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Ocular trachoma is a major cause of blindness in the developing world, and the WHO has recommended mass distribution of oral azithromycin in areas where the causative pathogen — Chlamydia trachomatis — is endemic. Azithromycin might also reduce rates of gastrointestinal and respiratory infections, or even malaria, thus decreasing childhood deaths. To investigate this possibility, researchers conducted a cluster-randomized trial of various approaches to azithromycin distribution for trachoma control.
The trial involved 48 communities in Ethiopia (baseline population, 66,404, including 18,415 children aged 1–9 years). These communities were randomized to a control condition (azithromycin delayed until 1 year after study initiation) or to one o…