Trachoma, an ocular infection caused by C. trachomatis, is the second leading infectious
cause of blindness worldwide. Years of repeated infection with C. trachomatis cause the
eyelid to scar and contract and ultimately to rotate inward such that the eyelashes rub
against the eyeball and abrade the cornea (trichiasis). The World Health Organization (WHO)
has endorsed a multi-faceted strategy to combat trachoma, which includes the use of
antibiotic treatment to reduce the community pool of infection with C. trachomatis. The
objective of this study is to conduct a randomized, community-based trial in three countries
(Niger, Tanzania and The Gambia), representing different baseline endemicities, of
alternative coverages and frequencies of administration of mass antibiotic treatment as well
as to determine the cost-effectiveness of these different strategies from a program
perspective.