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A targeted, single-dose azithromycin strategy for trachoma.

A C Laming¹, B J Currie, M DiFrancesco

¹Royal North Shore Hospital, Sydney, NSW.

The Medical Journal of Australia

|April 20, 2000

Summary

Treating children with acute trachoma and their contacts with azithromycin significantly reduced prevalence. However, sustained control requires comprehensive programs including health promotion and improved living conditions.

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Area of Science:

Ophthalmology
Infectious Diseases
Public Health

Background:

Trachoma remains a leading cause of preventable blindness globally.
Effective treatment strategies are crucial for controlling trachoma, especially in endemic communities.

Purpose of the Study:

To evaluate the impact of oral azithromycin treatment on acute trachoma in children and their contacts.
To assess the effectiveness of a community-based treatment strategy for trachoma.

Main Methods:

An open, uncontrolled, prospective study was conducted in an Aboriginal community in Central Australia.
216 schoolchildren and pre-schoolchildren aged 6 months to 15 years were treated with single-dose oral azithromycin.
Prevalence of acute trachoma was assessed using World Health Organization diagnostic criteria.

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Main Results:

Baseline trachoma prevalence was 42% in schoolchildren and 55% in pre-schoolchildren.
Following treatment, prevalence in schoolchildren decreased to 22% at 6-8 months and 31% at 12 months.
Pre-schoolchildren's trachoma prevalence dropped from 55% to 25% at 6 months post-treatment.

Conclusions:

Screening and treating a targeted group (35% screened, 20% treated) significantly reduced trachoma prevalence at 6 months.
Subsequent increases in prevalence highlight the need for comprehensive control programs.
Improved living conditions and health promotion are essential for long-term trachoma elimination.