TrachomaPhase 4TEFNCT00221364
Trachoma Elimination Follow-up
A Phase 4 study testing Mass treatment with oral azithromycin to an entire village in people with Trachoma and Chlamydia, run by University of California, San Francisco at 1 site in Ethiopia.
Trial summary
The WHO has initiated a program to eliminate blinding trachoma by the year 2020, in large part by mass oral azithromycin distributions. It is not clear how frequently or for how long these treatments are necessary. Here we assess the frequency and duration of treatment. Read more about this study
- Who is it for?
- Ages 1 year and older
- What is being tested?
- Mass treatment with oral azithromycin to an entire village
- Type of treatment
- Pill or oral medicine
- How many people
- 20,000 participants
- Where
- 1 siteEthiopia
- Study dates
- Mar 2003to Apr 2005
- Phase
- Phase 4
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 1 year and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Age 1 to 5 years old in a village in the Gurage zone with endemic trachoma
Who cannot join
- Refusal of village chief (for village inclusion), or refusal of parent or guardian (for individual inclusion)
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Trachoma Elimination With Repeated Mass Azithromycin Treatments
The WHO has initiated a program to eliminate blinding trachoma by the year 2020, in large part by mass oral azithromycin distributions. It is not clear how frequently or for how long these treatments are necessary. Here we assess the frequency and duration of treatment.
Read the detailed description
40 villages in the Gurage Zone of Ethiopia were randomly assigned to biannual treatment, annual treatment, and a single treatment. Each treatment consisted of a single dose of oral azithromycin to the entire population over the age of 1 year (when the study was started, azithromycin had not yet been approved for ages below 1 year). We assess the prevalence the ocular chlamydia that causes trachoma in the peak prevalence age of 1-5 years at baseline, and 2, 6, 12, 18, and 24 months post treatment. An extension of the study monitors infection at 30 and 36 months post treatment. Untreated villages from the same area are enrolled in a step-wedge design to assess the presence of a secular trend. A random sample of those not within the 1-5 year old age group are examined to assess the prevalence of infection in the entire community.
- Being tested
- Mass treatment with oral azithromycin to an entire village
- Keywords
- Trachoma, Chlamydia, Azithromycin
- Medical subject headings
- Trachoma, Chlamydia Infections
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Mass treatment with oral azithromycin to an entire villageDrug
What is being measured
The primary outcome is the main question the study is designed to answer.
The prevalence of ocular chlamydia infection in a village as determined by PCR
Secondary outcomes (1)
Clinical active trachoma, as determined by the WHO simplified grading system, by village
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Sep 2005 (estimated)
- Study startMar 2003
- Primary completionApr 2005
- Study completionApr 2005
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (18)Papers the sponsor has linked to this study.
- Other trials for TrachomaStudies of the same condition, open and under way.
- More trials run by University of California, San FranciscoThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Single blind
- Enrolment
- 20,000 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of California, San Francisco
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Thomas M Lietman, MD, Principal investigator, Proctor Foundation, UCSF
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00221364
- Sponsor's protocol ID
- 10-02630
- Acronym
- TEF
- Status last verified
- Jul 2015
- First submitted
- 14 Sep 2005
- Last updated
- 15 Jul 2015
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Melese M, Chidambaram JD, Alemayehu W, Lee DC, Yi EH, Cevallos V, Zhou Z, Donnellan C, Saidel M, Whitcher JP, Gaynor BD, Lietman TM. Feasibility of eliminating ocular Chlamydia trachomatis with repeat mass antibiotic treatments. JAMA. 2004 Aug 11;292(6):721-5. doi: 10.1001/jama.292.6.721.
PubMed 15304470Chidambaram JD, Melese M, Alemayehu W, Yi E, Prabriputaloong T, Lee DC, Cevallos V, Zhou Z, Whitcher JP, Gaynor BD, Lietman TM. Mass antibiotic treatment and community protection in trachoma control programs. Clin Infect Dis. 2004 Nov 1;39(9):e95-7. doi: 10.1086/424747. Epub 2004 Oct 6.
PubMed 15494901Ray KJ, Porco TC, Hong KC, Lee DC, Alemayehu W, Melese M, Lakew T, Yi E, House J, Chidambaram JD, Whitcher JP, Gaynor BD, Lietman TM. A rationale for continuing mass antibiotic distributions for trachoma. BMC Infect Dis. 2007 Aug 7;7:91. doi: 10.1186/1471-2334-7-91.
PubMed 17683646Lee S, Alemayehu W, Melese M, Lakew T, Lee D, Yi E, Cevallos V, Donnellan C, Zhou Z, Chidambaram JD, Gaynor BD, Whitcher JP, Lietman TM. Chlamydia on children and flies after mass antibiotic treatment for trachoma. Am J Trop Med Hyg. 2007 Jan;76(1):129-31.
PubMed 17255240Chidambaram JD, Alemayehu W, Melese M, Lakew T, Yi E, House J, Cevallos V, Zhou Z, Maxey K, Lee DC, Shapiro BL, Srinivasan M, Porco T, Whitcher JP, Gaynor BD, Lietman TM. Effect of a single mass antibiotic distribution on the prevalence of infectious trachoma. JAMA. 2006 Mar 8;295(10):1142-6. doi: 10.1001/jama.295.10.1142.
PubMed 16522834Haug S, Lakew T, Habtemariam G, Alemayehu W, Cevallos V, Zhou Z, House J, Ray K, Porco T, Rutar T, Keenan J, Lietman TM, Gaynor BD. The decline of pneumococcal resistance after cessation of mass antibiotic distributions for trachoma. Clin Infect Dis. 2010 Sep 1;51(5):571-4. doi: 10.1086/655697.
PubMed 20649409Shah NA, House J, Lakew T, Alemayehu W, Halfpenny C, Hong KC, Keenan JD, Porco TC, Whitcher JP, Lietman TM, Gaynor BD. Travel and implications for the elimination of trachoma in ethiopia. Ophthalmic Epidemiol. 2010 Mar;17(2):113-7. doi: 10.3109/09286581003624921.
PubMed 20302432Keenan JD, Lakew T, Alemayehu W, Melese M, Porco TC, Yi E, House JI, Zhou Z, Ray KJ, Acharya NR, Whitcher JP, Gaynor BD, Lietman TM. Clinical activity and polymerase chain reaction evidence of chlamydial infection after repeated mass antibiotic treatments for trachoma. Am J Trop Med Hyg. 2010 Mar;82(3):482-7. doi: 10.4269/ajtmh.2010.09-0315.
PubMed 20207878Biebesheimer JB, House J, Hong KC, Lakew T, Alemayehu W, Zhou Z, Moncada J, Roger A, Keenan J, Gaynor BD, Schachter J, Lietman TM. Complete local elimination of infectious trachoma from severely affected communities after six biannual mass azithromycin distributions. Ophthalmology. 2009 Nov;116(11):2047-50. doi: 10.1016/j.ophtha.2009.04.041. Epub 2009 Sep 10.
PubMed 19744717Lakew T, Alemayehu W, Melese M, Yi E, House JI, Hong KC, Zhou Z, Ray KJ, Porco TC, Gaynor BD, Lietman TM, Keenan JD. Importance of coverage and endemicity on the return of infectious trachoma after a single mass antibiotic distribution. PLoS Negl Trop Dis. 2009 Aug 25;3(8):e507. doi: 10.1371/journal.pntd.0000507.
PubMed 19707573Lakew T, House J, Hong KC, Yi E, Alemayehu W, Melese M, Zhou Z, Ray K, Chin S, Romero E, Keenan J, Whitcher JP, Gaynor BD, Lietman TM. Reduction and return of infectious trachoma in severely affected communities in Ethiopia. PLoS Negl Trop Dis. 2009;3(2):e376. doi: 10.1371/journal.pntd.0000376. Epub 2009 Feb 3.
PubMed 19190781Hong KC, Schachter J, Moncada J, Zhou Z, House J, Lietman TM. Lack of macrolide resistance in Chlamydia trachomatis after mass azithromycin distributions for trachoma. Emerg Infect Dis. 2009 Jul;15(7):1088-90. doi: 10.3201/eid1507.081563.
PubMed 19624926Yang JL, Hong KC, Schachter J, Moncada J, Lekew T, House JI, Zhou Z, Neuwelt MD, Rutar T, Halfpenny C, Shah N, Whitcher JP, Lietman TM. Detection of Chlamydia trachomatis ocular infection in trachoma-endemic communities by rRNA amplification. Invest Ophthalmol Vis Sci. 2009 Jan;50(1):90-4. doi: 10.1167/iovs.08-2247. Epub 2008 Aug 8.
PubMed 18689701Melese M, Alemayehu W, Lakew T, Yi E, House J, Chidambaram JD, Zhou Z, Cevallos V, Ray K, Hong KC, Porco TC, Phan I, Zaidi A, Gaynor BD, Whitcher JP, Lietman TM. Comparison of annual and biannual mass antibiotic administration for elimination of infectious trachoma. JAMA. 2008 Feb 20;299(7):778-84. doi: 10.1001/jama.299.7.778.
PubMed 18285589Gill DA, Lakew T, Alemayehu W, Melese M, Zhou Z, House JI, Hong KC, Ray KJ, Gandhi N, Whitcher JP, Gaynor BD, Lietman TM. Complete elimination is a difficult goal for trachoma programs in severely affected communities. Clin Infect Dis. 2008 Feb 15;46(4):564-6. doi: 10.1086/526777.
PubMed 18194094
Study at a glance
From the registry record, last updated by the sponsor on 15 Jul 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Trachoma Elimination With Repeated Mass Azithromycin Treatments
- ClinicalTrials.gov ID
- NCT00221364
- Acronym / sponsor ID
- TEF / 10-02630
- Keywords
- Trachoma, Chlamydia, Azithromycin
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 20,000 participants (estimated)
- Lead sponsor
- University of California, San FranciscoUniversity, hospital or other
- Study start
- Mar 2003
- Primary completion
- Apr 2005 (actual)
- Study completion
- Apr 2005 (actual)
- First posted
- 22 Sep 2005 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The WHO has initiated a program to eliminate blinding trachoma by the year 2020, in large part by mass oral azithromycin distributions. It is not clear how frequently or for how long these treatments are necessary. Here we assess the frequency and duration of treatment.
Detailed description
40 villages in the Gurage Zone of Ethiopia were randomly assigned to biannual treatment, annual treatment, and a single treatment. Each treatment consisted of a single dose of oral azithromycin to the entire population over the age of 1 year (when the study was started, azithromycin had not yet been approved for ages below 1 year). We assess the prevalence the ocular chlamydia that causes trachoma in the peak prevalence age of 1-5 years at baseline, and 2, 6, 12, 18, and 24 months post treatment. An extension of the study monitors infection at 30 and 36 months post treatment. Untreated villages from the same area are enrolled in a step-wedge design to assess the presence of a secular trend. A random sample of those not within the 1-5 year old age group are examined to assess the prevalence of infection in the entire community.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Single blind
Who may qualify
- Ages
- 1 year and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- Age 1 to 5 years old in a village in the Gurage zone with endemic trachoma
Key exclusion criteria (1 listed)
- Refusal of village chief (for village inclusion), or refusal of parent or guardian (for individual inclusion)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Mass treatment with oral azithromycin to an entire village | Drug | – |
Primary outcome
The prevalence of ocular chlamydia infection in a village as determined by PCR
1 secondary outcome
Clinical active trachoma, as determined by the WHO simplified grading system, by village
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Jul 2015.
- Background: PubMed 15304470Melese M, Chidambaram JD, Alemayehu W, Lee DC, Yi EH, Cevallos V, Zhou Z, Donnellan C, Saidel M, Whitcher JP, Gaynor BD, Lietman TM. Feasibility of eliminating ocular Chlamydia trachomatis with repeat mass antibiotic treatments. JAMA. 2004 Aug 11;292(6):721-5. doi: 10.1001/jama.292.6.721.
- Background: PubMed 15494901Chidambaram JD, Melese M, Alemayehu W, Yi E, Prabriputaloong T, Lee DC, Cevallos V, Zhou Z, Whitcher JP, Gaynor BD, Lietman TM. Mass antibiotic treatment and community protection in trachoma control programs. Clin Infect Dis. 2004 Nov 1;39(9):e95-7. doi: 10.1086/424747. Epub 2004 Oct 6.
- Background: PubMed 17683646Ray KJ, Porco TC, Hong KC, Lee DC, Alemayehu W, Melese M, Lakew T, Yi E, House J, Chidambaram JD, Whitcher JP, Gaynor BD, Lietman TM. A rationale for continuing mass antibiotic distributions for trachoma. BMC Infect Dis. 2007 Aug 7;7:91. doi: 10.1186/1471-2334-7-91.
- Background: PubMed 17255240Lee S, Alemayehu W, Melese M, Lakew T, Lee D, Yi E, Cevallos V, Donnellan C, Zhou Z, Chidambaram JD, Gaynor BD, Whitcher JP, Lietman TM. Chlamydia on children and flies after mass antibiotic treatment for trachoma. Am J Trop Med Hyg. 2007 Jan;76(1):129-31.
- Background: PubMed 16522834Chidambaram JD, Alemayehu W, Melese M, Lakew T, Yi E, House J, Cevallos V, Zhou Z, Maxey K, Lee DC, Shapiro BL, Srinivasan M, Porco T, Whitcher JP, Gaynor BD, Lietman TM. Effect of a single mass antibiotic distribution on the prevalence of infectious trachoma. JAMA. 2006 Mar 8;295(10):1142-6. doi: 10.1001/jama.295.10.1142.
- Background: PubMed 20649409Haug S, Lakew T, Habtemariam G, Alemayehu W, Cevallos V, Zhou Z, House J, Ray K, Porco T, Rutar T, Keenan J, Lietman TM, Gaynor BD. The decline of pneumococcal resistance after cessation of mass antibiotic distributions for trachoma. Clin Infect Dis. 2010 Sep 1;51(5):571-4. doi: 10.1086/655697.
- Background: PubMed 20302432Shah NA, House J, Lakew T, Alemayehu W, Halfpenny C, Hong KC, Keenan JD, Porco TC, Whitcher JP, Lietman TM, Gaynor BD. Travel and implications for the elimination of trachoma in ethiopia. Ophthalmic Epidemiol. 2010 Mar;17(2):113-7. doi: 10.3109/09286581003624921.
- Background: PubMed 20207878Keenan JD, Lakew T, Alemayehu W, Melese M, Porco TC, Yi E, House JI, Zhou Z, Ray KJ, Acharya NR, Whitcher JP, Gaynor BD, Lietman TM. Clinical activity and polymerase chain reaction evidence of chlamydial infection after repeated mass antibiotic treatments for trachoma. Am J Trop Med Hyg. 2010 Mar;82(3):482-7. doi: 10.4269/ajtmh.2010.09-0315.
- Background: PubMed 19744717Biebesheimer JB, House J, Hong KC, Lakew T, Alemayehu W, Zhou Z, Moncada J, Roger A, Keenan J, Gaynor BD, Schachter J, Lietman TM. Complete local elimination of infectious trachoma from severely affected communities after six biannual mass azithromycin distributions. Ophthalmology. 2009 Nov;116(11):2047-50. doi: 10.1016/j.ophtha.2009.04.041. Epub 2009 Sep 10.
- Background: PubMed 19707573Lakew T, Alemayehu W, Melese M, Yi E, House JI, Hong KC, Zhou Z, Ray KJ, Porco TC, Gaynor BD, Lietman TM, Keenan JD. Importance of coverage and endemicity on the return of infectious trachoma after a single mass antibiotic distribution. PLoS Negl Trop Dis. 2009 Aug 25;3(8):e507. doi: 10.1371/journal.pntd.0000507.
- Background: PubMed 19190781Lakew T, House J, Hong KC, Yi E, Alemayehu W, Melese M, Zhou Z, Ray K, Chin S, Romero E, Keenan J, Whitcher JP, Gaynor BD, Lietman TM. Reduction and return of infectious trachoma in severely affected communities in Ethiopia. PLoS Negl Trop Dis. 2009;3(2):e376. doi: 10.1371/journal.pntd.0000376. Epub 2009 Feb 3.
- Background: PubMed 19624926Hong KC, Schachter J, Moncada J, Zhou Z, House J, Lietman TM. Lack of macrolide resistance in Chlamydia trachomatis after mass azithromycin distributions for trachoma. Emerg Infect Dis. 2009 Jul;15(7):1088-90. doi: 10.3201/eid1507.081563.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Thomas M Lietman, MD principal investigator
Proctor Foundation, UCSF
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Mass treatment with oral azithromycin to an entire village in people with Trachoma and Chlamydia, run by University of California, San Francisco at 1 site in Ethiopia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Jul 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Ethiopia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The prevalence of ocular chlamydia infection in a village as determined by PCR. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00221364, which also lists 18 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jul 2015.