CHLAMYDIA ON CHILDREN AND FLIES AFTER MASS ANTIBIOTIC TREATMENT FOR TRACHOMA

SCOTT LEE F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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WONDU ALEMAYEHU F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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MULUKEN MELESE F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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TAKELE LAKEW F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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DAVID LEE F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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ELIZABETH YI F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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VICKY CEVALLOS F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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CATHY DONNELLAN F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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ZHAOXIA ZHOU F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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JAYA D. CHIDAMBARAM F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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BRUCE D. GAYNOR F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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JOHN P. WHITCHER F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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THOMAS M. LIETMAN F.I. Proctor Foundation, San Francisco, CA; Department of Ophthalmology, University of California, San Francisco, California; Orbis International, Addis Ababa, Ethiopia; Institute for Global Health, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

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There are various approaches to control trachoma. These include the elimination of the ocular strains of Chlamydia trachomatis that cause the disease and to decrease the spread of infection by other measures such as fly control. Here, we examined how these two are related (i.e., how treating children with antibiotics affects carriage of Chlamydia by flies). Flies were collected in villages that had received mass oral azithromycin distribution and were compared with flies in untreated villages. Polymerase chain reaction (PCR) was performed to detect chlamydial DNA on the flies. Conjunctival swabs were also taken to assay for chlamydial prevalence in the children. Chlamydia was found on 23% of the flies in the untreated villages but only 0.3% in treated villages. Prevalence of trachoma in children proved to be an excellent predictor of the prevalence on flies (correlation coefficient, 0.89). Thus, treating children with antibiotics may drastically reduce the role of flies as a vector.

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    Chidambaram JD, Melese M, Alemayehu W, Yi E, Prabriputaloong T, Lee DC, Cevallos V, Zhou Z, Whitcher JP, Gaynor BD, Lietman TM, 2004. Mass antibiotic treatment and community protection in trachoma control programs. Clin Infect Dis 39 :e95–e97.

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  • 9

    Melese M, Chidambaram JD, Alemayehu W, Lee DC, Yi EH, Cevallos V, Zhou Z, Donnellan C, Saidel M, Whitcher JP, Gaynor BD, Lietman TM, 2004. Feasibility of eliminating ocular Chlamydia trachomatis with repeat mass antibiotic treatments. JAMA 292 :721–725.

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    Emerson PM, Cairncross S, Bailey RL, Mabey DC, 2000. Review of the evidence base for the ‘F’ and ‘E’ components of the SAFE strategy for trachoma control. Trop Med Int Health 5 :515–527.

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  • 12

    Emerson PM, Lindsay SW, Alexander N, Bah M, Dibba SM, Foal HB, Lowe KO, McAdam KP, Ratcliff AA, Walraven GE, Bailey RL, 2004. Role of flies and provision of latrines in trachoma control: cluster-randomised controlled trial. Lancet 363 :1093–1098.

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