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The Easiest Children to Reach Are Most Likely to Be Infected with Ocular Chlamydia trachomatis in Trachoma Endemic Areas of Niger
BACKGROUND: Control programs for trachoma use mass antibiotic distributions to treat ocular Chlamydia trachomatis in an effort to eliminate this disease worldwide. To determine whether children infected with ocular Chlamydia are more likely to present later for examination than those who are uninfec...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3542188/ https://www.ncbi.nlm.nih.gov/pubmed/23326612 http://dx.doi.org/10.1371/journal.pntd.0001983 |
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author | Amza, Abdou Kadri, Boubacar Nassirou, Baido Yu, Sun N. Stoller, Nicole E. Bhosai, Satasuk J. Zhou, Zhaoxia McCulloch, Charles E. West, Sheila K. Bailey, Robin L. Keenan, Jeremy D. Lietman, Thomas M. Gaynor, Bruce D. |
author_facet | Amza, Abdou Kadri, Boubacar Nassirou, Baido Yu, Sun N. Stoller, Nicole E. Bhosai, Satasuk J. Zhou, Zhaoxia McCulloch, Charles E. West, Sheila K. Bailey, Robin L. Keenan, Jeremy D. Lietman, Thomas M. Gaynor, Bruce D. |
author_sort | Amza, Abdou |
collection | PubMed |
description | BACKGROUND: Control programs for trachoma use mass antibiotic distributions to treat ocular Chlamydia trachomatis in an effort to eliminate this disease worldwide. To determine whether children infected with ocular Chlamydia are more likely to present later for examination than those who are uninfected, we compare the order of presentation for examination of children 0–5 years, and the presence of ocular Chlamydia by PCR in 4 villages in Niger where trachoma is endemic. METHODS: We conducted a cluster-randomized, controlled trial where 48 randomly selected villages in Niger are divided into 4 study arms of different mass treatment strategies. In a substudy of the main trial, we randomly selected 1 village from each of the 4 study arms (4 total villages) and we evaluated the odds of ocular Chlamydia versus the rank order of presentation for examination and laboratory assessment before treatment was offered. FINDINGS: We found the odds of harboring ocular Chlamydia dropped by more than 70% from the first child examined to the last child examined (OR 0.27, 95% CI 0.13–0.59, P = 0.001) in the 4 randomly selected villages. We found the odds of active trachoma dropped by 80% from the first child examined to the last child examined (OR 0.20, 95% CI 0.10–0.4, P<0.0001) in the 48 villages in the main trial. INTERPRETATION: This study demonstrates that even if the WHO recommended 80% treatment coverage is not reached in certain settings, children 0–5 years with the greatest probability of ocular Chlamydia have higher odds of receiving attention because they are the first to present. These results suggest there may be diminishing returns when using scarce resources to track down the last few children in a mass treatment program. TRIAL REGISTRATION: ClinicalTrials.gov NCT00792922 |
format | Online Article Text |
id | pubmed-3542188 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-35421882013-01-16 The Easiest Children to Reach Are Most Likely to Be Infected with Ocular Chlamydia trachomatis in Trachoma Endemic Areas of Niger Amza, Abdou Kadri, Boubacar Nassirou, Baido Yu, Sun N. Stoller, Nicole E. Bhosai, Satasuk J. Zhou, Zhaoxia McCulloch, Charles E. West, Sheila K. Bailey, Robin L. Keenan, Jeremy D. Lietman, Thomas M. Gaynor, Bruce D. PLoS Negl Trop Dis Research Article BACKGROUND: Control programs for trachoma use mass antibiotic distributions to treat ocular Chlamydia trachomatis in an effort to eliminate this disease worldwide. To determine whether children infected with ocular Chlamydia are more likely to present later for examination than those who are uninfected, we compare the order of presentation for examination of children 0–5 years, and the presence of ocular Chlamydia by PCR in 4 villages in Niger where trachoma is endemic. METHODS: We conducted a cluster-randomized, controlled trial where 48 randomly selected villages in Niger are divided into 4 study arms of different mass treatment strategies. In a substudy of the main trial, we randomly selected 1 village from each of the 4 study arms (4 total villages) and we evaluated the odds of ocular Chlamydia versus the rank order of presentation for examination and laboratory assessment before treatment was offered. FINDINGS: We found the odds of harboring ocular Chlamydia dropped by more than 70% from the first child examined to the last child examined (OR 0.27, 95% CI 0.13–0.59, P = 0.001) in the 4 randomly selected villages. We found the odds of active trachoma dropped by 80% from the first child examined to the last child examined (OR 0.20, 95% CI 0.10–0.4, P<0.0001) in the 48 villages in the main trial. INTERPRETATION: This study demonstrates that even if the WHO recommended 80% treatment coverage is not reached in certain settings, children 0–5 years with the greatest probability of ocular Chlamydia have higher odds of receiving attention because they are the first to present. These results suggest there may be diminishing returns when using scarce resources to track down the last few children in a mass treatment program. TRIAL REGISTRATION: ClinicalTrials.gov NCT00792922 Public Library of Science 2013-01-10 /pmc/articles/PMC3542188/ /pubmed/23326612 http://dx.doi.org/10.1371/journal.pntd.0001983 Text en © 2013 Amza et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Amza, Abdou Kadri, Boubacar Nassirou, Baido Yu, Sun N. Stoller, Nicole E. Bhosai, Satasuk J. Zhou, Zhaoxia McCulloch, Charles E. West, Sheila K. Bailey, Robin L. Keenan, Jeremy D. Lietman, Thomas M. Gaynor, Bruce D. The Easiest Children to Reach Are Most Likely to Be Infected with Ocular Chlamydia trachomatis in Trachoma Endemic Areas of Niger |
title | The Easiest Children to Reach Are Most Likely to Be Infected with Ocular Chlamydia trachomatis in Trachoma Endemic Areas of Niger |
title_full | The Easiest Children to Reach Are Most Likely to Be Infected with Ocular Chlamydia trachomatis in Trachoma Endemic Areas of Niger |
title_fullStr | The Easiest Children to Reach Are Most Likely to Be Infected with Ocular Chlamydia trachomatis in Trachoma Endemic Areas of Niger |
title_full_unstemmed | The Easiest Children to Reach Are Most Likely to Be Infected with Ocular Chlamydia trachomatis in Trachoma Endemic Areas of Niger |
title_short | The Easiest Children to Reach Are Most Likely to Be Infected with Ocular Chlamydia trachomatis in Trachoma Endemic Areas of Niger |
title_sort | easiest children to reach are most likely to be infected with ocular chlamydia trachomatis in trachoma endemic areas of niger |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3542188/ https://www.ncbi.nlm.nih.gov/pubmed/23326612 http://dx.doi.org/10.1371/journal.pntd.0001983 |
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