Low Prevalence of Ocular Chlamydia trachomatis Infection and Active Trachoma in the Western Division of Fiji

Macleod, Colin; Butcher, Robert; Umesh, Mudaliar; Kinisimere, Natutusau; Pavluck, Alexandre L.; Willis, Rebecca; Alexander, Neal; Mabey, David; Luisa, Cikamatana; Kama, Mike; Rafai, Eric; Roberts, Chrissy h.; Solomon, Anthony W.

doi:10.1371/journal.pntd.0004798

Cited by 33 publications

(29 citation statements)

References 30 publications

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“…In a previous study in the Western Division of Fiji we reported a trachomatous inflammation – follicular (TF) prevalence of 2.8% and an ocular chlamydia infection prevalence of 2.3%. 2 These serology data are comparable to other settings where there is a low prevalence of both TF and ocular chlamydia infection. 21 Steeply increasing age-specific anti-pgp3 prevalence in children aged between 1 and 10 years is thought to be indicative of intense transmission of ocular C. trachomatis ; in this population the prevalence of anti-pgp3 antibodies was already high in the 1-year age group, suggesting the majority of seropositivity was acquired at in the first year of life.…”

Section: Discussionsupporting

confidence: 72%

“…2 No mass distribution of azithromycin for trachoma or yaws has previously been carried out in this region, nor any recent penicillin-based mass treatment campaigns for yaws, to the best of the authors’ knowledge. Data are reported in line with the STROBE guidelines for cross-sectional surveys (Supplementary File 1).…”

Section: Methodsmentioning

confidence: 93%

“…Finally we did not collect linked clinical data on active trachoma or ocular swabs for PCR during this survey. We had conducted a previous survey in this region of Fiji two years earlier where we have demonstrated a low prevalence of TF (2.8%) and ocular C. trachomatis infection (2.3%) amongst children 2 and where no cases of trachomatous trichasis were seen.…”

Section: Discussionmentioning

confidence: 99%

“…1 Trachoma, caused by ocular infection with Chlamydia trachomatis , is the leading infectious cause of blindness and is also endemic in the Pacific. 2,3 Both diseases are classified as neglected tropical diseases (NTDs) by WHO. WHO has targets for both the global eradication of yaws and elimination of blinding trachoma as a public health problem by 2020.…”

Section: Introductionmentioning

confidence: 99%

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Community seroprevalence survey for yaws and trachoma in the Western Division of Fiji

Cocks

Rainima-Qaniuci²,

Yalen

et al. 2016

Trans R Soc Trop Med Hyg

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BackgroundBoth yaws and trachoma are endemic in several countries in the Pacific. In co-endemic countries there may be potential synergies between both control programmes.MethodsWe undertook a cluster randomised trachoma and yaws seroprevalence survey of children in the Western Division of Fiji. Children were examined for skin lesions consistent with active yaws. A dried blood spot was collected which was tested using the Treponema pallidum particle agglutination (TPPA) test and an ELISA to detect antibodies against Pgp3.ResultsA total of 607 children from 305 households across 23 villages were recruited into the survey. On skin examination, no child had clinical evidence of yaws, and the TPPA assay was negative in all children (0%, 95% CI 0.0–0.6). The seroprevalence of Pgp3 antibodies was 20.9% (95% CI 17.8–24.6%).DiscussionIn this study there was neither clinical nor serological evidence that transmission of yaws was ongoing. The Pgp3 seroprevalence pattern was consistent with either low level transmission of ocular Chlamydia trachomatis or exposure to C. trachomatis in the birth canal which is consistent with a survey conducted in the same region in 2013. These data suggest neither yaws nor ocular chlamydia infection are a significant public health problem in the Western Division of Fiji.

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Section: Discussionsupporting

confidence: 72%

Section: Methodsmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Community seroprevalence survey for yaws and trachoma in the Western Division of Fiji

Cocks

Rainima-Qaniuci²,

Yalen

et al. 2016

Trans R Soc Trop Med Hyg

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“…Samples were tested for Homo sapiens ribonuclease subunit (RPP30; endogenous control) and open reading frame 2 of the Ct plasmid (diagnostic target) using a previously evaluated droplet digital PCR assay 20 with minor modifications 21 .…”

Section: Methodsmentioning

confidence: 99%

Clinical signs of trachoma are prevalent among Solomon Islanders who have no persistent markers of prior infection with Chlamydia trachomatis

Butcher¹,

Sokana²,

Jack³

et al. 2018

Wellcome Open Res

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Background: The low population-prevalence of trachomatous trichiasis and high prevalence of trachomatous inflammation–follicular (TF) provide contradictory estimates of the magnitude of the public health threat from trachoma in the Solomon Islands. Improved characterisation of the biology of trachoma in the region may support policy makers as they decide what interventions are required. Here, age-specific profiles of anti-Pgp3 antibodies and conjunctival scarring were examined to determine whether there is evidence of ongoing transmission and pathology from ocular Chlamydia trachomatis (Ct) infection. Methods: A total of 1511 individuals aged ≥1 year were enrolled from randomly selected households in 13 villages in which >10% of children aged 1–9 years had TF prior to a single round of azithromycin mass drug administration undertaken six months previously. Blood was collected to be screened for antibodies to the Ct antigen Pgp3. Tarsal conjunctival photographs were collected for analysis of scarring severity. Results: Anti-Pgp3 seropositivity was 18% in 1–9 year olds, sharply increasing around the age of sexual debut to reach 69% in those over 25 years. Anti-Pgp3 seropositivity did not increase significantly between the ages of 1–9 years and was not associated with TF (p=0.581) or scarring in children (p=0.472). Conjunctival scars were visible in 13.1% of photographs. Mild (p<0.0001) but not severe (p=0.149) scars increased in prevalence with age. Conclusions: Neither conjunctival scars nor lymphoid follicles were associated with antibodies to Ct, suggesting that they are unlikely to be a direct result of ocular Ct infection . Clinical signs of trachoma were prevalent in this population but were not indicative of the underlying rates of Ct infection. The current World Health Organization guidelines for trachoma elimination indicated that this population should receive intervention with mass distribution of antibiotics, but the data presented here suggest that this may not have been appropriate.

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Ocular Chlamydia trachomatis infection, anti-Pgp3 antibodies and conjunctival scarring in Vanuatu and Tarawa, Kiribati before antibiotic treatment for trachoma

Butcher

Handley

Garae

et al. 2020

Journal of Infection

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Introduction: In the peri-elimination setting, the positive predictive value of trachomatous inflammationfollicular (TF), the primary marker used to determine need for antibiotics for trachoma, is suboptimal. Here, three non-TF measures are used to compare two regions where TF prevalence exceeds the threshold for intervention, but where the Chlamydia trachomatis (Ct) prevalence is different. Methods: Population prevalence of trachoma was measured in Vanuatu (n = 3470) and Kiribati (n = 2922). Dried blood spots (DBS) and conjunctival photographs were collected from every survey participant, and conjunctival swabs were collected from those aged 1-9 years. Individuals were tested for blood anti-Pgp3 antibodies, Ct DNA at the conjunctiva and severity of conjunctival scarring. Results: The prevalence of TF in 1-9-year-olds was 16.5% in Vanuatu and 38.2% in Tarawa. 7% of people aged ≥1 year in Vanuatu had conjunctival scarring compared to 27% in Tarawa. The prevalence of ocular Ct infection in 1-9-year-olds was 1.5% in Vanuatu and 27.4% in Tarawa. The seroconversion rate amongst 1-9-year-old children in Vanuatu and Tarawa was 0.018 and 0.197 events per child per year, respectively. Conclusions: Comparing Vanuatu to Tarawa demonstrates several markers that could be used to differentiate the trachoma status of populations in these (and other) locations.

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Low Prevalence of Ocular Chlamydia trachomatis Infection and Active Trachoma in the Western Division of Fiji

Cited by 33 publications

References 30 publications

Community seroprevalence survey for yaws and trachoma in the Western Division of Fiji

Community seroprevalence survey for yaws and trachoma in the Western Division of Fiji

Clinical signs of trachoma are prevalent among Solomon Islanders who have no persistent markers of prior infection with Chlamydia trachomatis

Ocular Chlamydia trachomatis infection, anti-Pgp3 antibodies and conjunctival scarring in Vanuatu and Tarawa, Kiribati before antibiotic treatment for trachoma

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