I have two objectives in seeking a K23 career development award: 1. to improve our understanding of the effects of mass antibiotic distributions for trachoma by conducting an in depth analysis of populations in which trachoma has ostensibly been eliminated and by assessing the positive secondary effects of mass antibiotic treatments on childhood morbidity and mortality;2. to develop my career as an independent investigator through didactics, mentorship and hands-on research experience in the developing world. I will benefit from the infrastructure of two clinical trials: TANA (Trachoma Amelioration in Northern Amhara, U10 EY016214) and PRET (Partnership for the Rapid Elimination of Trachoma, Gates Foundation, #48027). The WHO launched the GET 2020 (Global Elimination of Trachoma by the year 2020) program to eliminate blinding trachoma, however, the goals have not been met, particularly in hyperendemic communities. Mass treatments have been used in several elimination campaigns and have been found to have unintended secondary effects. I have the following specific aims: SA1: To determine if C. trachomatis infection can be eliminated using rRNA-based nucleic acid amplification compared to DNA-based testing. SA2a: To determine if azithromycin treatments reduce mortality in 1-5 year olds from diarrhea, respiratory disease and malaria. SA2b: To determine if azithromycin treatments effect increases in height, weight, and arm circumference. My goal is to determine if complete elimination is attainable in hyperendemic communities and then to translate these research findings quickly into practice within trachoma programs in general and within the WHO GET 2020 program in particular. Growth indices are a common method for determining the efficacy of mass treatment;developing and testing an instrument for measuring growth and nutrition will provide an important bridge to future studies on integration of trachoma with other neglected tropical diseases (NTD).

Public Health Relevance

The goal of this project is to improve our understanding of mass antibiotic distributions for trachoma, assessing populations in which trachoma was presumably eliminated, and evaluating for secondary effects of these mass treatments. This is critical for establishing both the efficacy and safety of the WHO Global Elimination of Trachoma campaign.

National Institute of Health (NIH)
National Eye Institute (NEI)
Mentored Patient-Oriented Research Career Development Award (K23)
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Study Section
Special Emphasis Panel (ZEY1-VSN (10))
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Agarwal, Neeraj
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University of California San Francisco
Schools of Medicine
San Francisco
United States
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O'Brien, Kieran S; Cotter, Sun Y; Amza, Abdou et al. (2018) Childhood Mortality After Mass Distribution of Azithromycin: A Secondary Analysis of the PRET Cluster-randomized Trial in Niger. Pediatr Infect Dis J 37:1082-1086
Rahman, Salman A; Yu, Sun N; Amza, Abdou et al. (2014) Reliability of trachoma clinical grading--assessing grading of marginal cases. PLoS Negl Trop Dis 8:e2840
Gaynor, Bruce D; Amza, Abdou; Gebresailassie, Sintayehu et al. (2014) Importance of including borderline cases in trachoma grader certification. Am J Trop Med Hyg 91:577-9
Liu, Fengchen; Porco, Travis C; Mkocha, Harran A et al. (2014) The efficacy of oral azithromycin in clearing ocular chlamydia: mathematical modeling from a community-randomized trachoma trial. Epidemics 6:10-7
Gaynor, Bruce D; Amza, Abdou; Kadri, Boubacar et al. (2014) Impact of mass azithromycin distribution on malaria parasitemia during the low-transmission season in Niger: a cluster-randomized trial. Am J Trop Med Hyg 90:846-51
Amza, Abdou; Kadri, Boubacar; Nassirou, Baido et al. (2013) The easiest children to reach are most likely to be infected with ocular Chlamydia trachomatis in trachoma endemic areas of Niger. PLoS Negl Trop Dis 7:e1983
Keenan, Jeremy D; Hotez, Peter J; Amza, Abdou et al. (2013) Elimination and eradication of neglected tropical diseases with mass drug administrations: a survey of experts. PLoS Negl Trop Dis 7:e2562
Haile, Meron; Tadesse, Zerihun; Gebreselassie, Sintayehu et al. (2013) The association between latrine use and trachoma: a secondary cohort analysis from a randomized clinical trial. Am J Trop Med Hyg 89:717-20
Keenan, Jeremy D; Emerson, Paul M; Gaynor, Bruce D et al. (2013) Adult mortality in a randomized trial of mass azithromycin for trachoma. JAMA Intern Med 173:821-3
Amza, Abdou; Kadri, Boubacar; Nassirou, Baido et al. (2013) A cluster-randomized controlled trial evaluating the effects of mass azithromycin treatment on growth and nutrition in Niger. Am J Trop Med Hyg 88:138-43

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