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2004
OMIG, Abstract 3
OMIG
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Eliminating
Trachoma: Fly Control or Antibiotics?
S Lee1, A Wondu2, M Muluken2, D
Lee1, E Yi1, Z Zhou1, V Cevallos1,
K Donnallan1, J Chidambaram1, B Gaynor1,
J Whitcher1, T Lietman1. 1UCSF
Department of Ophthalmology, Proctor Foundation and 2Orbis
International, Ethiopia
Purpose:
Trachoma is by far the leading cause of infectious blindness worldwide.
There are two schools of thought in controlling trachoma: eliminate
the Chlamydial infection that causes the disease, or decrease the
spread of infection by flies (in particular Musca sorbens).
In fact, enormous efforts are being taken to reduce Musca sorbens
populations in trachoma endemic areas. Here, we determine how this
proportion depends on the prevalence of infection in children, and
how treating children with antibiotics affects carriage of chlamydia
by flies.
Methods: 120 flies were collected from the faces
of 120 children in three villages that had received mass oral azithromycin
distributions 6 months previously. 120 flies were also collected
from 120 children in three 'before treatment' villages, randomly
selected from the same pool as the treated villages. Roche Amplicor
PCR kits were performed in a masked fashion to detect chlamydial
DNA on the flies from both treated and untreated villages as previously
described. Conjunctival swabs were also taken to assay for chlamydial
prevalence in the children.
Results: Chlamydia trachomatis was found
on 23% of the flies in the untreated (control) villages, but only
0.3% of flies in the treated villages (P<0.001, Fisher's exact).
Prevalence of trachoma in children proved to be an excellent predictor
of the prevalence in flies in that village (correlation coefficient
0.3918).
Conclusion: The prevalence of chlamydia on flies
is highly correlated with the prevalence of chlamydial infection
in children. Great efforts are being made to reduce the prevalence
of flies in trachoma endemic villages, however treating children
with antibiotics drastically reduces the role of flies as a vector.
Fly control may not be necessary for effective trachoma control.
Acknowledgements: Osher Foundation, IntI Trachoma Initiative, Research
to Prevent Blindness
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