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Elimination of blinding trachoma — the leading infectious cause of blindness in the developing world — is entirely possible by 2020, says the New England Journal of Medicine.

Worldwide rates have dropped from about 100 million people infected in 1996 to 43 million in 2008, according to WHO estimates.

The assessment is based partly on a report from Tanzania in the same issue of the journal that notes the "remarkable effects" of a single mass treatment with azithromycin in a small village, and the complete absence of the trachoma-causing Chlamydia trachomatis organism five years after a second treatment.

But several elements of the WHO's strategy for dealing with trachoma need attention and improvement, says the article, including the spectre of potential bacterial resistance.

There are also questions about the required number of treatments in low-prevalence areas and whether the Tanzanian results can be replicated for mass treatment in large areas.

In addition, environmental aspects, such as improved facial hygiene and access to clean drinking water and sanitation still remain too expensive for many developing countries.

Link to full article in the New England Journal of Medicine

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