Efficacy of oral azithromycin versus topical tetracycline in mass treatment of endemic trachoma

Efficacy of oral azithromycin versus topical tetracycline in mass treatment of endemic trachoma

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OBJECTIVE: To compare the impact of mass treatment with oral azithromycin and topical tetracycline on the prevalence of active trachoma.METHODS: A total of 1803 inhabitants from 106 households of eight Gambian villages were randomized, in pairs, to receive either three doses of azithromycin at weekly intervals, or daily topical tetracycline over 6 weeks.Ocular examinations were conducted before treatment, and 2, 6 and 12 months after treatment.

FINDINGS: Prior to treatment, 16% of the study participants had active BROW PENCIL trachoma.Two months after treatment, the prevalence of trachoma was 4.6% and 5.

1% in the azithromycin and the tetracycline groups, respectively (adjusted odds ratio (OR) = 1.09; 95% confidence interval (CI) = 0.53, 2.

02).Subsequently, the prevalence rose to 16% in the tetracycline group, while remaining at 7.7% in the azithromycin group (adjusted OR at 12 months = 0.

52; 95% CI = 0.34, 0.80).

At 12 months post-treatment, there were fewer new prevalent cases in the azithromycin group, and trachoma resolution was significantly better for this group (adjusted OR = 2.02; 95% CI = 1.42, 3.

50).CONCLUSION: Oral azithromycin therefore appears to offer a means for controlling blinding trachoma.It is SAL SUDS easy to administer and higher coverages may be possible than have been achieved hitherto.