Relationship between community drug administration strategy and changes in trachoma prevalence, 2007 to 2013

Australia is the only high income country with persisting endemic trachoma and a national control program has been in place since 2006. The program involves annual screening of children for trachoma in communities designated to be at high risk of disease and treatment of those affected with the antibiotic azithromycin. Depending on the level of trachoma detected in children, antibiotic treatment is also given to households and other community members. We used data collected annually from 2007 to 2013 to examine what effect the extent of azithromycin treatment had on subsequent levels of trachoma in children aged 5–9 years. We found that in communities with high levels of trachoma, when all community members received azithromycin (community-wide treatment), the greatest reduction in trachoma level was achieved. However in communities with moderate levels of trachoma, using either community-wide treatment or more targeted (household) treatment resulted in equivalent reductions in trachoma. This observation needs to be confirmed in other studies before changes to current recommendations regarding trachoma control strategies are considered