Study indicates controlling trachoma could reduce child mortality

Accra, Sept. 3, GNA - Ethiopia's devastating child mortality rates, which are

among the highest in the world, could be significantly decreased as a result of

treatment to control the non-fatal eye disease trachoma, suggests new research. "We've known for 20 years that we can easily prevent trachoma and the

excruciating pain and blindness it causes. This study shows trachoma control

goes far beyond blindness prevention - it also saves lives," said former U.S.

President and Carter Centre Founder Jimmy Carter. The research was published in September 2 issue of the Journal of the

American Medical Association by the University of California at San Francisco

and The Carter Centre, in partnership with the Ethiopia Ministry of Health,

according to a statement issued by the Carter Centre. Trachoma is an infection of the eye caused by the bacterium Chlamydia

trachomatis. It is the leading cause of infectious blindness globally, and Ethiopia

is the most affected country in the world, with nearly the entire nation of 78

million at risk of the disease, 40 percent of children between one and nine

year-old with signs of infection, and more than 1.2 million people at immediate

risk of blindness. Trachoma is controlled using an integrated prevention programme developed

by the World Health Organization known as 'SAFE' (Surgery, Antibiotics, Facial

cleanliness, and Environmental improvements). To support Ethiopia's national Trachoma Control Program work, lead study

authors Dr. Travis Porco and Dr Tom Lietman from the University of California

at San Francisco and Dr. Paul Emerson, Director of the Carter Centre's

Trachoma Control Program, have been examining the most strategic use of

antibiotics in the context of SAFE. The principal antibiotic used for trachoma control is azithromycin

(Zithromax=AE), which is donated by Pfizer Inc. through the International

Trachoma Initiative. The statement said during the studies, which were conducted in the Amhara

Region, more than 18,000 children from 48 villages between the ages of one and

nine years were followed. Children in 36 villages received azithromycin at least once during a 12-month

period, while those in the remaining 12 villages did not receive treatment until after

the 12-month visit. Censuses were conducted at baseline and at 12 months to determine

population changes and to assess mortality. "A large study like this is needed to show an effect on mortality, and we

estimate that childhood mortality decreased by at least 10 percent," said Dr.

Emerson, who noted that a total of 12.6 million doses of azithromycin were

distributed in the Amhara Region in 2008 through the efforts of the Lions-Carter

Centre Trachoma Control Program. "Antibiotics aren't the answer to Africa's public health problems, but when

they are appropriately used as part of the SAFE strategy to fight trachoma, which

includes hygiene education and the promotion of water and sanitation, there

appear to be more collateral benefits to health," he said. Remarkably, the observed overall mortality in the children who had taken

azithromycin was just half of that observed in children who had not taken the

drug. The authors believe this was because the antibiotic also is effective against

other non-target killers such as respiratory tract infections, bacterial diarrheal

disease, and malaria. "For years, people in trachoma-affected communities have reported that the

antibiotic helped address other health problems, but we wanted to observe and

confirm scientifically that this was the case." said Dr. Lietman. "While we are very encouraged by our findings, we are eager for others in the

field to replicate this research in other countries and identify if the added benefits

of azithromycin distribution seen in Ethiopia are taking place throughout Africa." Since 2000, The Carter Centre, with funding from the Lions-Carter Centre

SightFirst Initiative, has worked with the government of Ethiopia to fight

trachoma in the Amhara Region, supporting sight-saving operations for 145,000

patients, distributing almost 30 million doses of azithromycin, assisting hygiene

education efforts for nearly 17 million people, and helping to construct 909,000

household latrines. "In light of these findings, we urge the international community to renew

resources and commitment to endemic nations' efforts to control trachoma,

particularly given how we have only begun to evaluate the broader impact of these

cost-effective interventions, "said Dr. Emerson. "Together, we can eliminate

blinding trachoma in Ethiopia and elsewhere in the world." 3 Sept. 09