Primary and Secondary Effects of Mass Antibiotic Distributions for Trachoma

描述（由申请人提供）：我有两个目标来寻求K23职业发展奖：1。通过对沙眼表面上已被消除的人群进行深入分析，并通过评估大规模抗生素治疗对儿童发病率和死亡率的积极次要影响，提高我们对大规模抗生素分布对沙眼的影响的理解；2. 通过在发展中国家的教学、指导和实践研究经验，发展我作为独立调查员的职业生涯。我将受益于两项临床试验的基础设施：TANA（北阿姆哈拉沙眼改善，U10 EY016214）和PRET（快速消除沙眼伙伴关系，盖茨基金会，#48027）。世卫组织发起了

DESCRIPTION (provided by applicant): I have two objectives in seeking a K23 career development award: 1. to improve our understanding of the effects of mass antibiotic distributions for trachoma by conducting an in depth analysis of populations in which trachoma has ostensibly been eliminated and by assessing the positive secondary effects of mass antibiotic treatments on childhood morbidity and mortality; 2. to develop my career as an independent investigator through didactics, mentorship and hands-on research experience in the developing world. I will benefit from the infrastructure of two clinical trials: TANA (Trachoma Amelioration in Northern Amhara, U10 EY016214) and PRET (Partnership for the Rapid Elimination of Trachoma, Gates Foundation, #48027). The WHO launched the GET 2020 (Global Elimination of Trachoma by the year 2020) program to eliminate blinding trachoma, however, the goals have not been met, particularly in hyperendemic communities. Mass treatments have been used in several elimination campaigns and have been found to have unintended secondary effects. I have the following specific aims: SA1: To determine if C. trachomatis infection can be eliminated using rRNA-based nucleic acid amplification compared to DNA-based testing. SA2a: To determine if azithromycin treatments reduce mortality in 1-5 year olds from diarrhea, respiratory disease and malaria. SA2b: To determine if azithromycin treatments effect increases in height, weight, and arm circumference. My goal is to determine if complete elimination is attainable in hyperendemic communities and then to translate these research findings quickly into practice within trachoma programs in general and within the WHO GET 2020 program in particular. Growth indices are a common method for determining the efficacy of mass treatment; developing and testing an instrument for measuring growth and nutrition will provide an important bridge to future studies on integration of trachoma with other neglected tropical diseases (NTD). PUBLIC HEALTH RELEVANCE: The goal of this project is to improve our understanding of mass antibiotic distributions for trachoma, assessing populations in which trachoma was presumably eliminated, and evaluating for secondary effects of these mass treatments. This is critical for establishing both the efficacy and safety of the WHO Global Elimination of Trachoma campaign.