Conjunctival Scarring, Corneal Pannus, and Herbert's Pits in Adolescent Children in Trachoma-endemic Populations of the Solomon Islands and Vanuatu.
Herbert’s pits
conjunctival scarring
corneal pannus
trachoma
Journal
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213
Informations de publication
Date de publication:
02 11 2021
02 11 2021
Historique:
received:
21
02
2020
pubmed:
11
8
2020
medline:
11
11
2021
entrez:
11
8
2020
Statut:
ppublish
Résumé
In the Solomon Islands and Vanuatu, the sign trachomatous inflammation-follicular (TF) is common, but ocular infection with Chlamydia trachomatis is not. It is therefore debatable whether azithromycin mass drug administration (MDA), the recommended antibiotic treatment strategy for trachoma's elimination as a public health problem, is necessary in this setting. We set out to estimate what proportion of adolescents were at risk of progression of trachomatous scarring. A cross-sectional survey was undertaken of all children aged 10-14 years resident in communities identified as high-TF clusters during previous population-based mapping. Graders examined children for clinical evidence of trachomatous scarring, pannus, and Herbert's pits (HPs) or limbal follicles in both eyes. A dried blood spot was collected from each child and tested for antibodies to C. trachomatis. A total of 492 children in 24 villages of the Solomon Islands and Vanuatu were examined. In total, 35/492 (7%) of children had limbal signs (pannus and/or HPs) plus any conjunctival scarring. And 9/492 (2%) had limbal signs and moderate or severe conjunctival scarring; 22% of children were anti-Pgp3 seropositive. Few adolescents here are at risk of future complications from trachoma, supporting the conclusion that further antibiotic MDA is not currently required for trachoma elimination purposes in these settings.
Sections du résumé
BACKGROUND
In the Solomon Islands and Vanuatu, the sign trachomatous inflammation-follicular (TF) is common, but ocular infection with Chlamydia trachomatis is not. It is therefore debatable whether azithromycin mass drug administration (MDA), the recommended antibiotic treatment strategy for trachoma's elimination as a public health problem, is necessary in this setting. We set out to estimate what proportion of adolescents were at risk of progression of trachomatous scarring.
METHODS
A cross-sectional survey was undertaken of all children aged 10-14 years resident in communities identified as high-TF clusters during previous population-based mapping. Graders examined children for clinical evidence of trachomatous scarring, pannus, and Herbert's pits (HPs) or limbal follicles in both eyes. A dried blood spot was collected from each child and tested for antibodies to C. trachomatis.
RESULTS
A total of 492 children in 24 villages of the Solomon Islands and Vanuatu were examined. In total, 35/492 (7%) of children had limbal signs (pannus and/or HPs) plus any conjunctival scarring. And 9/492 (2%) had limbal signs and moderate or severe conjunctival scarring; 22% of children were anti-Pgp3 seropositive.
CONCLUSIONS
Few adolescents here are at risk of future complications from trachoma, supporting the conclusion that further antibiotic MDA is not currently required for trachoma elimination purposes in these settings.
Identifiants
pubmed: 32776137
pii: 5890405
doi: 10.1093/cid/ciaa1151
pmc: PMC8563182
mid: EMS106909
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e2773-e2780Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Organisme : Fred Hollows Foundation
Organisme : Queen Elizabeth Diamond Jubilee Trust
Organisme : International Trachoma Initiative
Informations de copyright
© World Health Organization, 2020. All rights reserved. The World Health Organization has granted the Publisher permission for the reproduction of this article.
Références
PLoS Negl Trop Dis. 2009 Jun 16;3(6):e462
pubmed: 19529762
Lancet Glob Health. 2013 Dec;1(6):e339-49
pubmed: 25104599
PLoS Negl Trop Dis. 2016 Aug 02;10(8):e0004859
pubmed: 27483002
PLoS Negl Trop Dis. 2015 May 13;9(5):e0003763
pubmed: 25970613
Community Eye Health. 2017;30(100):90-91
pubmed: 29483755
Parasit Vectors. 2016 Jan 27;9:30
pubmed: 26812948
Bull World Health Organ. 1966;34(3):341-55
pubmed: 5296394
Wellcome Open Res. 2018 Feb 22;3:14
pubmed: 29588922
Trans Ophthalmol Soc U K. 1973;93(0):635-40
pubmed: 4526475
Ophthalmic Epidemiol. 2001 Jul;8(2-3):137-44
pubmed: 11471083
Ophthalmic Epidemiol. 2015;22(3):162-9
pubmed: 26158573
Am J Trop Med Hyg. 2006 Mar;74(3):505-8
pubmed: 16525114
Lancet. 1979 Aug 25;2(8139):377-80
pubmed: 89446
World Health Organ Tech Rep Ser. 1966;330:1-24
pubmed: 4956540
Ophthalmic Epidemiol. 2016;23(sup1):22-31
pubmed: 27893297
Eye (Lond). 1989;3 ( Pt 2):204-9
pubmed: 2620749
PLoS One. 2018 Nov 15;13(11):e0207393
pubmed: 30440006
PLoS Negl Trop Dis. 2016 Sep 07;10(9):e0004863
pubmed: 27603015
JAMA. 1986 Jun 27;255(24):3374-7
pubmed: 3712696
PLoS Negl Trop Dis. 2019 Aug 14;13(8):e0007638
pubmed: 31412025
PLoS Negl Trop Dis. 2012;6(11):e1873
pubmed: 23133684
J Infect. 2020 Apr;80(4):454-461
pubmed: 32017971
PLoS Negl Trop Dis. 2016 Jul 12;10(7):e0004798
pubmed: 27404379
BMJ Open. 2015 Apr 28;5(4):e007276
pubmed: 25922103
Rev Int Trach. 1958;35(3):295-304
pubmed: 13602388
PLoS Negl Trop Dis. 2017 Jan 24;11(1):e0005267
pubmed: 28118354
Sex Transm Dis. 2003 Apr;30(4):362-6
pubmed: 12671560
Ophthalmic Epidemiol. 2016;23(sup1):15-21
pubmed: 27937043
Br J Ophthalmol. 2019 Jul;103(7):878-884
pubmed: 30209084
Lancet. 2003 Jul 19;362(9379):198-204
pubmed: 12885481
Invest Ophthalmol Vis Sci. 2011 Apr 06;52(5):2181-6
pubmed: 21178143
Bull World Health Organ. 1987;65(4):477-83
pubmed: 3500800
Rev Int Trach. 1961;38:311-3
pubmed: 13738994