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The eye infection trachoma — the world's leading preventable cause of blindness — can be successfully eliminated with just two doses of antibiotic, scientists report.

Researchers used two doses of the standard antibiotic azithromycin, spaced two years apart, to eliminate trachoma in the community of Kahe Mpya, Tanzania.

They reported their results in the New England Journal of Medicine last week (April 24).

The success suggests an alternative to the WHO's current recommendations of annual doses of the antibiotic azithromycin over three years in at-risk communities.

Trachoma is caused by Chlamydia trachomatis infection. Repeated infections can cause scarring on the eyelid, resulting in it turning inside out and causing the eyelashes to scratch the cornea.

People in Kahe Mpya village were administered with azithromycin, and samples from their eyes monitored for the presence of trachoma infection. After the first treatment, infection fell from 9.5 per cent to 0.1 per cent. Three years after the second treatment, no infection was found in samples.

The Tanzanian research offers a solution to help nomadic communities in East Africa, who have the highest rates of trachoma in the world, says Hezron Ngugi, a trachoma researcher at the Kenya-based African Medical & Research Foundation (AMREF).

He says that as few doses of antibiotic as possible — coupled with environmental management, basic hygiene and improved sanitation — are key to combating trachoma, as the infection is passed on via eye discharge from an infected person.

Even the single dose treatment currently applied once a year requires government reliance on free donations from the International Trachoma Institute from pharmaceutical company Pfizer, Ngugi noted.

AMREF is currently researching the use of volunteer community health workers to give out azithromycin and provide advice to nomadic cattle herders in Kenya's isolated Samburu district. Final results will be known next year.

Link to full paper in the New England Journal of Medicine


The New England Journal of Medicine 358, 1870 (2008)

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