{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T19:26:58Z","timestamp":1748978818188},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2,7]]},"abstract":"<jats:p>Repeated oral azithromycin distribution targeted only to children has proven effective in reducing the ocular <jats:italic>Chlamydia<\/jats:italic> that causes trachoma. Here, we assess whether an enhanced coverage target of at least 90% of children is superior to the World Health Organization recommendation of at least 80%. Twenty-four trachoma-endemic communities in Matam\u00e8ye, Niger, were randomized to a single day of azithromycin distribution aiming for at least 80% coverage or up to 4 days of treatment and &gt; 90% coverage of children under age 12. All distributions were biannual. Children &lt; 5 years of age and adults &gt; 15 years were monitored for ocular <jats:italic>Chlamydia<\/jats:italic> infection by polymerase chain reaction every 6 months for 36 months in children and at baseline and 36 months in adults. Ocular <jats:italic>Chlamydia<\/jats:italic> prevalence in children decreased from 24.9% (95% confidence interval [CI] 15.9\u201333.8%) to 4.4% (95% CI 0.6\u20138.2%, <jats:italic>P<\/jats:italic> &lt; 0.001) at 36 months in the standard coverage arm and from 15.6% (95% CI 10.0\u201321.2%) to 3.3% (95% CI 1.0\u20135.5%; <jats:italic>P<\/jats:italic> &lt; 0.001) in the enhanced coverage arm. Enhanced coverage reduced ocular <jats:italic>Chlamydia<\/jats:italic> prevalence in children more quickly over time compared with standard (<jats:italic>P<\/jats:italic> = 0.04). There was no difference between arms at 36 months in children (2.4% lower with enhanced coverage, 95% CI 7.7\u201312.5%; <jats:italic>P<\/jats:italic> = 0.60). No infection was detected in adults at 36 months. Increasing antibiotic coverage among children from 80% to 90% may yield only short term improvements for trachoma control programs. Targeting treatment to children alone may be sufficient for trachoma control in this setting.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0501","type":"journal-article","created":{"date-parts":[[2017,12,19]],"date-time":"2017-12-19T07:01:15Z","timestamp":1513666875000},"page":"389-395","source":"Crossref","is-referenced-by-count":10,"title":["Comparison of Mass Azithromycin Coverage Targets of Children in Niger: A Cluster-Randomized Trachoma Trial"],"prefix":"10.4269","volume":"98","author":[{"given":"Catherine E.","family":"Oldenburg","sequence":"first","affiliation":[{"name":"F.I. Proctor Foundation, University of California San Francisco, San Francisco, California;"},{"name":"Department of Ophthalmology, University of California San Francisco, San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdou","family":"Amza","sequence":"additional","affiliation":[{"name":"Programme FSS\/Universit\u00e9 Abdou Moumouni de Niamey, Programme National de Sant\u00e9 Oculaire, Niamey, Niger;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boubacar","family":"Kadri","sequence":"additional","affiliation":[{"name":"Programme FSS\/Universit\u00e9 Abdou Moumouni de Niamey, Programme National de Sant\u00e9 Oculaire, Niamey, Niger;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beido","family":"Nassirou","sequence":"additional","affiliation":[{"name":"Programme FSS\/Universit\u00e9 Abdou Moumouni de Niamey, Programme National de Sant\u00e9 Oculaire, Niamey, Niger;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun Y.","family":"Cotter","sequence":"additional","affiliation":[{"name":"F.I. Proctor Foundation, University of California San Francisco, San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole E.","family":"Stoller","sequence":"additional","affiliation":[{"name":"F.I. Proctor Foundation, University of California San Francisco, San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila K.","family":"West","sequence":"additional","affiliation":[{"name":"Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin L.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Clinical Research Unit, Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Travis C.","family":"Porco","sequence":"additional","affiliation":[{"name":"F.I. Proctor Foundation, University of California San Francisco, San Francisco, California;"},{"name":"Department of Ophthalmology, University of California San Francisco, San Francisco, California;"},{"name":"Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce D.","family":"Gaynor","sequence":"additional","affiliation":[{"name":"F.I. Proctor Foundation, University of California San Francisco, San Francisco, California;"},{"name":"Department of Ophthalmology, University of California San Francisco, San Francisco, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy D.","family":"Keenan","sequence":"additional","affiliation":[{"name":"F.I. 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