The use of serology for trachoma surveillance: Current status and priorities for future investigation

Comparison of platforms for testing antibodies to Chlamydia trachomatis antigens in the Democratic Republic of the Congo and Togo

“…Existing models are over-informed by data from Pacific Island nations, which were early adopters of serological testing as a means to understand the local discordance between high TF prevalences in children and low prevalences of trachomatous trichiasis and trachoma-related blindness in adults 27 – 29 . The addition of serology testing to baseline surveys in pre-intervention trachoma-endemic populations has been identified as an operational research priority 9 . The rapid implementation of baseline trachoma mapping within the Global Trachoma Mapping Project from 2012–2016 30 now leaves few suspected-endemic areas remaining to be mapped, so the current data are likely to be especially valuable for informing appropriate thresholds for the use of trachoma serology.…”

“…A growing body of evidence demonstrating the utility of serology for post-validation surveillance is being generated 2 – 9 . While serology has no diagnostic utility for trachoma at an individual level, the longevity of the anti- Ct antibody responses is appropriate for assessing trends in transmission at population level over time.…”

The Performance of Immunoassays to Measure Antibodies to the Chlamydia trachomatis Antigen Pgp3 in Different Epidemiological Settings for Trachoma

“…Tools to monitor for recrudescence of infection will be essential upon cessation of interventions once countries achieve EPHP targets. 2 Antibodies against Ct antigens show potential as a surveillance tool in postelimination settings. [2][3][4][5] Although not diagnostic of infection in an individual, the presence of antibodies indicates exposure to Ct and can show transmission trends in a community.…”

“…2 Antibodies against Ct antigens show potential as a surveillance tool in postelimination settings. [2][3][4][5] Although not diagnostic of infection in an individual, the presence of antibodies indicates exposure to Ct and can show transmission trends in a community. 6 It is still unclear how serological results should be used to detect potential recrudescence of infection.…”

“…7 More data are needed from a variety of epidemiological settings to understand the relationship between TF, SCR, and seroprevalence, and to define appropriate seropositivity thresholds for programs to maintain EPHP. 2 There are three platforms available to measure antibodies against the immunodominant Ct antigen Pgp3-multiplex bead assay (MBA), ELISA, and lateral flow assay (LFA)-that were developed to be responsive to the needs of national programs. [8][9][10] As the evidence base to understand the utility of serology for population-based trachoma surveillance is being developed through operational research, the antibody tests have been refined and improved.…”