Global progress toward the elimination of active trachoma: an analysis of 38 countries

Renneker, Kristen; Abdala, Mariamo; Addy, James; Al-Khatib, Tawfik; Amer, Khaled A; Badiane, Mouctar Dieng; Batcho, Wilfrid; Bella, Lucienne; Bougouma, Clarisse; Bucumi, Victor; Chisenga, Tina; Dat, Tran Minh; Dézoumbé, Djore; Elshafie, Balgesa Elkheir; Garae, Mackline; Goépogui, Andre; Hammou, Jaouad; Kabona, George; Kadri, Boubacar; Kalua, Khumbo; Kanyi, Sarjo; Khan, Asad Aslam; Marfo, Benjamin; Matendechero, Sultani; Meïté, Aboulaye; Minnih, Abdellahi; Mugume, Francis; Olobio, Nicholas; Omar, Fatma; Phiri, Isaac; Sanha, Salimato; Sharma, Shaveta; Seife, Fikre; Sokana, Oliver; Taoaba, Raebwebwe; Tesfazion, Andeberhan; Traoré, Lamine; Uvon, Naomi; Yaya, Georges; Logora, Makoy Yibi; Hooper, Pamela J.; Emerson, Paul M.; Ngondi, Jeremiah

doi:10.1016/s2214-109x(22)00050-x

Cited by 19 publications

(20 citation statements)

References 14 publications

(17 reference statements)

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“…For example, the included studies come from five countries in Africa, but trachoma continues to be endemic in the other regions of Africa, Latin America, Asia, and the Pacific Islands. 44 As a secondary analysis, our work was also affected by design features of individual studies, such as site selection in RCTs, which were typically not selected using probability samples. Second, all models used to estimate seroconversion, except for the semiparametric spline model, assumed homogeneity of seroconversion rate over age and time.…”

Section: Discussionmentioning

confidence: 99%

Monitoring transmission intensity of trachoma with serology

Tedijanto

Solomon

Martin

et al. 2023

Preprint

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Trachoma, caused by ocular Chlamydia trachomatis infection, is targeted for global elimination as a public health problem by 2030. To provide evidence for use of antibodies to monitor C. trachomatis transmission, we collated IgG responses to Pgp3 antigen, PCR positivity, and clinical observations from 19,811 children aged 1-9 years in 14 populations. We demonstrate that age-seroprevalence curves consistently shift along a gradient of transmission intensity: rising steeply in populations with high levels of infection and active trachoma and becoming flat in populations near elimination. Seroprevalence (range: 0-54%) and seroconversion rates (range: 0-15 per 100 person-years) correlate with PCR prevalence (r: 0.88, 95% CI: 0.77, 0.93). A seroprevalence threshold of 13.5% (seroconversion rate 2.75 per 100 person-years) identifies clusters with any infection at high sensitivity (>90%) and moderate specificity (69-75%). Antibody responses in young children provide a robust, generalizable approach to monitor population progress toward and beyond trachoma elimination.

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Section: Discussionmentioning

confidence: 99%

Monitoring transmission intensity of trachoma with serology

Tedijanto

Solomon

Martin

et al. 2023

Preprint

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“…By June 2021, remarkable progress toward this goal had been achieved, with a reported 136 million people living in areas with a TF 1–9 ≥5% [ 2 ], a greater than 91% reduction from 2002 estimates [ 3 ]. Furthermore, the total number of known districts above the active trachoma elimination threshold (TF 1–9 ≥ 5%) has decreased year-on-year since a global peak in 2015 [ 4 ]. Ethiopia represents a near-majority of the global burden of active trachoma, with just under half (49.4%) of the total global population living in areas that are known to warrant interventions (antibiotics, facial cleanliness and environmental improvement) residing in Ethiopia as of June 2021 [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Forecasting the elimination of active trachoma: An empirical model

et al. 2022

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Background Great progress has been made toward the elimination of trachoma as a public-health problem. Mathematical and statistical models have been used to forecast when the program will attain the goal of the elimination of active trachoma, defined as prevalence of trachomatous inflammation—follicular in 1–9 year olds (TF1–9) <5%. Here we use program data to create an empirical model predicting the year of attaining global elimination of TF1–9. Methodology/Principal findings We calculated the mean number of years (95% CI) observed for an implementation unit (IU) to move from a baseline TF1–9 prevalence ≥5% to the elimination threshold, based on the region (Ethiopia vs. non-Ethiopia) and baseline prevalence category. Ethiopia IUs had significantly different rates of reaching the TF1–9 elimination threshold after a trachoma impact survey (TIS) compared to non-Ethiopia IUs across all baseline categories. We used those estimates to predict when remaining active trachoma-endemic IUs (TF1–9 ≥5%) would have their last round of mass drug administration (MDA) based on the mean number of years required and number of MDA rounds already completed. Our model predicts that elimination of TF1–9 will be achieved in 2028 in Ethiopia (95% CI: 2026–2033) and 2029 outside of Ethiopia (95% CI: 2023–2034), with some IUs in East Africa predicted to be the last requiring MDA globally. Conclusions/Significance Our empirical estimate is similar to those resulting from previous susceptible-infectious-susceptible (SIS) and mathematical models, suggesting that the forecast achievement of TF1–9 elimination is realistic with the caveat that although disease elimination progress can be predicted for most IUs, there is an important minority of IUs that is not declining or has not yet started trachoma elimination activities. These IUs represent an important barrier to the timely global elimination of active trachoma.

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“…Trachoma programs have had considerable success around the world, but although 15 previously endemic countries have now declared control, about twice that many have not. 1 Ethiopia is home to the majority of districts that have failed to meet this goal. Two publications in this issue of the American Journal of Tropical Medicine & Hygiene address the challenges Ethiopia faces to achieve trachoma control.…”

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confidence: 99%