Serological Measures of Trachoma Transmission Intensity

Martin, Diana L.; Wiegand, Ryan E.; Goodhew, Brook; Lammie, Patrick J.; Black, Carolyn M.; West, Sheila K.; Gaydos, Charlotte A.; Dize, Laura; Mkocha, Harran; Kasubi, Mabula; Gambhir, Manoj

doi:10.1038/srep18532

Cited by 34 publications

(42 citation statements)

References 15 publications

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“…Based on the low prevalence of ocular Ct infection prior to MDA (1.3%), we expected the seroprevalence to be approximately 10%, in line with other communities with low Ct prevalence 14 . To estimate seroprevalence with ±5% precision at the 95% confidence level assuming a design effect of 2.65 (as utilised in the baseline study) at least 367 children were required 15 .…”

Section: Methodsmentioning

confidence: 84%

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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Section: Methodsmentioning

confidence: 84%

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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“…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. 12,21 As Pgp3 is conserved between urogenital and ocular strains of C. trachomatis we cannot discount the possibility that the Pgp3 seroprevalence may reflect transmission in the birth canal as well as, or indeed more than, ocular transmission of chlamydia.…”

Section: Discussionmentioning

confidence: 94%

“…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. 12,21 As Pgp3 is conserved between urogenital and ocular strains of C. trachomatis we cannot discount the possibility that the Pgp3 seroprevalence may reflect transmission in the birth canal as well as, or indeed more than, ocular transmission of chlamydia. The prevalence of urogenital C. trachomatis infection amongst pregnant women has previously been reported to be high in Fiji and community prevalence surveys in other Pacific countries have also reported high rates of urogenital C. trachomatis .…”

Section: Discussionmentioning

confidence: 94%

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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“…More recently, there is revival in use of serology in C. trachomatis eye infections. [71] In recent times, the diagnostic performance of Chlamydia antibody detection was improved using species-specific proteins or peptides. Immunogenic proteins of C. trachomatis identified by two-dimensional polyacrylamide gel electrophoresis were used with analogous proteins of C. pneumoniae and Chlamydophila psittaci to allow differential evaluation of Chlamydia antibody reactivity.…”

Section: Role Of Serology In Laboratory Diagnosismentioning

confidence: 99%

“…[72] In a trachoma surveillance based on serology for the 12-year cohort of Kahe Mpya, Tanzania, it was reported that the prevalence of trachoma was 6.5%, whereas only 3.5% were seropositive. [71]…”

Section: Role Of Serology In Laboratory Diagnosismentioning

confidence: 99%

Chlamydial eye infections: Current perspectives

Satpathy

Behera

Ahmed

2017

Indian J Ophthalmol

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Chlamydia trachomatis, an obligate intraocular bacteria causing trachoma, adult and neonatal inclusion conjunctivitis, was the leading cause of blindness in the last century worldwide. Improvement in socioeconomic and living conditions, availability of antibiotics, and introduction of National Trachoma Control Programmes reduced the prevalence in developed countries, but it persisted in resource-poor settings of Africa and Asia, including India. In 2016, as per the WHO report, trachoma is restricted to 42 countries, causing blindness/visual impairment in ~1.9 million people. India is one of the five countries with nearly half of total active trachoma patients. Introduction of Global Elimination of Trachoma 2020 program by the WHO, using SAFE strategy (surgery for trachomatous trichiasis; Antibiotics for C. trachomatis; Facial cleanliness; and environmental improvement) greatly reduced the prevalence, but trachoma still persists in India. Global increase in the reproductive tract infection by C. trachomatis urogenital serotypes (D-K) has led to concurrent increase in C. trachomatis eye infections. Therefore, kerato eye infections due to chlamydial infections continue to be seen in hospitals. Over the years, there have been advances in laboratory diagnostics, in understanding the pathogenesis, tissue tropism, C. trachomatis genomics, and treatment modalities. Due attention and research is still needed for the study of C. trachomatis eye infections.

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Serological Measures of Trachoma Transmission Intensity

Cited by 34 publications

References 15 publications

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

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

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

Chlamydial eye infections: Current perspectives

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