Azithromycin Reduction to Reach Elimination of Trachoma (ARRET) : study protocol for a cluster randomized trial of stopping mass azithromycin distribution for trachoma

BACKGROUND: The World Health Organization (WHO) recommends annual mass azithromycin distribution until districts drop below 5% prevalence of trachomatous inflammation-follicular (TF). Districts with very low TF prevalence may have little or no transmission of the ocular strains of Chlamydia trachomatis that cause trachoma, and additional rounds of mass azithromycin distribution may not be useful. Here, we describe the protocol for a randomized controlled trial designed to evaluate whether mass azithromycin distribution can be stopped prior to the current WHO guidelines.

METHODS: The Azithromycin Reduction to Reach Elimination of Trachoma (ARRET) study is a 1:1 community randomized non-inferiority trial designed to evaluate whether mass azithromycin distribution can be stopped in districts with baseline prevalence of TF under 20%. Communities in Maradi, Niger are randomized after baseline assessment either to continued annual mass azithromycin distribution or stopping annual azithromycin distribution over a 3-year period. We will compare the prevalence of ocular C. trachomatis (primary outcome), TF and other clinical signs of trachoma, and serologic markers of trachoma after 3 years. We hypothesize that stopping annual azithromycin distribution will be non-inferior to continued annual azithromycin distributions for all markers of trachoma prevalence and transmission.

DISCUSSION: The results of this trial are anticipated to provide potentially guideline-changing evidence for when mass azithromycin distributions can be stopped in low TF prevalence areas. TRIAL REGISTRATION NUMBER: This study is registered at clinicaltrials.gov ( NCT04185402 ). Registered December 4, 2019; prospectively registered pre-results.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:21

Enthalten in:

BMC ophthalmology - 21(2021), 1 vom: 06. Jan., Seite 15

Sprache:

Englisch

Beteiligte Personen:

Amza, Abdou [VerfasserIn]
Kadri, Boubacar [VerfasserIn]
Nassirou, Beido [VerfasserIn]
Arzika, Ahmed M [VerfasserIn]
Austin, Ariana [VerfasserIn]
Nyatigo, Fanice [VerfasserIn]
Lebas, Elodie [VerfasserIn]
Arnold, Benjamin F [VerfasserIn]
Lietman, Thomas M [VerfasserIn]
Oldenburg, Catherine E [VerfasserIn]

Links:

Volltext

Themen:

83905-01-5
Anti-Bacterial Agents
Azithromycin
Clinical Trial Protocol
Journal Article
Mass drug administration
Neglected tropical diseases
Trachoma

Anmerkungen:

Date Completed 14.05.2021

Date Revised 14.05.2021

published: Electronic

ClinicalTrials.gov: NCT04185402

Citation Status MEDLINE

doi:

10.1186/s12886-020-01776-4

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM31971022X