Yearly Mass Treatment C. Trachomatis: When Can We Stop?

每年的大规模治疗沙眼衣原体：我们什么时候可以停止？

• 批准号: 7390968
• 负责人: SHEILA K WEST
• 金额: $ 5.92万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2009-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7390968
• 关键词: Address; Africa; Age; Antibiotic Therapy; Asia; Azithromycin; Child; Chronic; Classification; Clinical; Clinical Markers; Clinical Treatment; Communities; Country; Data; Disease; Dose; Enrollment; Exposure to; Goals; Infection; Institutes; Laboratories; Life; Middle East; Modeling; Monitor; Morocco; Numbers; Personal Communication; Poverty; Predictive Value; Prevalence; Public Health; Rate; Research; Research Personnel; Resources; Rest; Risk; Sampling; School-Age Population; Schools; Sensitivity and Specificity; Sentinel; Surveys; Tanzania; Testing; Time; Trachoma; Work; World Health Organization; base; design; experience; programs; success; virtual

Country trachoma control programs are currently mass treating trachoma endemic communities every year using single dose azithromycin, with no evidence base for how long treatment must continue to reach these goals, or the optimal clinical marker with which to monitor progress.The World Health Organization currently suggests using follicular trachoma (TF)for monitoring, but data suggest this is sub-optimal. This proposal addresses the following critical aims for national programs: first, we determine the prevalence of infection in Tanzanian communities after exposure to mass treatment for 3 to 7 years, and whether an optimal number of yearly rounds can be identified after which mass treatment could be reconsidered. Second, we assess the utility and predictive value of specific combinations of clinical trachoma signs, following rounds of mass treatment, that might be used to chart progress and guide decisions to stop mass treatment. Working with the Tanzania National Trachoma Control Program communities, we propose to survey samples within 18 communities in each of five strata, reflecting exposure to 3, 4, 5, 6, and 7 rounds of mass treatment. Within the 90 communities, a random sample of children age 1-7 years will be selected to serve as a sentinel sample of current status of trachoma and infection with ocular C. trachomatis, according to years of exposure to mass treatment. Analyses, using models adjusted for clustering of infection within villages, will determine the prevalence of infection as a function of years of exposure to mass treatment, treatment coverage over time, baseline prevalence of trachoma, and other village level predictors. Within strata of exposure to rounds of mass treatment, the utility of other clinical markers against infection, compared to the WHO-recommended use of TF alone against infection, will be assessed. The results are critical for National Trachoma Programs, who need a better understanding of infection in their communities following several rounds of mass treatment and better clinical markers to guide decisions of when to stop mass treatment.

目前，国家沙眼控制计划每年都会对沙眼流行社区进行大规模治疗 使用单剂量阿奇霉素，没有证据表明治疗必须持续多长时间才能达到这些目标 目标，或监测进展的最佳临床标志物。世界卫生组织目前 建议使用滤泡性沙眼（TF）进行监测，但数据表明这不是最理想的。这个提议 解决国家方案的以下关键目标：首先，我们确定感染流行率 接受大规模治疗 3 到 7 年之后的坦桑尼亚社区，以及是否有最佳数量 可以确定每年的轮次，然后可以重新考虑集体治疗。其次，我们评估 肿块数轮后临床沙眼体征特定组合的实用性和预测价值 治疗，可用于绘制进展情况并指导停止大规模治疗的决策。与...一起工作 坦桑尼亚国家沙眼控制计划社区，我们建议在 18 年内调查样本 五个阶层中每一层的社区，反映了遭受 3、4、5、6 和 7 轮大规模治疗的情况。之内 在90个社区中，随机抽取1-7岁儿童作为哨兵 根据多年的沙眼和眼部沙眼衣原体感染现状样本 接受集体治疗。使用针对村庄内感染聚集进行调整的模型进行分析，将 确定感染流行率与接受大规模治疗、治疗的年数的函数关系 随时间变化的覆盖率、沙眼基线患病率以及其他村级预测因素。地层内 与接受多轮大规模治疗相比，其他临床标志物对抗感染的效用 世卫组织建议单独使用 TF 来对抗感染，将进行评估。结果对于国家而言至关重要 沙眼项目，需要更好地了解其社区中的感染情况 多轮大规模治疗和更好的临床标志物来指导何时停止大规模治疗的决定。