@article {226,
	title = {Diversity of Chlamydia trachomatis in Trachoma-Hyperendemic Communities Treated With Azithromycin.},
	journal = {Am J Epidemiol},
	volume = {187},
	year = {2018},
	month = {2018 09 01},
	pages = {1840-1845},
	abstract = {<p>Prior studies have theorized that low chlamydial genetic diversity following mass azithromycin treatments for trachoma may create a population bottleneck that prevents the return of infection, but little empirical evidence exists to support this hypothesis. In this study, a single mass azithromycin distribution was administered to 21 communities in the Gurage Zone of Ethiopia in 2003. All children aged 1-5 years had conjunctival swabs performed before treatment and 2 and 6 months after treatment. All swabs positive for Chlamydia trachomatis at 2 months underwent typing of the gene encoding the major outer membrane protein (ompA) of C. trachomatis, as did the same number of swabs per community from the pretreatment and 6-month visits. Diversity of ompA types, expressed as the reciprocal of Simpson{\textquoteright}s index, was calculated for each community. In total, 15 ompA types belonging to the A and B genovars were identified. The mean diversity was 2.11 (95\% confidence interval: 1.79, 2.43) before treatment and 2.16 (95\% confidence interval: 1.76, 2.55) 2 months after treatment (P = 0.78, paired t test). Diversity of ompA was not associated with the prevalence of ocular chlamydia (P = 0.76) and did not predict subsequent changes in the prevalence of ocular chlamydia (P = 0.32). This study found no evidence to support the theory that ompA diversity is associated with transmission of ocular chlamydia.</p>
},
	keywords = {Anti-Bacterial Agents, Azithromycin, Bacterial Outer Membrane Proteins, Chlamydia trachomatis, Genetic Variation, Humans, Trachoma},
	issn = {1476-6256},
	doi = {10.1093/aje/kwy071},
	author = {Chin, Stephanie A and Morberg, Daniel P and Alemayehu, Wondu and Melese, Muluken and Lakew, Takele and Chen, Michael C and Zhou, Zhaoxia and Doan, Thuy and Cevallos, Vicky and Lietman, Thomas M and Keenan, Jeremy D}
}
