02687nas a2200421   4500000000100000008004100001653002200042653001300064653001300077653002100090653001700111653001500128653002300143653001100166653002400177653002700201653002500228653002800253653002600281653002600307100001200333700001300345700001300358700001400371700001100385700001200396700001500408700001200423700001400435700001600449700001500465245008500480856007800565300000900643490000600652520159300658022001402251       2009                            d10aTreatment Failure10aTrachoma10aTanzania10aRural Population10aRisk Factors10aPrevalence10aModels, Biological10aGambia10aFeasibility Studies10aFamily Characteristics10aDeveloping countries10aCross-Sectional Studies10aChlamydia trachomatis10aAnti-Bacterial Agents1 aBlake I1 aBurton M1 aBailey R1 aSolomon A1 aWest S1 aMunoz B1 aHolland MJ1 aMabey D1 aGambhir M1 aBasáñez M1 aGrassly NC00aEstimating household and community transmission of ocular Chlamydia trachomatis.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2655714/pdf/pntd.0000401.pdf  ae4010 v33 a<p><strong>INTRODUCTION: </strong>Community-wide administration of antibiotics is one arm of a four-pronged strategy in the global initiative to eliminate blindness due to trachoma. The potential impact of more efficient, targeted treatment of infected households depends on the relative contribution of community and household transmission of infection, which have not previously been estimated.</p>

<p><strong>METHODS: </strong>A mathematical model of the household transmission of ocular Chlamydia trachomatis was fit to detailed demographic and prevalence data from four endemic populations in The Gambia and Tanzania. Maximum likelihood estimates of the household and community transmission coefficients were obtained.</p>

<p><strong>RESULTS: </strong>The estimated household transmission coefficient exceeded both the community transmission coefficient and the rate of clearance of infection by individuals in three of the four populations, allowing persistent transmission of infection within households. In all populations, individuals in larger households contributed more to the incidence of infection than those in smaller households.</p>

<p><strong>DISCUSSION: </strong>Transmission of ocular C. trachomatis infection within households is typically very efficient. Failure to treat all infected members of a household during mass administration of antibiotics is likely to result in rapid re-infection of that household, followed by more gradual spread across the community. The feasibility and effectiveness of household targeted strategies should be explored.</p>
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