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首页> 外文期刊>The Lancet >Comparison of annual versus twice-yearly mass azithromycin treatment for hyperendemic trachoma in Ethiopia: a cluster-randomised trial.
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Comparison of annual versus twice-yearly mass azithromycin treatment for hyperendemic trachoma in Ethiopia: a cluster-randomised trial.

机译：埃塞俄比亚腹血性沙眼对两次对两次大众氮霉素治疗的比较：综合随机试验。

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BACKGROUND: In trachoma control programmes, azithromycin is distributed to treat the strains of chlamydia that cause ocular disease. We aimed to compare the effect of annual versus twice-yearly distribution of azithromycin on infection with these strains. METHODS: We did a cluster-randomised trial in 24 subdistricts in northern Ethiopia, which we randomly assigned to receive annual or twice-yearly treatment for all residents of all ages. Random assignment was done with the RANDOM and SORT functions of Microsoft Excel. All individuals were offered their assigned treatment of a single, directly observed, oral dose of azithromycin. A 6 week course of topical 1% tetracycline ointment, applied twice daily to both eyes but not directly observed, was offered as an alternative to azithromycin in patients younger than 12 months, and in patients with self-reported pregnancy, with allergy, or who refused azithromycin. Our primary, prespecified outcome was the prevalence of ocular chlamydial infection in a random sample of children aged 0-9 years at baseline and every 6 months for a total of 42 months within sentinel villages. Our analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00322972. FINDINGS: Antibiotic coverage of children aged 1-9 years was greater than 80% (range 80.9 to 93.0) at all study visits. In the groups treated annually, the prevalence of infection in children aged 0-9 years was reduced from a mean 41.9% (95% CI 31.5 to 52.2) at baseline to 1.9% (0.3 to 3.5) at 42 months. In the groups treated twice yearly, the prevalence of infection was reduced from a mean 38.3% (29.0 to 47.6) at baseline to 3.2 % (0.0 to 6.5) at 42 months. The prevalence of ocular chlamydial infection in children aged 0-9 years in groups treated annually was not different from that of the groups treated twice yearly at 18, 30, and 42 months (pooled regression p>0.99, 95 % CI -0.06 to 0.06). The mean elimination time in the twice-yearly treatment group was 7.5 months earlier (2.3 to 17.3) than that of the annual group (p=0.10, Cox proportional hazards model). INTERPRETATION: After 42 months of treatment, the prevalence of ocular infection with chlamydia was similar in the groups treated annually and twice yearly. However, elimination of infection might have been more rapid in the groups of villages that received treatment twice yearly. FUNDING: National Institutes of Health (NEI U10 EY016214).
机译：背景：在沙眼控制程序中，氮霉素分布以治疗导致眼部疾病的衣原体菌株。我们旨在比较年度与氮霉素两次分布对这些菌株感染的效果。方法：我们在埃塞俄比亚北部的24个次议度中进行了一项集群随机审判，我们随机分配到为所有年龄段的所有居民接受每年或两次待遇。随机分配是使用Microsoft Excel的随机和排序函数完成的。所有人都提供了他们分配的单一，直接观察到的口服剂量的阿奇霉素的治疗。一个6周的局部局部1％四环素软膏，每天两次施用于两次眼睛但没有直接观察到，作为12个月的患者的含氮霉素，以及自我报告的怀孕患者，过敏或谁拒绝氮霉素。我们的主要预期结果是在0-9岁以上的血液样本中的眼衣蜂鸣感染在基线时，每6个月在Sentinel村共计42个月。我们的分析是意图治疗。本研究以ClinicalTrials.gov注册，NCT00322972。结果：在所有研究访问中，1-9岁儿童的抗生素覆盖率大于80％（范围80.9至93.0）。在每年对待的群体中，0-9岁儿童感染的患病率从平均41.9％（95％CI 31.5至52.2）在基线下减少到42个月的1.9％（0.3至3.5）。在每年对两次治疗的组中，感染的患病率从平均38.3％（29.0至47.6）减少到基线，在42个月内为3.2％（0.0至6.5）。每年治疗的群体患者的眼衣衣衣腔感染的患病率与18,30,30,24个月（合并回归P> 0.99,95％CI -0.06至0.06〜0.06 ）。两次治疗组的平均消除时间比年前7.5个月（2.3至17.3）比年度组（P = 0.10，Cox比例危险模型）更早。解释：治疗42个月后，用衣原体的眼镜感染患病率在每年治疗的群体中和每年两次治疗。然而，在每年接受治疗的村群中，消除感染可能更快。资金：国家健康研究院（Nei U10 Ey016214）。

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