Community-level chlamydial serology for assessing trachoma elimination in trachoma-endemic Niger.
Anti-Bacterial Agents
/ administration & dosage
Antibodies, Bacterial
/ blood
Antigens, Bacterial
/ analysis
Azithromycin
/ administration & dosage
Bacterial Proteins
/ analysis
Child, Preschool
Chlamydia trachomatis
/ drug effects
DNA, Bacterial
/ genetics
Disease Eradication
Endemic Diseases
/ prevention & control
Humans
Infant
Infant, Newborn
Mass Drug Administration
Niger
Trachoma
/ blood
Journal
PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
18
10
2018
accepted:
04
01
2019
revised:
07
02
2019
pubmed:
29
1
2019
medline:
24
4
2019
entrez:
29
1
2019
Statut:
epublish
Résumé
Program decision-making for trachoma elimination currently relies on conjunctival clinical signs. Antibody tests may provide additional information on the epidemiology of trachoma, particularly in regions where it is disappearing or elimination targets have been met. A cluster-randomized trial of mass azithromycin distribution strategies for trachoma elimination was conducted over three years in a mesoendemic region of Niger. Dried blood spots were collected from a random sample of children aged 1-5 years in each of 24 study communities at 36 months after initiation of the intervention. A multiplex bead assay was used to test for antibodies to two Chlamydia trachomatis antigens, Pgp3 and CT694. We compared seropositivity to either antigen to clinical signs of active trachoma (trachomatous inflammation-follicular [TF] and trachomatous inflammation-intense [TI]) at the individual and cluster level, and to ocular chlamydia prevalence at the community level. Of 988 children with antibody data, TF prevalence was 7.8% (95% CI 6.1 to 9.5) and TI prevalence was 1.6% (95% CI 0.9 to 2.6). The overall prevalence of antibody positivity to Pgp3 was 27.2% (95% CI 24.5 to 30), and to CT694 was 23.7% (95% CI 21 to 26.2). Ocular chlamydia infection prevalence was 5.2% (95% CI 2.8 to 7.6). Seropositivity to Pgp3 and/or CT694 was significantly associated with TF at the individual and community level and with ocular chlamydia infection and TI at the community level. Older children were more likely to be seropositive than younger children. Seropositivity to Pgp3 and CT694 correlates with clinical signs and ocular chlamydia infection in a mesoendemic region of Niger. ClinicalTrials.gov NCT00792922.
Sections du résumé
BACKGROUND
Program decision-making for trachoma elimination currently relies on conjunctival clinical signs. Antibody tests may provide additional information on the epidemiology of trachoma, particularly in regions where it is disappearing or elimination targets have been met.
METHODS
A cluster-randomized trial of mass azithromycin distribution strategies for trachoma elimination was conducted over three years in a mesoendemic region of Niger. Dried blood spots were collected from a random sample of children aged 1-5 years in each of 24 study communities at 36 months after initiation of the intervention. A multiplex bead assay was used to test for antibodies to two Chlamydia trachomatis antigens, Pgp3 and CT694. We compared seropositivity to either antigen to clinical signs of active trachoma (trachomatous inflammation-follicular [TF] and trachomatous inflammation-intense [TI]) at the individual and cluster level, and to ocular chlamydia prevalence at the community level.
RESULTS
Of 988 children with antibody data, TF prevalence was 7.8% (95% CI 6.1 to 9.5) and TI prevalence was 1.6% (95% CI 0.9 to 2.6). The overall prevalence of antibody positivity to Pgp3 was 27.2% (95% CI 24.5 to 30), and to CT694 was 23.7% (95% CI 21 to 26.2). Ocular chlamydia infection prevalence was 5.2% (95% CI 2.8 to 7.6). Seropositivity to Pgp3 and/or CT694 was significantly associated with TF at the individual and community level and with ocular chlamydia infection and TI at the community level. Older children were more likely to be seropositive than younger children.
CONCLUSION
Seropositivity to Pgp3 and CT694 correlates with clinical signs and ocular chlamydia infection in a mesoendemic region of Niger.
TRIAL REGISTRATION
ClinicalTrials.gov NCT00792922.
Identifiants
pubmed: 30689671
doi: 10.1371/journal.pntd.0007127
pii: PNTD-D-18-01612
pmc: PMC6366708
doi:
Substances chimiques
Anti-Bacterial Agents
0
Antibodies, Bacterial
0
Antigens, Bacterial
0
Bacterial Proteins
0
CT694 protein, Chlamydia trachomatis
0
DNA, Bacterial
0
pgp3 protein, Chlamydia
0
Azithromycin
83905-01-5
Banques de données
ClinicalTrials.gov
['NCT00792922']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0007127Subventions
Organisme : NIMH NIH HHS
ID : R25 MH083620
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Epidemiol Infect. 1999 Dec;123(3):479-86
pubmed: 10694161
Am J Trop Med Hyg. 2010 Mar;82(3):482-7
pubmed: 20207878
Invest Ophthalmol Vis Sci. 2011 Jul 29;52(8):6012-7
pubmed: 21693601
Invest Ophthalmol Vis Sci. 2011 Nov 11;52(12):8806-10
pubmed: 22025578
PLoS Negl Trop Dis. 2012;6(11):e1873
pubmed: 23133684
Ophthalmic Epidemiol. 2014 Apr;21(2):86-91
pubmed: 24621121
BMC Infect Dis. 2014 Apr 22;14:216
pubmed: 24755001
PLoS Negl Trop Dis. 2015 Feb 25;9(2):e0003555
pubmed: 25714363
PLoS Negl Trop Dis. 2015 Apr 22;9(4):e0003670
pubmed: 25901349
Sci Rep. 2015 Dec 21;5:18532
pubmed: 26687891
PLoS Negl Trop Dis. 2016 Jan 15;10(1):e0004352
pubmed: 26771906
PLoS Negl Trop Dis. 2016 Oct 26;10(10):e0005080
pubmed: 27783678
Clin Infect Dis. 2017 Mar 15;64(6):743-750
pubmed: 27956455
Diagn Microbiol Infect Dis. 2017 May;88(1):3-6
pubmed: 28214223
J Microbiol Methods. 2017 Aug;139:95-102
pubmed: 28487054
Invest Ophthalmol Vis Sci. 2017 Feb 1;58(2):997-1000
pubmed: 28535271
Br J Ophthalmol. 2018 May;102(5):680-686
pubmed: 28893761
PLoS Negl Trop Dis. 2017 Sep 12;11(9):e0005863
pubmed: 28898240
JAMA Ophthalmol. 2017 Nov 1;135(11):1141-1146
pubmed: 28973295
Am J Trop Med Hyg. 2017 Dec;97(6):1662-1668
pubmed: 29016320
Sci Rep. 2017 Nov 8;7(1):15040
pubmed: 29118442
Am J Trop Med Hyg. 2018 Feb;98(2):389-395
pubmed: 29260659
Sci Rep. 2018 Feb 23;8(1):3520
pubmed: 29476106
Sci Rep. 2018 Mar 9;8(1):4232
pubmed: 29523810
Wellcome Open Res. 2018 Feb 22;3:14
pubmed: 29588922
Bull World Health Organ. 1987;65(4):477-83
pubmed: 3500800