02969nas a2200421   4500000000100000008004100001653002200042653001300064653001700077653001500094653000900109653001200118653001100130653002100141653002200162653001100184653001300195653002500208653002800233653002600261653002100287653001000308653001700318653002700335653002600362100001700388700001400405700001200419700001900431700001600450700001200466700001100478245011700489300001100606490000700617520190900624022001402533       2008                            d10aTreatment Outcome10aTrachoma10aRural Health10aPrevalence10aMale10aHygiene10aHumans10aHealth Education10aFollow-Up Studies10aFemale10aEthiopia10aDeveloping countries10aCross-Sectional Studies10aChlamydia trachomatis10aChild, Preschool10aChild10aAzithromycin10aAntibiotic Prophylaxis10aAnti-Bacterial Agents1 aCumberland P1 aEdwards T1 aHailu G1 aHarding-Esch E1 aAndreasen A1 aMabey D1 aTodd J00aThe impact of community level treatment and preventative interventions on trachoma prevalence in rural Ethiopia.  a549-580 v373 a<p><strong>BACKGROUND: </strong>The International Trachoma Initiative (ITI) trachoma control programme based on the SAFE strategy (Surgery, Antibiotics, Facial cleanliness and Environmental improvement) was implemented in 2002 in two rural Ethiopian zones, with mass delivery of azithromycin starting in 2003. We evaluate the impact of combined antibiotic and health educational interventions on active trachoma and Chlamydia trachomatis detected from ocular swabs, in children aged 3-9 years. Method Three-year follow-up cross-sectional survey was carried out in 40 rural Ethiopian communities to evaluate the programme. Households were randomly selected and all children were invited for eye examination for active trachoma. In 2005, eye swabs were taken for Polymerase Chain Reaction (PCR) detection of ocular C. trachomatis DNA. Adult knowledge and behaviour related to trachoma were assessed.</p>

<p><strong>RESULTS: </strong>Community summarized mean prevalence, overall, was 35.6% (SD = 17.6) for active trachoma, 34.0% (18.7) for trachomatous inflammation, follicular (TF) alone and 4.3% (5.3) for PCR positivity for C. trachomatis. After adjustment, odds of active trachoma were reduced in communities receiving antibiotics and one or two educational intervention components (OR = 0.35, 95% CI: 0.13-0.89 or OR = 0.31, 0.11-0.89, respectively). The odds of being PCR positive were lower in these intervention arms, compared with control (OR = 0.20, 0.06-0.62 and OR = 0.07, 0.02-0.30, respectively). Knowledge of treatment and preventative methods were reported with much higher frequency, compared with baseline.</p>

<p><strong>CONCLUSIONS: </strong>Trachoma remains a public health problem in Ethiopia. Antibiotic administration remains the most effective intervention but community-based health education programmes can impact, to additionally reduce prevalence of C. trachomatis.</p>
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