Primary and Secondary Effects of Mass Antibiotic Distributions for Trachoma

描述（由申请人提供）：我在寻求K23职业发展奖有两个目标：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（北方阿姆哈拉州沙眼改善，U10 EY 016214）和PRET（快速消除沙眼伙伴关系，盖茨基金会，#48027）。世界卫生组织发起 尽管已经制定了GET 2020（到2020年全球消除沙眼）计划，以消除致盲性沙眼，但这些目标尚未实现，特别是在高流行社区。大规模治疗已被用于几个消除运动，并已被发现有意想不到的副作用。我有以下具体目标：SA 1：确定是否C。与基于DNA的检测相比，使用基于rRNA的核酸扩增可以消除沙眼感染。 SA 2a：确定阿奇霉素治疗是否能降低1-5奥尔兹腹泻、呼吸道疾病和疟疾的死亡率。 SA 2b：确定阿奇霉素治疗是否影响身高、体重和臂围的增加。我的目标是确定在高流行社区是否可以实现完全消除，然后将这些研究结果迅速转化为沙眼项目的实践，特别是WHO GET 2020项目。生长指数是确定大规模治疗效果的常用方法;开发和测试一种测量生长和营养的仪器将为今后关于沙眼与其他被忽视的热带病（NTD）整合的研究提供一个重要的桥梁。 公共卫生相关性：该项目的目标是改善我们的 了解沙眼的抗生素分布情况，评估 沙眼被假定消除的人群，并评估 这些大规模治疗的副作用。这对于建立两个 世卫组织全球消除沙眼运动的有效性和安全性。

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.