Trachoma is a chronic ocular disease caused by Chlamydia trachomatis. it is the second leading cause of blindness worldwide. To date no vaccine has been proven to be efficacious in a clinical setting. While topical antibiotic preparations are effective against the chlamydia organism, previous large-scale treatment efforts have been disappointing. The objective of this proposal is to develop a systematic treatment program to prevent blindness from trachoma based on a detailed understanding of the dynamics of the transmission of chlamydia. This understanding will be achieved by using the approaches of molecular epidemiology and epidemiological modeling. The following specific questions will be answered: l) Does previous infection with chlamydia offer any protection against subsequent reinfection? 2) Is the apparently inevitable recurrence of chlamydial infection after initially effective treatment, secondary to reinfection or to within-host persistence of the original organism? 3) How effective would a vaccine have to be to eliminate trachoma in endemic areas? 4) What is the most effective use of antibiotic treatment in decreasing the incidence of trachoma? As a Mentored Clinical Scientist Training program, this proposal also aims to develop the research abilities of the PI, and enable him to be a productive independent researcher.
| Zhang, Jianzhi; Lietman, Thomas; Olinger, Lynn et al. (2004) Genetic diversity of Chlamydia trachomatis and the prevalence of trachoma. Pediatr Infect Dis J 23:217-20 |
| Schiedler, Vivian; Bhatta, Ramesh C; Miao, Yinghui et al. (2003) Pattern of antibiotic use in a trachoma-endemic region of Nepal: implications for mass azithromycin distribution. Ophthalmic Epidemiol 10:31-6 |
| Bird, Mariko; Dawson, Chandler R; Schachter, Julius S et al. (2003) Does the diagnosis of trachoma adequately identify ocular chlamydial infection in trachoma-endemic areas? J Infect Dis 187:1669-73 |
| Gaynor, B D; Holbrook, K A; Whitcher, J P et al. (2003) Community treatment with azithromycin for trachoma is not associated with antibiotic resistance in Streptococcus pneumoniae at 1 year. Br J Ophthalmol 87:147-8 |
| Gaynor, Bruce D; Miao, Yinghui; Cevallos, Vicky et al. (2003) Eliminating trachoma in areas with limited disease. Emerg Infect Dis 9:596-8 |
| Gaynor, Bruce D; Yi, Elizabeth; Lietman, Tom (2002) Rationale for mass antibiotic distribution for trachoma elimination. Int Ophthalmol Clin 42:85-92 |
| Jha, Hem; Chaudary, J S P; Bhatta, Ramesh et al. (2002) Disappearance of trachoma from Western Nepal. Clin Infect Dis 35:765-8 |
| Lietman, T; Fry, A (2001) Can we eliminate trachoma? Br J Ophthalmol 85:385-7 |
| Bailey, R; Lietman, T (2001) The SAFE strategy for the elimination of trachoma by 2020: will it work? Bull World Health Organ 79:233-6 |
| Holm, S O; Jha, H C; Bhatta, R C et al. (2001) Comparison of two azithromycin distribution strategies for controlling trachoma in Nepal. Bull World Health Organ 79:194-200 |
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