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trachomatis (primary outcome), TF and other clinical signs of trachoma, and serologic markers of trachoma after 3years. We hypothesize that stopping annual azithromycin distribution will be non-inferior to continued annual azithromycin distributions for all markers of trachoma prevalence and transmission. The results of this trial are anticipated to provide potentially guideline-changing evidence for when mass azithromycin distributions can be stopped in low TF prevalence areas. TRIALREGISTRATION NUMBER This study is registered at cli