Trachoma, Childhood Mortality, and Corneal Ulcer Treatment and Prevention
About
Dr. Lietman investigates which community treatment strategies are most effective in eliminating trachoma. With Dr. Porco, he builds mathematical models to determine who within communities needs to be targeted, how often communities need treatment, and whether the World Health Organization's antibiotic program risks generating drug resistance. With Dr. Keenan, he conducts clinical trials evaluating the long-term effects of mass antibiotic treatment to determine whether infectious trachoma can truly be eliminated through repeat community treatment. Together with Drs. Acharya, Keenan, and Rose-Nussbaumer, he leads corneal ulcer treatment and prevention trials in collaboration with the Aravind Eye Care System, Seva, and Bharatpur Eye Hospital in South India and Nepal.
Education & Training
BA, Molecular Biophysics and Biochemistry — Yale College
MD — Columbia University College of Physicians and Surgeons
Fellow — National Eye Institute, HHMI-NIH, Bethesda, MD
Residency, Ophthalmology — Wilmer Eye Institute, Johns Hopkins University
Fellow, Cornea & External Diseases and Uveitis — F.I. Proctor Foundation, UCSF
Fellow, Modeling of Infectious Diseases — Department of Epidemiology & Biostatistics, UCSF
Complex Systems Summer School — Santa Fe Institute
Key Collaborators
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UCSF Profile & Full Publication List
Research Areas: Trachoma, Cornea, Infectious Diseases
Learn more about UCSF Ophthalmology faculty research
Featured Media:
NYT: Global Health Infant Deaths Fall Sharply in Africa With Routine Antibiotics
Research Projects
ONGOING
Fungal Ulcer Treatment Augmented With Natamycin and Cyclosporine A (FANCY)
The goal of this clinical trial is to learn if adjunctive topical Cyclosporine A eye drops combined with standard of care topical Natamycin treatment improves vision outcomes in patients with fungal keratitis.
Collaborators: Aravind Eye Hospitals, India, Aravind Eye Care System
NCT06658002 →
Rose Bengal Electromagnetic Activation With Green Light for Infection Reduction II (REAGIR II)
Rose Bengal Electromagnetic Activation with Green light for Infection Reduction II (REAGIR II) is a randomized, double-masked feasibility study.
Collaborators: Stanford University, Aravind Eye Care System, Federal University of São Paulo
NCT06271772 →
Kebele Elimination of Trachoma for Ocular Health (KETFO)
The investigators propose a cluster-randomized clinical trial to determine whether an intensive, targeted azithromycin distribution strategy is effective for elimination of trachoma at the kebele level compared to the World Health Organization (WHO) recommendation of annual azithromycin distribution.
Collaborators: National Eye Institute (NEI), Eyu-Ethiopia, Bahir Dar University
NCT03335072 →
Infant Mortality Reduction by the Mass Administration of Azithromycin (MIRAMA)
This trial will investigate the supplementation of azithromycin distribution to the "Child Health Days" platform in Burkina Faso for child mortality reduction.
Collaborators: Helen Keller International, Centre de Recherche en Sante de Nouna, Burkina Faso, Bill and Melinda Gates Foundation
NCT04716712 →
Village Integrated Eye Workers Trial (VIEW)
VIEW is a community-randomized trial designed to determine whether it is possible to prevent corneal ulcers on a large scale.
Collaborators: National Eye Institute (NEI), Seva Foundation, Bharatpur Eye Hospital
NCT01969786 →
COMPLETED
Rose Bengal Electromagnetic Activation With Green Light for Infection Reduction (REAGIR)
Rose Bengal Electromagnetic Activation with Green light for Infection Reduction (REAGIR ) is an international, randomized, doubled masked, clinical trial.
Collaborators: Aravind Eye Care System, National Eye Institute (NEI), Stanford University, Federal University of São Paulo
NCT05110001 →
Azithromycin for Child Survival in Niger: Delivery Trial (AVENIR)
This cluster-randomized trial aims to compare the impact of different delivery approaches to azithromycin distribution on coverage, costs, and feasibility outcomes.
Collaborators: Bill and Melinda Gates Foundation, Programme National de Santé Oculaire, Ministère de la Santé Publique du Niger
NCT04774991 →
Azithromycin Reduction to Reach Elimination of Trachoma (ARRET)
The investigators propose a randomized controlled trial of discontinuation versus continuation of annual mass azithromycin distribution in hypoendemic communities of Maradi, Niger.
Collaborators: Programme National de Santé Oculaire (PNSO), National Eye Institute (NEI)
NCT04185402 →
Azithromycin for Child Survival in Niger: Mortality and Resistance Trial (AVENIR)
The MORDOR trial found that biannual distribution of azithromycin to children 1-59 months old reduced child mortality.
Collaborators: Bill and Melinda Gates Foundation, Ministry of Health, Niger
NCT04224987 →
Steroids and Cross-linking for Ulcer Treatment (SCUT II)
Steroids and Cross-linking for Ulcer Treatment (SCUT II) is an international, randomized, double-masked, clinical trial.
Collaborators: Aravind Eye Care System, National Eye Institute (NEI), University of Miami, Stanford University
NCT04097730 →
MORDOR II Burkina Faso: Longitudinal Trial (GAMIN)
Globally, childhood mortality has shown a promising downward trend in recent years, however, many sub-Saharan countries still have relatively high child mortality rates.
Collaborators: Centre de Recherche en Sante de Nouna, Burkina Faso, Bill and Melinda Gates Foundation
NCT03676751 →
Community Health Azithromycin Trial in Burkina Faso (CHAT)
An estimated 7.7 million pre-school aged children die each year, the majority from infectious diseases. Mass azithromycin distributions for trachoma may have the unintended benefit of reducing childhood mortality.
Collaborators: Centre de Recherche en Sante de Nouna, Burkina Faso, Bill and Melinda Gates Foundation
NCT03676764 →
Neonates and Azithromycin, an Innovation in the Treatment of Children in Burkina Faso (NAITRE)
Although under-5 mortality rates are declining globally, neonatal mortality remains persistently high in many regions of sub-Saharan Africa.
Collaborators: Centre de Recherche en Sante de Nouna, Burkina Faso, Bill and Melinda Gates Foundation
NCT03682653 →
Mortality Reduction After Oral Azithromycin Contingency: Mortality Study (MORDORIIMortY5)
MORDOR was a cluster-randomized placebo controlled trial that assessed the efficacy of mass azithromycin distributions for the prevention of childhood mortality. All communities were subsequently treated with mass azithromycin for one year.
Collaborators: The Carter Center, Bill and Melinda Gates Foundation
NCT03338244 →
Antibiotic Resistance and Microbiome in Children Aged 6-59 Months in Nouna, Burkina Faso (ARMCA)
The use of antibiotics has saved millions of human lives, however consumption of antibiotics can select for antibiotic resistant organisms and may lead to changes in commensal microbiome.
Collaborators: Centre de Recherche en Sante de Nouna, Burkina Faso, Heidelberg University
NCT03187834 →
Mortality Reduction After Oral Azithromycin: Mortality Study (MORDORIMort)
Our long-term goal is to more precisely define the role of mass azithromycin treatments as an intervention for reducing childhood mortality.
Collaborators: Bill and Melinda Gates Foundation, Johns Hopkins University, London School of Hygiene and Tropical Medicine
NCT02047981 →
Mortality Reduction After Oral Azithromycin: Morbidity Study (MORDORMorb)
The long-term goal of this study is to more precisely define the role of mass azithromycin treatments as an intervention for reducing childhood morbidity and increasing growth, and for the potential selection of antibiotic resistance.
Collaborators: Bill and Melinda Gates Foundation, Johns Hopkins University, London School of Hygiene and Tropical Medicine
NCT02048007 →
Tripartite International Research for the Elimination of Trachoma (TIRET)
Mass antimicrobial administrations have been remarkably successful in reducing the prevalence of the ocular strains of Chlamydia that cause trachoma.
NCT01202331 →
The Mycotic Ulcer Treatment Trial II: A Randomized Trial Comparing Oral Voriconazole vs Placebo (MUTTII)
The purpose of this study is to determine if the addition of oral voriconazole to topical treatment regimens results in lower rates of perforation in severe fungal corneal ulcers.
Collaborators: Aravind Eye Hospitals, India, Dartmouth-Hitchcock Medical Center, Lumbini Eye Institute and Research Centre, Bharatpur Eye Hospital, National Eye Institute (NEI)
NCT00997035 →
Mycotic Ulcer Treatment Trial I (MUTT I)
The purpose of this study is to determine if natamycin or voriconazole results in better visual outcomes in fungal corneal ulcers, especially visual acuity.
Collaborators: Aravind Eye Hospitals, India, Dartmouth-Hitchcock Medical Center, National Eye Institute (NEI)
NCT00996736 →
Therapeutic Exploratory Study of Comparing Natamycin and Voriconazole to Treat Fungal Corneal Ulcer (MUTT_TE)
We evaluated whether voriconazole is a superior treatment to natamycin for filamentous fungal keratitis in a randomized, masked, controlled trial.
Collaborators: That Man May See, Inc., Aravind Eye Hospitals, India, Dartmouth-Hitchcock Medical Center
NCT00557362 →
Steroids for Corneal Ulcers Trial (SCUT)
The purpose of this study is to determine whether adding topical steroids improves the outcomes of bacterial corneal ulcers, especially visual acuity.
Collaborators: Aravind Eye Hospitals, India, Dartmouth-Hitchcock Medical Center, National Eye Institute (NEI)
NCT00324168 →
Trachoma Amelioration in Northern Amhara (TANA) (TANA)
The WHO has initiated a program to eliminate trachoma, blinding eye infection caused by Chlamydia trachomatis, in large part by mass distributions of oral azithromycin.
NCT00322972 →
Trachoma Elimination Follow-up (TEF)
The WHO has initiated a program to eliminate blinding trachoma by the year 2020, in large part by mass oral azithromycin distributions. It is not clear how frequently or for how long these treatments are necessary.
NCT00221364 →
CLOSED EARLY
Azithromycin Reduction to Reach Elimination of Trachoma B (ARRET)
The investigators propose a randomized controlled trial of discontinuation versus continuation of annual mass azithromycin distribution in hypoendemic communities of Maniema, DRC.
Collaborators: Institut National de Recherche Biomédicale. Kinshasa, République Démocratique du Congo, National Eye Institute (NEI)
NCT06289647 →
Azithromycin for Child Survival in Niger: Programmatic Trial (AVENIR) (AVENIR)
The MORDOR trial found that biannual distribution of azithromycin to children 1-59 months old reduced child mortality.
Collaborators: Bill and Melinda Gates Foundation, Ministry of Health, Niger
NCT05288023 →
Azithromycin for COVID-19 Treatment in Outpatients Nationwide (ACTION)
This individually randomized telemedicine-based trial aims to evaluate the efficacy of a single dose of azithromycin for prevention of progression of COVID-19 in patients with a recent positive SARS-CoV-2 test who are not currently hospitalized.
Collaborators: Bill and Melinda Gates Foundation, Pfizer, Stanford University
NCT04332107 →
Source: ClinicalTrials.gov. Last reviewed August 2026.