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[e-drug] Trachoma 'eliminated' in Tanzanian village

 E-DRUG: Trachoma 'eliminated' in Tanzanian village
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{I think it must be recognised that azithromycin alone cannot wipe out trachoma 
as suggested by the headline.  As the authors state 'environmental management, 
basic hygiene and improved sanitation ­ are key to combating trachoma, as the 
infection is passed on via eye discharge from an infected person'.  So long as 
the pool of infection remains in the environment, re-infection of humans can 
occur.  BS]

Henry Neondo and Christina Scott
1 May 2008 
<http://www.scidev.net/en/news/trachoma-eliminated-in-tanzanian-village.html>http://www.scidev.net/en/news/trachoma-eliminated-in-tanzanian-village.html

The eye infection trachoma ­ the world's leading preventable cause of blindness 
­ can be successfully eliminated with just two doses of antibiotic, scientists 
report. 

Researchers used two doses of the standard antibiotic azithromycin, spaced two 
years apart, to eliminate trachoma in the community of Kahe Mpya, Tanzania.

They reported their results in the New England Journal of Medicine last week 
(April 24). 

The success suggests an alternative to the WHO's current recommendations of 
annual doses of the antibiotic azithromycin over three years in at-risk 
communities.

Trachoma is caused by Chlamydia trachomatis infection. Repeated infections can 
cause scarring on the eyelid, resulting in it turning inside out and causing 
the eyelashes to scratch the cornea.

People in Kahe Mpya village were administered with azithromycin, and samples 
from their eyes monitored for the presence of trachoma infection. After the 
first treatment, infection fell from 9.5 per cent to 0.1 per cent. Three years 
after the second treatment, no infection was found in samples.

The Tanzanian research offers a solution to help nomadic communities in East 
Africa, who have the highest rates of trachoma in the world, says Hezron Ngugi, 
a trachoma researcher at the Kenya-based African Medical & Research Foundation 
(AMREF). 

He says that as few doses of antibiotic as possible ­ coupled with 
environmental management, basic hygiene and improved sanitation ­ are key to 
combating trachoma, as the infection is passed on via eye discharge from an 
infected person. 

Even the single dose treatment currently applied once a year requires 
government reliance on free donations from the International Trachoma Institute 
from pharmaceutical company Pfizer, Ngugi noted. 

AMREF is currently researching the use of volunteer community health workers to 
give out azithromycin and provide advice to nomadic cattle herders in Kenya's 
isolated Samburu district. Final results will be known next year.

<http://content.nejm.org/cgi/content/full/358/17/1870>Link to full paper in the 
<http://content.nejm.org/cgi/content/full/358/17/1870>New England Journal of 
Medicine 

References

The New England Journal of Medicine 358, 1870 (2008)

Leela McCullough, Ed.D.
Director of Information Services

AED-SATELLIFE Center for Health Information and Technology
30 California Street, Watertown, MA 02472, USA
Tel: +617-926-9400    Fax: +617-926-1212
Email: lmccullough@aed.org
Web: http://www.healthnet.org

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