Strategies for control of trachoma: observational study with quantitative PCR


Solomon, AW; Holland, MJ; Burton, MJ; West, SK; Alexander, ND; Aguirre, A; Massae, PA; Mkocha, H; Munoz, B; Johnson, GJ; Peeling, RW; Bailey, RL; Foster, A; Mabey, DC; (2003) Strategies for control of trachoma: observational study with quantitative PCR. Lancet, 362 (9379). pp. 198-204. ISSN 0140-6736 DOI: 10.1016/S0140-6736(03)13909-8

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Abstract

Background Antibiotics are an important part of WHO's strategy to eliminate trachoma as a blinding disease by 2020. At present, who needs to be treated is unclear. We aimed to establish the burden of ocular Chlamydia trachomatis in three trachoma-endemic communities in Tanzania and The Gambia with real-time quantitative PCR.Methods Conjunctival swabs were obtained at examination from 3146 individuals. Swabs were first tested by the qualitative Amplicor PCR, which is known to be highly sensitive. In positive samples, the number of copies of omp1 (a single-copy C trachomatis gene) was measured by quantitative PCR.Findings Children had the highest ocular loads of C trachomatis, although the amount of pooling in young age groups was less striking at the site with the lowest trachoma frequency. Individuals with intense inflammatory trachoma had higher loads than did those with other conjunctival signs. At the site with the highest prevalence of trachoma, 48 of 93 (52%) individuals with conjunctival scarring but no sign of active disease were positive for ocular chlamydiae.Interpretation Children younger than 10 years old, and those with intense inflammatory trachoma, probably represent the major source of ocular C trachomatis infection in endemic communities. Success of antibiotic distribution programmes could depend on these groups receiving effective treatment.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Malaria Centre
Neglected Tropical Diseases Network
Tropical Epidemiology Group
The International Centre for Evidence in Disability
International Centre for Eye Health
PubMed ID: 12885481
Web of Science ID: 184232000010
URI: http://researchonline.lshtm.ac.uk/id/eprint/16213

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