Ocular Chlamydia trachomatis infection and infectious load among pre-school aged children within trachoma hyperendemic districts receiving the SAFE strategy, Amhara region, Ethiopia.


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:
05 2020
Historique:
received: 22 10 2019
accepted: 17 03 2020
revised: 29 05 2020
pubmed: 19 5 2020
medline: 18 7 2020
entrez: 19 5 2020
Statut: epublish

Résumé

After approximately 5 years of SAFE (surgery, antibiotics, facial cleanliness, environmental improvement) interventions for trachoma, hyperendemic (trachomatous inflammation-follicular (TF) ≥30%) districts remained in Amhara, Ethiopia. This study's aim was to characterize the epidemiology of Chlamydia trachomatis (Ct) infection and load among pre-school aged children living under the SAFE strategy. Conjunctival swabs from a population-based sample of children aged 1-5 years collected between 2011 and 2015 were assayed to provide Ct infection data from 4 endemic zones (comprised of 58 districts). Ct load was determined using a calibration curve. Children were graded for TF and trachomatous inflammation-intense (TI). 7,441 children were swabbed in 4 zones. TF and TI prevalence were 39.9% (95% confidence Interval [CI]: 37.5%, 42.4%), and 9.2% (95% CI: 8.1%, 10.3%) respectively. Ct infection prevalence was 6.0% (95% CI: 5.0%, 7.2%). Infection was highest among children aged 2 to 4 years (6.6%-7.0%). Approximately 10% of infection occurred among children aged 1 year. Ct load decreased with age (P = 0.002), with the highest loads observed in children aged 1 year (P = 0.01) vs. aged 5 years. Participants with TF (P = 0.20) and TI (P<0.01) had loads greater than individuals without active trachoma. In this hyperendemic setting, it appears that the youngest children may contribute in meaningful ways towards persistent active trachoma.

Sections du résumé

BACKGROUND
After approximately 5 years of SAFE (surgery, antibiotics, facial cleanliness, environmental improvement) interventions for trachoma, hyperendemic (trachomatous inflammation-follicular (TF) ≥30%) districts remained in Amhara, Ethiopia. This study's aim was to characterize the epidemiology of Chlamydia trachomatis (Ct) infection and load among pre-school aged children living under the SAFE strategy.
METHODS
Conjunctival swabs from a population-based sample of children aged 1-5 years collected between 2011 and 2015 were assayed to provide Ct infection data from 4 endemic zones (comprised of 58 districts). Ct load was determined using a calibration curve. Children were graded for TF and trachomatous inflammation-intense (TI).
RESULTS
7,441 children were swabbed in 4 zones. TF and TI prevalence were 39.9% (95% confidence Interval [CI]: 37.5%, 42.4%), and 9.2% (95% CI: 8.1%, 10.3%) respectively. Ct infection prevalence was 6.0% (95% CI: 5.0%, 7.2%). Infection was highest among children aged 2 to 4 years (6.6%-7.0%). Approximately 10% of infection occurred among children aged 1 year. Ct load decreased with age (P = 0.002), with the highest loads observed in children aged 1 year (P = 0.01) vs. aged 5 years. Participants with TF (P = 0.20) and TI (P<0.01) had loads greater than individuals without active trachoma.
CONCLUSIONS
In this hyperendemic setting, it appears that the youngest children may contribute in meaningful ways towards persistent active trachoma.

Identifiants

pubmed: 32421719
doi: 10.1371/journal.pntd.0008226
pii: PNTD-D-19-01732
pmc: PMC7259799
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0008226

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Scott D Nash (SD)

Trachoma Control Program, The Carter Center, Atlanta, United States of America.

Ambahun Chernet (A)

Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia.

Jeanne Moncada (J)

Department of Laboratory Medicine, University of California, San Francisco, United States of America.

Aisha E P Stewart (AEP)

Trachoma Control Program, The Carter Center, Atlanta, United States of America.

Tigist Astale (T)

Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia.

Eshetu Sata (E)

Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia.

Mulat Zerihun (M)

Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia.

Demelash Gessese (D)

Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia.

Berhanu Melak (B)

Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia.

Gedefaw Ayenew (G)

Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia.

Zebene Ayele (Z)

Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia.

Melsew Chanyalew (M)

Health Promotion and Disease Prevention Core Process, Amhara Regional Health Bureau, Bahir Dar, Ethiopia.

Thomas M Lietman (TM)

Francis I. Proctor Foundation, University of California, San Francisco, United States of America.

E Kelly Callahan (EK)

Trachoma Control Program, The Carter Center, Atlanta, United States of America.

Julius Schachter (J)

Department of Laboratory Medicine, University of California, San Francisco, United States of America.

Zerihun Tadesse (Z)

Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia.

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Classifications MeSH