Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
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
_version_ 1782255470428291072
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
work_keys_str_mv AT amzaabdou theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT kadriboubacar theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT nassiroubaido theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT yusunn theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT stollernicolee theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT bhosaisatasukj theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT zhouzhaoxia theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT mccullochcharlese theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT westsheilak theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT baileyrobinl theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT keenanjeremyd theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT lietmanthomasm theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT gaynorbruced theeasiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT amzaabdou easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT kadriboubacar easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT nassiroubaido easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT yusunn easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT stollernicolee easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT bhosaisatasukj easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT zhouzhaoxia easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT mccullochcharlese easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT westsheilak easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT baileyrobinl easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT keenanjeremyd easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT lietmanthomasm easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger
AT gaynorbruced easiestchildrentoreacharemostlikelytobeinfectedwithocularchlamydiatrachomatisintrachomaendemicareasofniger