ASS ANTIMICROBIAL ADministrations have been used in several control programs and have been contemplated for many others. They have proven to be effective against some parasitic diseases (eg, onchocerciasis and filariasis), but at times have not lived up to expectations (eg, malaria). 1-3 Various forms of mass treatment have been used for bacterial diseases, including sexually transmitted chlamydia and syphilis. 4,5 The World Health Organization (WHO) 6 and its partners are now using repeated mass azithromycin administrations to control the ocular strains of chlamydia that cause trachoma, the world's leading cause of infectious blindness. 7 Trachoma meets the critical criteria for eradicability: there is an effective treatment for the ocular strains of Chlamydia trachomatis, and there is no known animal reservoir. Cur

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Despite modest inter-grader reliability and correlation with evidence of infection, the clinical exam is widely used due to its convenience and low cost. Efforts to make laboratory tests for ocular Chlamydia trachomatis more affordable would be useful.

There are various approaches to control trachoma. These include the elimination of the ocular strains of Chlamydia trachomatis that cause the disease and to decrease the spread of infection by other measures such as fly control. Here, we examined how these two are related (i.e., how treating children with antibiotics affects carriage of Chlamydia by flies). Flies were collected in villages that had received mass oral azithromycin distribution and were compared with flies in untreated villages. Polymerase chain reaction (PCR) was performed to detect chlamydial DNA on the flies. Conjunctival swabs were also taken to assay for chlamydial prevalence in the children. Chlamydia was found on 23% of the flies in the untreated villages but only 0.3% in treated villages. Prevalence of trachoma in children proved to be an excellent predictor of the prevalence on flies (correlation coefficient, 0.89). Thus, treating children with antibiotics may drastically reduce the role of flies as a vector.