There is concern that antimicrobial resistance is spreading worldwide, seriously limiting our ability to successfully treat a wide variety of diseases. Mathematical models have contributed much to our understanding of drug resistance, but their results have not been widely accepted in clinical medicine, perhaps because of parameter uncertainty and lack of validation. Mass antibiotic distributions are currently being implemented around the world as part of the WHO's effort to eliminate trachoma, the leading cause of infectious blindness. These distributions offer an unprecedented opportunity to model the emergence of antimicrobial resistance and to test the model's predictions empirically. Programs know precisely who is treated, when they are treated, and what dose of antibiotic is taken. In this application, we develop mathematical models to predict how much resistance will emerge after multiple rounds of mass antibiotic administrations, and then test the models' predictions by collecting data from the field. We anticipate that this project will evaluate several principles of resistance modeling and evaluate the validity of mathematical transmission models in general.
Specific Aims : 1. To determine the strength of the association between macrolide use and macrolide-resistant pneumococcus using data from existing epidemiological studies. 2. To estimate the level of resistance following mass azithromycin distributions for trachoma with mathematical models. 3. To test the validity of mathematical models by determining the prevalence of pneumococcal resistance empirically after multiple mass distributions.
| Chin, Stephanie A; Alemayehu, Wondu; Melese, Muluken et al. (2018) Association of Chlamydia trachomatis ompA genovar with trachoma phenotypes. Eye (Lond) 32:1411-1420 |
| Chin, Stephanie A; Morberg, Daniel P; Alemayehu, Wondu et al. (2018) Diversity of Chlamydia trachomatis in Trachoma-Hyperendemic Communities Treated With Azithromycin. Am J Epidemiol 187:1840-1845 |
| Maher, M Cyrus; Alemayehu, Wondu; Lakew, Takele et al. (2012) The fitness cost of antibiotic resistance in Streptococcus pneumoniae: insight from the field. PLoS One 7:e29407 |
| See, Craig W; Alemayehu, Wondu; Melese, Muluken et al. (2011) How reliable are tests for trachoma?--a latent class approach. Invest Ophthalmol Vis Sci 52:6133-7 |
| Haug, Sara; Lakew, Takele; Habtemariam, Gabremaskal et al. (2010) The decline of pneumococcal resistance after cessation of mass antibiotic distributions for trachoma. Clin Infect Dis 51:571-4 |
| Melese, Muluken; Alemayehu, Wondu; Lakew, Takele et al. (2008) Comparison of annual and biannual mass antibiotic administration for elimination of infectious trachoma. JAMA 299:778-84 |
| Lee, David C; Chidambaram, Jaya D; Porco, Travis C et al. (2005) Seasonal effects in the elimination of trachoma. Am J Trop Med Hyg 72:468-70 |
| Gaynor, B D; Chidambaram, J D; Cevallos, V et al. (2005) Topical ocular antibiotics induce bacterial resistance at extraocular sites. Br J Ophthalmol 89:1097-9 |
| Chidambaram, Jaya D; Bird, Mariko; Schiedler, Vivian et al. (2004) Trachoma decline and widespread use of antimicrobial drugs. Emerg Infect Dis 10:1895-9 |
| Melese, Muluken; Chidambaram, Jaya Devi; Alemayehu, Wondu et al. (2004) Feasibility of eliminating ocular Chlamydia trachomatis with repeat mass antibiotic treatments. JAMA 292:721-5 |
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