Trachoma Treatment Could Interrupt Course of Infection

Antibiotic treatment may interrupt time necessary for acquired immunity

TUESDAY, Sept. 26 (HealthDay News) -- The rise in trachoma reinfection suggests treatment could be interrupting the length of infection course necessary for developing immunity, thereby increasing disease prevalence, according to a paper in the Sept. 27 issue of the Journal of the American Medical Association.

Berna Atik, M.D., of the Children's Hospital Oakland Research Institute in Oakland, Calif., and colleagues performed a longitudinal study of 3,186 children in three Vietnamese communes -- one participating in the surgery, antibiotics, facial cleanliness and environmental improvement (SAFE) strategy; another in the surgery and antibiotics (SA) strategy; and a third participating in surgery only. Chlamydial testing and disease grading were performed every six months for three years, while children in the first two communes with active trachoma and their household members were given azithromycin at baseline and a year later.

Reinfection rose significantly between 12 and 36 months for children in the SAFE and SA strategies, compared with those in the surgery-only commune after 24 months. The SAFE and SA groups had significantly higher reinfection risks at 36 months compared to the children in the surgery-only commune.

"It has been proposed that treatment for trachoma control must be continued indefinitely until underlying conditions are improved to prevent reintroduction of infection. Based on our findings, treatment appears to result in increased rates of reinfection that may adversely affect the prevalence of disease over time," the authors conclude.

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