Risk factors for active trachoma and Chlamydia trachomatis infection in rural Ethiopia after mass treatment with azithromycin
Risk factors for active trachoma and Chlamydia trachomatis infection in rural Ethiopia after mass treatment with azithromycin
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DOI：
10.1111/j.1365-3156.2008.02034.x
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发表时间：
2008-04-01
影响因子：
3.3
通讯作者：
Cumberland, Phillippa
中科院分区：
文献类型：
--
作者：
Edwards, Tansy;Harding-Esch, Emma M.;Cumberland, Phillippa
目的探讨眼部沙眼衣原体感染和活动性沙眼的危险因素，比较接受和未接受阿奇霉素社区综合治疗和健康教育的社区的沙眼衣原体感染和活动性沙眼的危险因素。方法在为期3年的干预后随访调查中，随机抽取37个社区家庭的1722名3~9岁儿童进行沙眼衣原体体征检查，并用聚合酶链式反应检测眼部沙眼沙眼衣原体。多因素随机效应Logistic回归分析考虑了社区干预措施，并适当调整了其他独立危险因素。结果年龄较小、眼分泌物和眼上苍蝇是社区活动性沙眼的危险因素。阿奇霉素治疗后，6~9岁儿童发生活动性沙眼的几率低于3~5岁儿童(OR 0.48，95%CI：0.36~0.66)，而有眼分泌物(OR 4.5，95%CI：2.6~7.7)或眼上苍蝇(OR 2.5，95%CI：1.6~3.7)的儿童发生活动性沙眼的几率较高。6~9岁儿童感染沙眼衣原体的几率低于年龄较小的儿童(OR 0.47，95%CI：0.23~0.96)，接种2或3剂的儿童感染沙眼衣原体的几率低于1剂(OR 0.26，95%CI：0.08~0.88)。结论在接受或未接受大规模抗生素治疗的社区，沙眼衣原体和活动性沙眼的危险因素相同。教育和环境改善需要补充抗生素运动，以便对这些剩余的儿童水平的风险因素产生积极影响。
Objectives To investigate risk factors for ocular Chlamydia trachomatis infection and active trachoma, comparing communities receiving or not receiving an intervention programme of community-wide azithromycin treatment and health education.Methods In a 3-year post-intervention follow-up survey, 1722 children aged 3-9 years, from randomly selected households in 37 communities, were examined for signs of active trachoma and had samples taken to test for ocular C. trachomatis by polymerase chain reaction. Multivariate random effects logistic regression analyses considered interventions at community level, adjusting for other independent risk factors as appropriate.Results Younger age, ocular discharge and flies on eyes were risk factors for active trachoma in communities with and without antibiotic treatment. After azithromycin treatment, odds of active trachoma were lower in children aged 6-9 years than in children aged 3-5 years (OR 0.48, 95% CI: 0.36-0.66) and higher for children with ocular discharge (OR 4.5, 95% CI: 2.6-7.7) or flies on their eyes (OR 2.5, 95% CI: 1.6-3.7). Odds of C. trachomatis infection were lower in children aged 6-9 years than in younger children (OR 0.47, 95% CI: 0.23-0.96); and in children who received 2 or 3 doses rather than 1 (OR 0.26, 95% CI: 0.08-0.88).Conclusions In communities that received or did not receive the mass antibiotic treatment, the same risk factors for C. trachomatis and active trachoma were identified. Education and environmental improvements need to supplement antibiotic campaigns in order to positively impact on these remaining child level risk factors.