Ocular Chlamydia trachomatis infection: elimination with mass drug administration

Abstract

Introduction: Ocular Chlamydia trachomatis infection, the causative agent for trachoma, is responsible for 1.9 million cases of visual loss world-wide. Mass Drug Administration (MDA) with azithromycin to entire trachoma-endemic districts is part of the World Health Organization's public health strategy for trachoma elimination.Areas covered: Background on C. trachomatis and the epidemiology of trachoma are presented, followed by a review of the antibiotics for treatment and the need for a public health approach to trachoma elimination. The effectiveness of mass drug administration is presented, concluding with challenges to trachoma elimination in the future. Expert opinion: MDA using azithromycin is a key component of the public health strategy for trachoma elimination. With high coverage in children, there is good evidence that MDA drops the community pool of infection. There are challenges to trachoma elimination by the year 2020, and the drug donation program for country MDAs will be integral to ongoing efforts

Comparison of School-Based and Community-Wide Mass Drug Administration for Schistosomiasis Control in an Area of Western Kenya with High Initial Schistosoma mansoni Infection Prevalence: A Cluster Randomized Trial

“…The programs for different NTDs are at various stages of maturation. Whereas lymphatic filariasis and blinding trachoma have fairly well-defined strategies for where to initiate MDA, how to track progress, and when treatment can be stopped, 2,3 other programs such as schistosomiasis control still have important operational research questions that require attention. This is in part due to the longer time that donated drugs used for treating lymphatic filariasis (ivermectin and albendazole) and trachoma (azithromycin) have been available.…”

wIRA: hyperthermia as a treatment option for intracellular bacteria, with special focus on Chlamydiae and Mycobacteria

“…Trachoma is associated with poor hygiene status and extreme poverty [60]. The disease is spread by direct contact with ocular and nasal discharges, contact with fomites, or contact with eye-seeking flies (reviewed in [61,62]). One episode of infection results in selflimiting chlamydial conjunctivitis, an acute phase referred to as active trachoma [63,64].…”

Toward the Elimination of Disease: the 2019 Weisenfeld Award Lecture

“…The disease is spread from person to person by contact with infected secretions in an environment that favors poor hygiene practices. 6 Once the pathogenesis of blinding trachoma, caused by this cycle of repeated infections from ongoing transmission, was understood, interventions could be designed to interrupt the transmission cycle that leads to progressive scarring and trichiasis.…”