Trachoma Elimination Follow-up

Chlamydia Clinical Trial

— TEF  

Official title:

Trachoma Elimination With Repeated Mass Azithromycin Treatments

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00221364
• Other study ID #: 10-02630
• Status: Completed
• Phase: Phase 4
• First received: September 14, 2005
• Last updated: July 13, 2015
• Start date: March 2003
• Est. completion date: April 2005

Study information

• Verified date: July 2015
• Source: University of California, San Francisco
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

The WHO has initiated a program to eliminate blinding trachoma by the year 2020, in large part by mass oral azithromycin distributions. It is not clear how frequently or for how long these treatments are necessary. Here we assess the frequency and duration of treatment.

Description:

40 villages in the Gurage Zone of Ethiopia were randomly assigned to biannual treatment, annual treatment, and a single treatment. Each treatment consisted of a single dose of oral azithromycin to the entire population over the age of 1 year (when the study was started, azithromycin had not yet been approved for ages below 1 year). We assess the prevalence the ocular chlamydia that causes trachoma in the peak prevalence age of 1-5 years at baseline, and 2, 6, 12, 18, and 24 months post treatment. An extension of the study monitors infection at 30 and 36 months post treatment. Untreated villages from the same area are enrolled in a step-wedge design to assess the presence of a secular trend. A random sample of those not within the 1-5 year old age group are examined to assess the prevalence of infection in the entire community.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 20000
• Est. completion date: April 2005
• Est. primary completion date: April 2005
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 1 Year and older

Eligibility

Inclusion Criteria:

Age 1 to 5 years old in a village in the Gurage zone with endemic trachoma

Exclusion Criteria:

Refusal of village chief (for village inclusion), or refusal of parent or guardian (for individual inclusion)

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Chlamydia
• Trachoma

Intervention

Drug:
• Mass treatment with oral azithromycin to an entire village

Locations

Country	Name	City	State
Ethiopia	ORBIS-Ethiopia	Addis Ababa

Sponsors (1)

Lead Sponsor	Collaborator
University of California, San Francisco

Country where clinical trial is conducted

Ethiopia, 

References & Publications (16)

Biebesheimer JB, House J, Hong KC, Lakew T, Alemayehu W, Zhou Z, Moncada J, Rogér A, Keenan J, Gaynor BD, Schachter J, Lietman TM. Complete local elimination of infectious trachoma from severely affected communities after six biannual mass azithromycin distributions. Ophthalmology. 2009 Nov;116(11):2047-50. doi: 10.1016/j.ophtha.2009.04.041. Epub 2009 Sep 10. — View Citation

Chidambaram JD, Alemayehu W, Melese M, Lakew T, Yi E, House J, Cevallos V, Zhou Z, Maxey K, Lee DC, Shapiro BL, Srinivasan M, Porco T, Whitcher JP, Gaynor BD, Lietman TM. Effect of a single mass antibiotic distribution on the prevalence of infectious trachoma. JAMA. 2006 Mar 8;295(10):1142-6. — View Citation

Chidambaram JD, Melese M, Alemayehu W, Yi E, Prabriputaloong T, Lee DC, Cevallos V, Zhou Z, Whitcher JP, Gaynor BD, Lietman TM. Mass antibiotic treatment and community protection in trachoma control programs. Clin Infect Dis. 2004 Nov 1;39(9):e95-7. Epub 2004 Oct 6. — View Citation

Gill DA, Lakew T, Alemayehu W, Melese M, Zhou Z, House JI, Hong KC, Ray KJ, Gandhi N, Whitcher JP, Gaynor BD, Lietman TM. Complete elimination is a difficult goal for trachoma programs in severely affected communities. Clin Infect Dis. 2008 Feb 15;46(4):564-6. doi: 10.1086/526777. — View Citation

Haug S, Lakew T, Habtemariam G, Alemayehu W, Cevallos V, Zhou Z, House J, Ray K, Porco T, Rutar T, Keenan J, Lietman TM, Gaynor BD. The decline of pneumococcal resistance after cessation of mass antibiotic distributions for trachoma. Clin Infect Dis. 2010 Sep 1;51(5):571-4. doi: 10.1086/655697. — View Citation

Hong KC, Schachter J, Moncada J, Zhou Z, House J, Lietman TM. Lack of macrolide resistance in Chlamydia trachomatis after mass azithromycin distributions for trachoma. Emerg Infect Dis. 2009 Jul;15(7):1088-90. doi: 10.3201/eid1507.081563. — View Citation

Keenan JD, Lakew T, Alemayehu W, Melese M, House JI, Acharya NR, Porco TC, Gaynor BD, Lietman TM. Slow resolution of clinically active trachoma following successful mass antibiotic treatments. Arch Ophthalmol. 2011 Apr;129(4):512-3. doi: 10.1001/archophthalmol.2011.46. — View Citation

Keenan JD, Lakew T, Alemayehu W, Melese M, Porco TC, Yi E, House JI, Zhou Z, Ray KJ, Acharya NR, Whitcher JP, Gaynor BD, Lietman TM. Clinical activity and polymerase chain reaction evidence of chlamydial infection after repeated mass antibiotic treatments for trachoma. Am J Trop Med Hyg. 2010 Mar;82(3):482-7. doi: 10.4269/ajtmh.2010.09-0315. — View Citation

Lakew T, Alemayehu W, Melese M, Yi E, House JI, Hong KC, Zhou Z, Ray KJ, Porco TC, Gaynor BD, Lietman TM, Keenan JD. Importance of coverage and endemicity on the return of infectious trachoma after a single mass antibiotic distribution. PLoS Negl Trop Dis. 2009 Aug 25;3(8):e507. doi: 10.1371/journal.pntd.0000507. — View Citation

Lakew T, House J, Hong KC, Yi E, Alemayehu W, Melese M, Zhou Z, Ray K, Chin S, Romero E, Keenan J, Whitcher JP, Gaynor BD, Lietman TM. Reduction and return of infectious trachoma in severely affected communities in Ethiopia. PLoS Negl Trop Dis. 2009;3(2):e376. doi: 10.1371/journal.pntd.0000376. Epub 2009 Feb 3. — View Citation

Lee S, Alemayehu W, Melese M, Lakew T, Lee D, Yi E, Cevallos V, Donnellan C, Zhou Z, Chidambaram JD, Gaynor BD, Whitcher JP, Lietman TM. Chlamydia on children and flies after mass antibiotic treatment for trachoma. Am J Trop Med Hyg. 2007 Jan;76(1):129-31. — View Citation

Melese M, Alemayehu W, Lakew T, Yi E, House J, Chidambaram JD, Zhou Z, Cevallos V, Ray K, Hong KC, Porco TC, Phan I, Zaidi A, Gaynor BD, Whitcher JP, Lietman TM. Comparison of annual and biannual mass antibiotic administration for elimination of infectious trachoma. JAMA. 2008 Feb 20;299(7):778-84. doi: 10.1001/jama.299.7.778. — View Citation

Melese M, Chidambaram JD, Alemayehu W, Lee DC, Yi EH, Cevallos V, Zhou Z, Donnellan C, Saidel M, Whitcher JP, Gaynor BD, Lietman TM. Feasibility of eliminating ocular Chlamydia trachomatis with repeat mass antibiotic treatments. JAMA. 2004 Aug 11;292(6):721-5. — View Citation

Ray KJ, Porco TC, Hong KC, Lee DC, Alemayehu W, Melese M, Lakew T, Yi E, House J, Chidambaram JD, Whitcher JP, Gaynor BD, Lietman TM. A rationale for continuing mass antibiotic distributions for trachoma. BMC Infect Dis. 2007 Aug 7;7:91. — View Citation

Shah NA, House J, Lakew T, Alemayehu W, Halfpenny C, Hong KC, Keenan JD, Porco TC, Whitcher JP, Lietman TM, Gaynor BD. Travel and implications for the elimination of trachoma in ethiopia. Ophthalmic Epidemiol. 2010 Mar;17(2):113-7. doi: 10.3109/09286581003624921. — View Citation

Yang JL, Hong KC, Schachter J, Moncada J, Lekew T, House JI, Zhou Z, Neuwelt MD, Rutar T, Halfpenny C, Shah N, Whitcher JP, Lietman TM. Detection of Chlamydia trachomatis ocular infection in trachoma-endemic communities by rRNA amplification. Invest Ophthalmol Vis Sci. 2009 Jan;50(1):90-4. doi: 10.1167/iovs.08-2247. Epub 2008 Aug 8. — View Citation

* Note: There are 16 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The prevalence of ocular chlamydia infection in a village as determined by PCR
Secondary	Clinical active trachoma, as determined by the WHO simplified grading system, by village