Azithromycin use for trachoma control: lessons learned from Tanzania

Abstract

Trachoma, the leading infectious cause of blindness, is a chronic conjunctivitis caused by repeated reinfections with Chlamydia trachomatis. Trachoma is a disease of entire communities, with the reservoir of infection residing in children, especially preschool children. The World Health Assembly has targeted the year 2020 for the elimination of blinding trachoma as a public health problem, and mass treatment with antibiotics is part of the multifaceted SAFE strategy recommended for country programs. Tanzania was one of the first countries to be the recipient of azithromycin for use in mass distribution programs and has been the site of a continuous research effort on trachoma control in the Kongwa district, the Kongwa Trachoma Project, since 1986. The authors discuss some events leading up to the use of azithromycin for trachoma, our experiences and lessons learned with use of azithromycin, intervention goals, achieving high coverage and the challenges to achieving elimination by 2020.

Keywords::

• azithromycin
• ocular Chlamydia trachomatis infection
• population study
• Tanzania
• trachoma

Acknowledgements

The authors acknowledge with gratitude the people of the communities of Kongwa, who have worked with us over the 26 years of the Kongwa Trachoma Project to provide the information for trachoma control that has helped countries everywhere. We are also grateful to the funding agencies over these many years that have provided support for our research, including Edna McConnell Clark Foundation, National Institute of Allergy and Infectious Disease, National Eye Institute, International Trachoma Initiative, World Health Organization, Research to Prevent Blindness, Pfizer International and the Bill and Melinda Gates Foundation.

Financial & competing interests disclosure

S West is a member of the Technical Expert Committee of the International Trachoma Initiative. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.