Stopping azithromycin mass drug administration for trachoma: A systematic review.

The World Health Organization (WHO) recommends continuing azithromycin mass drug administration (MDA) for trachoma until endemic regions drop below 5% prevalence of active trachoma in children aged 1-9 years. Azithromycin targets the ocular strains of Chlamydia trachomatis that cause trachoma. Regio...

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Autores principales:	Hamidah Mahmud, Emma Landskroner, Abdou Amza, Solomon Aragie, William W Godwin, Anna de Hostos Barth, Kieran S O'Brien, Thomas M Lietman, Catherine E Oldenburg
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/00a67f0c27c84c1b908259ee1f956be2
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spelling	oai:doaj.org-article:00a67f0c27c84c1b908259ee1f956be22021-11-25T06:33:31ZStopping azithromycin mass drug administration for trachoma: A systematic review.1935-27271935-273510.1371/journal.pntd.0009491https://doaj.org/article/00a67f0c27c84c1b908259ee1f956be22021-07-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009491https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735The World Health Organization (WHO) recommends continuing azithromycin mass drug administration (MDA) for trachoma until endemic regions drop below 5% prevalence of active trachoma in children aged 1-9 years. Azithromycin targets the ocular strains of Chlamydia trachomatis that cause trachoma. Regions with low prevalence of active trachoma may have little if any ocular chlamydia, and, thus, may not benefit from azithromycin treatment. Understanding what happens to active trachoma and ocular chlamydia prevalence after stopping azithromycin MDA may improve future treatment decisions. We systematically reviewed published evidence for community prevalence of both active trachoma and ocular chlamydia after cessation of azithromycin distribution. We searched electronic databases for all peer-reviewed studies published before May 2020 that included at least 2 post-MDA surveillance surveys of ocular chlamydia and/or the active trachoma marker, trachomatous inflammation-follicular (TF) prevalence. We assessed trends in the prevalence of both indicators over time after stopping azithromycin MDA. Of 140 identified studies, 21 met inclusion criteria and were used for qualitative synthesis. Post-MDA, we found a gradual increase in ocular chlamydia infection prevalence over time, while TF prevalence generally gradually declined. Ocular chlamydia infection may be a better measurement tool compared to TF for detecting trachoma recrudescence in communities after stopping azithromycin MDA. These findings may guide future trachoma treatment and surveillance efforts.Hamidah MahmudEmma LandskronerAbdou AmzaSolomon AragieWilliam W GodwinAnna de Hostos BarthKieran S O'BrienThomas M LietmanCatherine E OldenburgPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 7, p e0009491 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Hamidah Mahmud Emma Landskroner Abdou Amza Solomon Aragie William W Godwin Anna de Hostos Barth Kieran S O'Brien Thomas M Lietman Catherine E Oldenburg Stopping azithromycin mass drug administration for trachoma: A systematic review.
description	The World Health Organization (WHO) recommends continuing azithromycin mass drug administration (MDA) for trachoma until endemic regions drop below 5% prevalence of active trachoma in children aged 1-9 years. Azithromycin targets the ocular strains of Chlamydia trachomatis that cause trachoma. Regions with low prevalence of active trachoma may have little if any ocular chlamydia, and, thus, may not benefit from azithromycin treatment. Understanding what happens to active trachoma and ocular chlamydia prevalence after stopping azithromycin MDA may improve future treatment decisions. We systematically reviewed published evidence for community prevalence of both active trachoma and ocular chlamydia after cessation of azithromycin distribution. We searched electronic databases for all peer-reviewed studies published before May 2020 that included at least 2 post-MDA surveillance surveys of ocular chlamydia and/or the active trachoma marker, trachomatous inflammation-follicular (TF) prevalence. We assessed trends in the prevalence of both indicators over time after stopping azithromycin MDA. Of 140 identified studies, 21 met inclusion criteria and were used for qualitative synthesis. Post-MDA, we found a gradual increase in ocular chlamydia infection prevalence over time, while TF prevalence generally gradually declined. Ocular chlamydia infection may be a better measurement tool compared to TF for detecting trachoma recrudescence in communities after stopping azithromycin MDA. These findings may guide future trachoma treatment and surveillance efforts.
format	article
author	Hamidah Mahmud Emma Landskroner Abdou Amza Solomon Aragie William W Godwin Anna de Hostos Barth Kieran S O'Brien Thomas M Lietman Catherine E Oldenburg
author_facet	Hamidah Mahmud Emma Landskroner Abdou Amza Solomon Aragie William W Godwin Anna de Hostos Barth Kieran S O'Brien Thomas M Lietman Catherine E Oldenburg
author_sort	Hamidah Mahmud
title	Stopping azithromycin mass drug administration for trachoma: A systematic review.
title_short	Stopping azithromycin mass drug administration for trachoma: A systematic review.
title_full	Stopping azithromycin mass drug administration for trachoma: A systematic review.
title_fullStr	Stopping azithromycin mass drug administration for trachoma: A systematic review.
title_full_unstemmed	Stopping azithromycin mass drug administration for trachoma: A systematic review.
title_sort	stopping azithromycin mass drug administration for trachoma: a systematic review.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/00a67f0c27c84c1b908259ee1f956be2
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Stopping azithromycin mass drug administration for trachoma: A systematic review.

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