期刊论文详细信息
BMC Medicine
Enhanced antibiotic distribution strategies and the potential impact of facial cleanliness and environmental improvements for the sustained control of trachoma: a modelling study
Research Article
Amy Pinsent1  Manoj Gambhir1  Matthew J. Burton2 
[1] Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia;International Centre for Eye Health, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK;
关键词: Mathematical modelling;    Trachoma;    Mass drug administration;    GET 2020;    Control;    Elimination;   
DOI  :  10.1186/s12916-016-0614-6
 received in 2016-02-08, accepted in 2016-04-05,  发布年份 2016
来源: Springer
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【 摘 要 】

BackgroundDespite some success in controlling trachoma with repeated mass drug administration (MDA), some hyperendemic regions are not responding as fast as anticipated. Available data suggests that individuals with higher bacterial infection loads are less likely to resolve infection following a single dose of treatment, and thus remain a source of re-emergent infection following treatment. We assessed the potential impact of a new double-dose antibiotic distribution strategy in addition to enhanced facial cleanliness (F) and environmental improvements (E).MethodsUsing a within-community mathematical model of trachoma transmission we assessed the impact of a new double-dose antibiotic distribution strategy given 2 weeks apart, with and without enhanced F&E. We compared the annual double-dose strategy to single-dose annual MDA treatment in hyper-, meso- and hypoendemic settings, and to biannual MDA at 6-monthly intervals in hyperendemic communities.ResultsThe findings from our mathematical model suggest that implementing the new double-dose strategy for 5 years or less was predicted to control infection more successfully than annual or 6-monthly treatment. Infection was controlled more readily if treatment was combined with enhanced F&E. The results appeared robust to variation in a number of key epidemiological parameters. To have long-term impact on transmission, enhanced F&E is essential for high transmission settings.ConclusionOur current findings are based on simualtion modelling only, due to lack of epidemilogical data, however they do suggest that the  annual double-dose treatment strategy is encouraging for trachoma control. In high transmission settings, both MDA and enhanced F&E are needed for sustained control.

【 授权许可】

CC BY   
© Pinsent et al. 2016

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