Infection with C. trachomatis has decreased substantially in trachoma endemic areas following repeated annual mass drug administration with azithromycin, although not as rapidly as anticipated. We propose to conduct a clinical trial to determine the added benefit for communities, which are now at low levels of infection, of a program to identify and treat new families who came after mass treatment, and travelers who return to the community, as they could be the source of re-emergent infection. The proportion of communities who are able to stop mass treatment will be compared in the group of communities randomized to mass treatment plus the newcomer treatment program compared to the communities randomized to mass treatment alone.
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