Stopping azithromycin mass drug administration for trachoma: A systematic review.
Stopping azithromycin mass drug administration for trachoma: A systematic review.
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DOI：
10.1371/journal.pntd.0009491
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发表时间：
2021-07
影响因子：
3.8
通讯作者：
Oldenburg CE
中科院分区：
文献类型：
--
作者：
Mahmud H;Landskroner E;Amza A;Aragie S;Godwin WW;de Hostos Barth A;O'Brien KS;Lietman TM;Oldenburg CE
The World Health Organization (WHO) recommends continuing azithromycin mass drug administration (MDA) for trachoma until endemic regions drop below 5% prevalence of active trachoma in children aged 1–9 years. Azithromycin targets the ocular strains of Chlamydia trachomatis that cause trachoma. Regions with low prevalence of active trachoma may have little if any ocular chlamydia, and, thus, may not benefit from azithromycin treatment. Understanding what happens to active trachoma and ocular chlamydia prevalence after stopping azithromycin MDA may improve future treatment decisions. We systematically reviewed published evidence for community prevalence of both active trachoma and ocular chlamydia after cessation of azithromycin distribution. We searched electronic databases for all peer-reviewed studies published before May 2020 that included at least 2 post-MDA surveillance surveys of ocular chlamydia and/or the active trachoma marker, trachomatous inflammation–follicular (TF) prevalence. We assessed trends in the prevalence of both indicators over time after stopping azithromycin MDA. Of 140 identified studies, 21 met inclusion criteria and were used for qualitative synthesis. Post-MDA, we found a gradual increase in ocular chlamydia infection prevalence over time, while TF prevalence generally gradually declined. Ocular chlamydia infection may be a better measurement tool compared to TF for detecting trachoma recrudescence in communities after stopping azithromycin MDA. These findings may guide future trachoma treatment and surveillance efforts. Trachoma, caused by repeated infections with ocular Chlamydia trachomatis, substantially contributes to the global burden of blindness. Community-wide distribution of the oral antibiotic azithromycin in trachoma endemic regions has contributed to significant decline in the prevalence of both ocular chlamydia infection and clinical findings of active trachoma. After azithromycin mass drug administration (MDA) stops, both ocular chlamydia and active trachoma can return. Our systematic review finds that ocular chlamydia infection may return to communities faster than signs of active trachoma, which may help better understand the utility of different trachoma indicators for post-MDA surveillance.
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DOI：
10.1093/trstmh/traa171
发表时间：
2021-03-06
影响因子：
2.2
作者：
Borlase A;Blumberg S;Callahan EK;Deiner MS;Nash SD;Porco TC;Solomon AW;Lietman TM;Prada JM;Hollingsworth TD
通讯作者：
Hollingsworth TD
影响因子：
3.8
作者：
Burton, Matthew J.;Holland, Martin J.;Bailey, Robin L.
通讯作者：
Bailey, Robin L.
影响因子：
120.7
作者：
Chidambaram, JD;Alemayehu, W;Lietman, TM
通讯作者：
Lietman, TM
影响因子：
3.8
作者：
Lakew, Takele;Alemayehu, Wondu;Keenan, Jeremy D.
通讯作者：
Keenan, Jeremy D.
影响因子：
15.8
作者：
Keenan JD;Tadesse Z;Gebresillasie S;Shiferaw A;Zerihun M;Emerson PM;Callahan K;Cotter SY;Stoller NE;Porco TC;Oldenburg CE;Lietman TM
通讯作者：
Lietman TM