Mass treatment with azithromycin for trachoma control: participation clusters in households.

<h4>Background</h4>Mass treatment to trachoma endemic communities is a critical part of the World Health Organization SAFE strategy. However, non-participation may not be at random, affecting coverage surveys and effectiveness if infection is differential.<h4>Methodology/principal...

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Autores principales:	Elizabeth N Ssemanda, Beatriz Munoz, Emma M Harding-Esch, Tansy Edwards, Harran Mkocha, Robin L Bailey, Ansumana Sillah, Dianne Stare, David C W Mabey, Sheila K West, PRET Project Team
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2010
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/fe4b02fa4f8243d9b95d27742b2c3566
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spelling	oai:doaj.org-article:fe4b02fa4f8243d9b95d27742b2c35662021-11-18T09:13:47ZMass treatment with azithromycin for trachoma control: participation clusters in households.1935-27271935-273510.1371/journal.pntd.0000838https://doaj.org/article/fe4b02fa4f8243d9b95d27742b2c35662010-10-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20957196/pdf/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Mass treatment to trachoma endemic communities is a critical part of the World Health Organization SAFE strategy. However, non-participation may not be at random, affecting coverage surveys and effectiveness if infection is differential.<h4>Methodology/principal findings</h4>As part of the Partnership for Rapid Elimination of Trachoma (PRET), 32 communities in Tanzania, and 48 in The Gambia had a detailed census taken followed by mass treatment with azithromycin. The target coverage in each community was >80% of children ages <10 years. Community treatment assistants observed treatment and recorded compliance, thus coverage at the community, household, and individual level could be determined. Within each community, we determined the actual proportions of households where all, some, or none of the children were treated. Assuming the coverage in children <10 years of the community was as observed and non-participation was at random, we did 500 simulations to derive expected proportions of households where all, some, or none of the children were treated. Clustering of household treatment was detected comparing greater-than-expected proportions of households where none or all of children were treated, and the intraclass correlation (ICC) was calculated. Tanzanian and Gambian mass treatment coverages for children <10 years of age ranged from 82-100% and 62-99%, respectively. Clustering of households where all children were treated or no children were treated was greater than expected. Compared to model simulations, all Tanzanian communities and 44 of 48 (91.7%) Gambian communities had significantly higher proportions of households where all children were treated. Furthermore, 30 of 32 (93.8%) Tanzanian communities and 34 of 48 (70.8%) Gambian communities had a significantly elevated proportion of households compared to the expected proportion where no children were treated. The ICC for Tanzania was 0.77 (95% CI 0.74-0.81) and for The Gambia was 0.55 (95% CI 0.51-0.59).<h4>Conclusions/significance</h4>In programs aiming for high coverage, complete compliance or non-compliance with mass treatment clusters within households. Non-compliance cannot be assumed to be at random.Elizabeth N SsemandaBeatriz MunozEmma M Harding-EschTansy EdwardsHarran MkochaRobin L BaileyAnsumana SillahDianne StareDavid C W MabeySheila K WestPRET Project TeamPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 4, Iss 10 (2010)
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 Elizabeth N Ssemanda Beatriz Munoz Emma M Harding-Esch Tansy Edwards Harran Mkocha Robin L Bailey Ansumana Sillah Dianne Stare David C W Mabey Sheila K West PRET Project Team Mass treatment with azithromycin for trachoma control: participation clusters in households.
description	<h4>Background</h4>Mass treatment to trachoma endemic communities is a critical part of the World Health Organization SAFE strategy. However, non-participation may not be at random, affecting coverage surveys and effectiveness if infection is differential.<h4>Methodology/principal findings</h4>As part of the Partnership for Rapid Elimination of Trachoma (PRET), 32 communities in Tanzania, and 48 in The Gambia had a detailed census taken followed by mass treatment with azithromycin. The target coverage in each community was >80% of children ages <10 years. Community treatment assistants observed treatment and recorded compliance, thus coverage at the community, household, and individual level could be determined. Within each community, we determined the actual proportions of households where all, some, or none of the children were treated. Assuming the coverage in children <10 years of the community was as observed and non-participation was at random, we did 500 simulations to derive expected proportions of households where all, some, or none of the children were treated. Clustering of household treatment was detected comparing greater-than-expected proportions of households where none or all of children were treated, and the intraclass correlation (ICC) was calculated. Tanzanian and Gambian mass treatment coverages for children <10 years of age ranged from 82-100% and 62-99%, respectively. Clustering of households where all children were treated or no children were treated was greater than expected. Compared to model simulations, all Tanzanian communities and 44 of 48 (91.7%) Gambian communities had significantly higher proportions of households where all children were treated. Furthermore, 30 of 32 (93.8%) Tanzanian communities and 34 of 48 (70.8%) Gambian communities had a significantly elevated proportion of households compared to the expected proportion where no children were treated. The ICC for Tanzania was 0.77 (95% CI 0.74-0.81) and for The Gambia was 0.55 (95% CI 0.51-0.59).<h4>Conclusions/significance</h4>In programs aiming for high coverage, complete compliance or non-compliance with mass treatment clusters within households. Non-compliance cannot be assumed to be at random.
format	article
author	Elizabeth N Ssemanda Beatriz Munoz Emma M Harding-Esch Tansy Edwards Harran Mkocha Robin L Bailey Ansumana Sillah Dianne Stare David C W Mabey Sheila K West PRET Project Team
author_facet	Elizabeth N Ssemanda Beatriz Munoz Emma M Harding-Esch Tansy Edwards Harran Mkocha Robin L Bailey Ansumana Sillah Dianne Stare David C W Mabey Sheila K West PRET Project Team
author_sort	Elizabeth N Ssemanda
title	Mass treatment with azithromycin for trachoma control: participation clusters in households.
title_short	Mass treatment with azithromycin for trachoma control: participation clusters in households.
title_full	Mass treatment with azithromycin for trachoma control: participation clusters in households.
title_fullStr	Mass treatment with azithromycin for trachoma control: participation clusters in households.
title_full_unstemmed	Mass treatment with azithromycin for trachoma control: participation clusters in households.
title_sort	mass treatment with azithromycin for trachoma control: participation clusters in households.
publisher	Public Library of Science (PLoS)
publishDate	2010
url	https://doaj.org/article/fe4b02fa4f8243d9b95d27742b2c3566
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Mass treatment with azithromycin for trachoma control: participation clusters in households.

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