The Relationship between Active Trachoma and Ocular Chlamydia trachomatis Infection before and after Mass Antibiotic Treatment |
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| Authors: | Athumani M Ramadhani Tamsyn Derrick David Macleod Martin J Holland Matthew J Burton |
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| Institution: | 1Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, United Kingdom;2Kilimanjaro Christian Medical Centre, Moshi, Tanzania;3Tropical Epidemiology Group. London School of Hygiene & Tropical Medicine, United Kingdom;4Moorfields Eye Hospital, London, United Kingdom;University of California San Diego School of Medicine, UNITED STATES |
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| Abstract: | BackgroundTrachoma is a blinding disease, initiated in early childhood by repeated conjunctival infection with the obligate intracellular bacterium Chlamydia trachomatis. The population prevalence of the clinical signs of active trachoma; ‘‘follicular conjunctivitis” (TF) and/or ‘‘intense papillary inflammation” (TI), guide programmatic decisions regarding the initiation and cessation of mass drug administration (MDA). However, the persistence of TF following resolution of infection at both the individual and population level raises concerns over the suitability of this clinical sign as a marker for C. trachomatis infection.Conclusions/SignificancePrior to MDA, TF is a good indicator of the community prevalence of C. trachomatis infection. Following MDA, the prevalence of TF tends to overestimate the underlying infection prevalence. In order to prevent unnecessary additional rounds of MDA and to accurately ascertain when elimination goals have been reached, a cost-effective test for C. trachomatis that can be administered in low-resource settings remains desirable. |
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