{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:28:38Z","timestamp":1789658918842,"version":"4.0.1"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014445","name":"Fred Hollows Foundation","doi-asserted-by":"publisher","award":["ANCP22-PRG9922--PRJ93"],"award-info":[{"award-number":["ANCP22-PRG9922--PRJ93"]}],"id":[{"id":"10.13039\/100014445","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["7200AA18CA00040"],"award-info":[{"award-number":["7200AA18CA00040"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NHMRC","award":["APP 2018220"],"award-info":[{"award-number":["APP 2018220"]}],"id":[{"id":"https:\/\/ror.org\/011kf5r70","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Trachoma, caused by ocular infection with the bacterium\n                      <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                      , is the primary infectious cause of blindness globally. To contribute to the elimination of trachoma as a public health problem, Naoero undertook two rounds of antibiotic mass drug administration (MDA) using azithromycin, with population-level coverage estimated at 87% and 93%. This study aimed to estimate the post-MDA prevalence of trachoma, and infection with\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      , in children aged 1\u20139 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A two-stage cluster sampled survey was conducted 12 months after the second MDA round. All residents aged \u22651 year were examined for signs of trachoma, and conjunctival swabs were collected from children aged 1\u20139 years for PCR testing. Data on domestic access to water, sanitation, and hygiene services were also collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 2,150 residents were examined, with 724 aged 1\u20139 years. The age-adjusted prevalence of trachomatous inflammation\u2014follicular (TF) in children aged 1\u20139 years was 6.0% (95%CI 3.9\u20137.7). The age-adjusted prevalence of\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      in the same age group was 2.7% (95%CI 0.3\u20135.1). There was evidence of trachomatous trichiasis (TT) previously unknown to the health system in one resident aged \u226515 years out of 1114 examined (age- and gender-adjusted prevalence 0.04%, 95%CI 0\u20130.12). Access to improved water sources for hygiene purposes was reported in 99.8% of households surveyed, and 99% of households reported access to an improved latrine.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In Naoero, the impact survey prevalence of TF was above, and of TT was below, the thresholds defined by WHO as indicating \u201celimination as a public health problem\u201d. The\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      prevalence estimate was lower than it was pre-MDA (39.4%), demonstrating the impact of antibiotic MDA. Despite the potential value of PCR data in addition to clinical indicators to help inform the need for trachoma elimination interventions, particularly in post-MDA or low TF prevalence areas, standardised thresholds for interpreting\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      prevalence have yet to be established. They are urgently needed so that they can be formally used to guide future interventions.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014679","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:44:03Z","timestamp":1789580643000},"page":"e0014679","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of two rounds of azithromycin mass drug administration on active trachoma and ocular Chlamydia trachomatis infection in Naoero"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8539-1083","authenticated-orcid":true,"given":"Carleigh S.","family":"Cowling","sequence":"first","affiliation":[{"name":"The Kirby Institute, UNSW","place":["Sydney, 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