence interval [CI]: 9.0%-24.4%) in the targeted arm and 22.3% (95% CI: 11.1%-33.6%) in the delayed arm (P = .61). The final mean prevalence of ocular chlamydia among 8-12 year-olds was 13.5% (95% CI: 7.9%-19.1%) in the targeted arm and 5.5% (95% CI: 0.3%-10.7%) in the mass treatment arm (adjusted risk difference 8.5 percentage points [pp] higher in the targeted arm, 95% CI: 0.9 pp-16.1 pp higher).

conclusionsAntibiotic treatments targeted to infected preschool children did not result in significantly less ocular chlamydia infections compared with untreated communities and did not meet noninferiority criteria relative to mass azithromycin distributions. Targeted approaches may require treatment of a broader segment of the population in areas with hyperendemic trachoma.

Indexed as

GonorrheaTrachomaAnti-Bacterial AgentsAzithromycinChildChild, PreschoolChlamydia trachomatisHumansInfantPrevalenceAnti-Bacterial AgentsAzithromycinAfricaantibacterial agentschlamydiamass drug administrationtrachoma

Identifiers

PMID33674869
PMCPMC8442777
OpenAlexW3133899249

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.