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

•In Vanuatu, ocular Chlamydia infection prevalence is low; in Kiribati it is high.•In Vanuatu, Pgp3 seroprevalence does not increase in childhood; in Kiribati it does.•Conjunctival scarring is more common in adults in Kiribati than in Vanuatu.•Trachomatous inflammation—follicular lacks specificity f...

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Published inThe Journal of infection Vol. 80; no. 4; pp. 454 - 461
Main Authors Butcher, Robert, Handley, Becca, Garae, Mackline, Taoaba, Raebwebwe, Pickering, Harry, Bong, Annie, Sokana, Oliver, Burton, Matthew J, Sepúlveda, Nuno, Cama, Ana, Mesurier, Richard Le, Solomon, Anthony W., Mabey, David, Taleo, Fasihah, Tekeraoi, Rabebe, Roberts, Chrissy h
Format Journal Article
LanguageEnglish
Published England Elsevier Ltd 01.04.2020
W.B. Saunders
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Abstract •In Vanuatu, ocular Chlamydia infection prevalence is low; in Kiribati it is high.•In Vanuatu, Pgp3 seroprevalence does not increase in childhood; in Kiribati it does.•Conjunctival scarring is more common in adults in Kiribati than in Vanuatu.•Trachomatous inflammation—follicular lacks specificity for ocular Chlamydia infection.•Non-TF markers may help to determine need for interventions against active trachoma. In the peri-elimination setting, the positive predictive value of trachomatous inflammation–follicular (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. 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. 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. Comparing Vanuatu to Tarawa demonstrates several markers that could be used to differentiate the trachoma status of populations in these (and other) locations.
AbstractList •In Vanuatu, ocular Chlamydia infection prevalence is low; in Kiribati it is high.•In Vanuatu, Pgp3 seroprevalence does not increase in childhood; in Kiribati it does.•Conjunctival scarring is more common in adults in Kiribati than in Vanuatu.•Trachomatous inflammation—follicular lacks specificity for ocular Chlamydia infection.•Non-TF markers may help to determine need for interventions against active trachoma. In the peri-elimination setting, the positive predictive value of trachomatous inflammation–follicular (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. 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. 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. Comparing Vanuatu to Tarawa demonstrates several markers that could be used to differentiate the trachoma status of populations in these (and other) locations.
• In Vanuatu, ocular Chlamydia infection prevalence is low; in Kiribati it is high. • In Vanuatu, Pgp3 seroprevalence does not increase in childhood; in Kiribati it does. • Conjunctival scarring is more common in adults in Kiribati than in Vanuatu. • Trachomatous inflammation—follicular lacks specificity for ocular Chlamydia infection. • Non-TF markers may help to determine need for interventions against active trachoma.
In the peri-elimination setting, the positive predictive value of trachomatous inflammation-follicular (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. 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. 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. Comparing Vanuatu to Tarawa demonstrates several markers that could be used to differentiate the trachoma status of populations in these (and other) locations.
INTRODUCTIONIn the peri-elimination setting, the positive predictive value of trachomatous inflammation-follicular (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. METHODSPopulation 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. RESULTSThe 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. CONCLUSIONSComparing Vanuatu to Tarawa demonstrates several markers that could be used to differentiate the trachoma status of populations in these (and other) locations.
Author Handley, Becca
Bong, Annie
Pickering, Harry
Mabey, David
Butcher, Robert
Solomon, Anthony W.
Taoaba, Raebwebwe
Burton, Matthew J
Cama, Ana
Sepúlveda, Nuno
Garae, Mackline
Tekeraoi, Rabebe
Roberts, Chrissy h
Taleo, Fasihah
Sokana, Oliver
Mesurier, Richard Le
AuthorAffiliation d Eye Department, Vanuatu Ministry of Health and Medical Services, Port Vila, Vanuatu
b Department of Neglected Tropical Diseases, Vanuatu Ministry of Health and Medical Services, Port Vila, Vanuatu
g Fred Hollows Foundation, Melbourne, Australia
c Eye Department, Kiribati Ministry of Health and Medical Services, Bikenibeu, Tarawa, Kiribati
e Eye Department, Solomon Islands Ministry of Health and Medical Services, Honiara, Solomon Islands
a Clinical Research Department, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
f Department of Infection Biology, London School of Hygiene & Tropical Medicine & Centre of Statistics and Its Applications, University of Lisbon, Portugal
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Copyright 2020
Copyright © 2020. Published by Elsevier Ltd.
2020 The Authors. Published by Elsevier Ltd on behalf of The British Infection Association. 2020
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Issue 4
Keywords Neglected tropical diseases
Trachoma
Vanuatu
Chlamydia trachomatis
Kiribati
Anti-Pgp3 antibodies
Language English
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Snippet •In Vanuatu, ocular Chlamydia infection prevalence is low; in Kiribati it is high.•In Vanuatu, Pgp3 seroprevalence does not increase in childhood; in Kiribati...
In the peri-elimination setting, the positive predictive value of trachomatous inflammation-follicular (TF), the primary marker used to determine need for...
INTRODUCTIONIn the peri-elimination setting, the positive predictive value of trachomatous inflammation-follicular (TF), the primary marker used to determine...
• In Vanuatu, ocular Chlamydia infection prevalence is low; in Kiribati it is high. • In Vanuatu, Pgp3 seroprevalence does not increase in childhood; in...
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SubjectTerms Aged
Anti-Bacterial Agents - therapeutic use
Anti-Pgp3 antibodies
Child
Child, Preschool
Chlamydia trachomatis
Cicatrix - drug therapy
Cicatrix - epidemiology
Humans
Infant
Kiribati
Micronesia
Neglected tropical diseases
Trachoma
Trachoma - drug therapy
Trachoma - epidemiology
Vanuatu
Title Ocular Chlamydia trachomatis infection, anti-Pgp3 antibodies and conjunctival scarring in Vanuatu and Tarawa, Kiribati before antibiotic treatment for trachoma
URI https://dx.doi.org/10.1016/j.jinf.2020.01.015
https://www.ncbi.nlm.nih.gov/pubmed/32017971
https://search.proquest.com/docview/2351503693
https://pubmed.ncbi.nlm.nih.gov/PMC7113835
Volume 80
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