BACKGROUND: Antibiotics are a major tool in the WHO's @entity11738 control program. Even a single mass distribution reduces the prevalence of the ocular chlamydia that causes @entity11738 . Unfortunately, @entity281 returns after a single treatment, at least in severely affected areas. Here, we test whether additional scheduled treatments further @entity281 , and whether @entity281 returns after distributions are discontinued. METHODS: Sixteen communities in Ethiopia were randomly selected. @entity5517 in 1- to 5-year-old @entity1 was monitored over four biannual @entity4580 distributions and for 24 months after the last treatment. FINDINGS: The average prevalence of @entity281 in 1- to 5-year-old @entity1 was reduced from 63.5% pre-treatment to 11.5% six months after the first distribution (P<0.0001). It further decreased to 2.6% six months after the fourth and final treatment (P = 0.0004). In the next 18 months, @entity281 returned to 25.2%, a significant increase from six months after the last treatment (P = 0.008), but still far lower than baseline (P<0.0001). Although the prevalence of @entity281 in any particular village fluctuated, the mean prevalence of the 16 villages steadily decreased with each treatment and steadily returned after treatments were discontinued. CONCLUSION: In some of the most severely affected communities ever studied, we demonstrate that repeated mass oral @entity4580 distributions progressively reduce @entity5517 in a community, as long as these distributions are given frequently enough and at a high enough coverage. However, @entity281 returns into the communities after the last treatment. Sustainable changes or complete local elimination of @entity281 will be necessary. TRIAL REGISTRATION: ClinicalTrials.gov NCT00221364.

Reduction and return of infectious XXXX in severely affected communities in Ethiopia.

@entity1 :: ('9606', 'Species') :: ['children'] @entity5517 :: ('MESH:D015817', 'Disease') :: ['ocular chlamydial infection', 'Ocular chlamydial infection'] @entity11738 :: ('MESH:D014141', 'Disease') :: ['trachoma'] @entity4580 :: ('MESH:D017963', 'Chemical') :: ['azithromycin'] @entity281 :: ('MESH:D007239', 'Disease') :: ['reduce infection', 'infection']
@entity11738 :: (MESH:D014141,Disease) :: ['trachoma']
