AI Article Synopsis
- The World Health Organization (WHO) requires a second surveillance survey for trachoma with a prevalence of follicular trachoma (TF) <5% to check for re-emergence, leading to a study in two districts of Nepal.
- In this study, 20 clusters were selected; 50 children and 100 adults from each cluster were examined for TF, trachomatous trichiasis (TT), and tested for chlamydial infection and antibodies.
- The findings revealed 3 cases of TF and 1 case of infection, with a low pgp3 antibody positivity of 2.4%, indicating no evidence of trachoma resurgence, suggesting the need for further research on the implications of low antibody levels.
Article Abstract
Background: The World Health Organization (WHO) now requires a second surveillance survey for trachoma after an impact assessment has found follicular trachoma (TF) <5% to determine if re-emergence has occurred. Using new WHO guidelines, we undertook surveillance surveys, and determined the prevalence of infection and antibody positivity, in two districts in Nepal.
Methods: 20 clusters were randomly selected within each district, 15 were randomly selected for antibody testing. In each cluster, we randomly selected 50 children ages 1-9 years and 100 adults ≥15 years. TF and trachomatous trichiasis (TT) were evaluated. Conjunctival swabs to test for chlamydial infection using GenXpert platform were obtained, and dried blood spots were collected to test for antibodies to Chlamydia Trachomatis pgp3 using the Luminex platform.
Findings: 3 cases of TF were found in the two districts, and one case of infection. Pgp3 antibody positivity was 2·4% (95% confidence interval: 1·4%, 3·7%), and did not increase with age (P = 0.24). No clustering of antibody positivity within communities was found. TT prevalence was <1/1,000 population.
Interpretation: The surveillance surveys, as proposed by WHO, showed no evidence for re-emergence of trachoma in two districts of Nepal. The low level and no significant increase by age in seroprevalence of antibodies to C trachomatis pgp3 antigen deserve further investigation as a marker of interruption of transmission.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5031451 | PMC |
| http://dx.doi.org/10.1371/journal.pntd.0005003 | DOI Listing |
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