Trachoma Amelioration in Northern Amhara (TANA)

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
Thomas M. Lietman, University of California, San Francisco
ClinicalTrials.gov Identifier:
NCT00322972
First received: May 5, 2006
Last updated: September 16, 2013
Last verified: September 2013

May 5, 2006
September 16, 2013
June 2006
November 2009   (final data collection date for primary outcome measure)
The average prevalence of ocular chlamydia infection in communities in an arm as determined by pooled NAAT (Nucleic Acid Amplification Test)(at 42 months for Aim 1, at 12 months for Aim 2, post-treatment relative to pre-treatment for Aim 3) [ Time Frame: 42 months ] [ Designated as safety issue: No ]
The prevalence of ocular chlamydia infection in a community as determined by PCR
Complete list of historical versions of study NCT00322972 on ClinicalTrials.gov Archive Site
  • Clinical active trachoma in community, as determined by the WHO simplified grading system [ Time Frame: 42 months ] [ Designated as safety issue: No ]
  • Childhood (>= 1 year of age) mortality, analyzed as 1-5, 6-10 years of age, and total [ Time Frame: 42 months ] [ Designated as safety issue: No ]
  • Macrolide resistance in pneumococcus (% resistance over time, clustered by randomization unit) [ Time Frame: 42 months ] [ Designated as safety issue: No ]
  • Average prevalence of ocular chlamydia infection in annually and biennially treated communities as determined by pooled NAAT (Nucleic Acid Amplification Test) [ Time Frame: 48 months ] [ Designated as safety issue: No ]
  • Diversity measure in the conjunctival and nasopharyngeal microbiomes of children (age 0-9) [ Time Frame: 0, 6, 12, 18, 24, 30, 36, 42, and 48 months ] [ Designated as safety issue: No ]
  • Clinical active trachoma, as determined by the WHO simplified grading system, by community
  • Infant mortality
  • Macrolide resistance in pneumococcus
Not Provided
Not Provided
 
Trachoma Amelioration in Northern Amhara (TANA)
Eliminating Trachoma With Repeat Mass Drug Treatment

The WHO has initiated a program to eliminate trachoma, blinding eye infection caused by Chlamydia trachomatis, in large part by mass distributions of oral azithromycin. The proposed study will determine the frequency and treatment target of community-wide mass antibiotic treatment. We will also study the impact of mass antibiotic distribution on antibiotic-resistance in pneumococcus.

The proposed study is a group-randomized trial to determine the frequency and treatment target of community-wide mass antibiotic treatment to eliminate trachoma. We will also study the impact of community-wide antibiotic distribution on antibiotic-resistance in pneumococcus. Communities in Goncha Siso Enese district of East Gojam Zone, Ethiopia will be randomly assigned to different treatment schemes and monitored to study the following research questions:

Specific Aim 1. To determine whether biannual mass treatments is more likely to eliminate ocular chlamydia from hyper-endemic communities than annual mass treatments.

Specific Aim 2. To determine whether children form a core group for the transmission of trachoma.

Specific Aim 3. To determine whether latrine construction prevents the return of infection into a community after mass treatment.

Specific Aim 4. To determine the effect of mass azithromycin treatments on antibiotic resistance in pneumococcus and the reduction in mortality.

Specific Aim 5. To determine whether annual mass treatments are more likely to eliminate ocular chlamydia from hyper-endemic communities than biennial mass treatments.

Interventional
Phase 4
Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
  • Trachoma
  • Chlamydia
Drug: Mass treatment with oral azithromycin to an entire community
For baseline and follow-up surveys prior to azithromycin distribution, a stratified random sample from two age groups will be chosen: 1) 60 study participants younger than 10 years old and 2) 60 study participants aged 10 years and above. Clinical examination will be performed and conjunctival swabs will be taken from all the study participants. For study arm C and D, nasopharyngeal swabs will be collected from 10 randomly selected children among the 60 participants under 10 who were recruited for conjunctival swabbing. Then a single dose of azithromycin will be distributed according to study design: in tablet form for adults; a weight-adjusted tablet dose for children ages 8-10; and pediatric suspension for children ages 1 - 7.
  • A
    Annual mass treatment
    Intervention: Drug: Mass treatment with oral azithromycin to an entire community
  • B
    Biannual mass treatment
    Intervention: Drug: Mass treatment with oral azithromycin to an entire community
  • Experimental: C
    Mass administration of antibiotic; treatment of children (1-10 years of age) only
    Intervention: Drug: Mass treatment with oral azithromycin to an entire community
  • No Intervention: D
    Delayed initiation of mass administration of antibiotic
  • F
    One-time mass administration only
    Intervention: Drug: Mass treatment with oral azithromycin to an entire community
  • Experimental: G
    One-time mass administration of antibiotics, plus intensive latrine construction
    Intervention: Drug: Mass treatment with oral azithromycin to an entire community

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Active, not recruiting
36000
May 2014
November 2009   (final data collection date for primary outcome measure)

Inclusion Criteria:

• All residents residing in the state-teams which are randomly selected for this study.

Exclusion Criteria:

  • Pregnant women
  • Children under 6 months of age
  • All those who are allergic to macrolides or azalides
  • Refusal of village chief (for village inclusion), or refusal of parent or guardian (for individual inclusion)

Individuals in these three exclusion criteria will not be given the study antibiotic azithromycin, but offered the current WHO-recommended alternative treatment to azithromycin for active trachoma, which is 1% tetracycline eye ointment, to be used twice a day, topically to both eyes, for six weeks. Note that the exclusion criteria refer to the exclusion to the treatment drug, but not to the monitoring, treatment of trachoma, and examinations.

Both
1 Year and older
Yes
Contact information is only displayed when the study is recruiting subjects
Ethiopia
 
NCT00322972
10-02576
Yes
Thomas M. Lietman, University of California, San Francisco
University of California, San Francisco
Not Provided
Principal Investigator: Tom Lietman, MD Proctor Foundation, UCSF
Study Director: Nicole Stoller, MPH Proctor Foundation, UCSF
Study Director: Sintayehu Gebresillasie, MSc Carter Center, Ethiopia
Study Director: Paul Emerson, MD Emory University
University of California, San Francisco
September 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP