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Trachoma, a chronic keratoconjunctivitis caused by Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. The infection is transmitted between individuals by hands, shared cloths or towels, and flies; improved sanitation led to its disappearance in the developed world. The finding that a single oral dose of azithromycin can cure ocular chlamydial infection has raised the possibility that mass antibiotic administration might eliminate trachoma; the antibiotic’s manufacturer has donated the agent in several countries for this purpose.
To better delineate an optimal eradication strategy, a multinational team of investigators performed a cluster-randomized clinical trial comparing the effectiveness of annual and biannual …