Characterizing trachoma elimination using serology

Everlyn Kamau (), Pearl Anne Ante-Testard, Sarah Gwyn, Seth Blumberg, Zeinab Abdalla, Kristen Aiemjoy, Abdou Amza, Solomon Aragie, Ahmed M. Arzika, Marcel S. Awoussi, Robin L. Bailey, Robert Butcher, E. Kelly Callahan, David Chaima, Adisu Abebe Dawed, Martha Idalí Saboyá Díaz, Abou-Bakr Sidik Domingo, Chris Drakeley, Belgesa E. Elshafie, Paul M. Emerson, Kimberly Fornace, Katherine Gass, E. Brook Goodhew, Jaouad Hammou, Emma M. Harding-Esch, Hooper Pj, Boubacar Kadri, Khumbo Kalua, Sarjo Kanyi, Mabula Kasubi, Amir B. Kello, Robert Ko, Patrick J. Lammie, Andres G. Lescano, Ramatou Maliki, Michael Peter Masika, Stephanie J. Migchelsen, Beido Nassirou, John M. Nesemann, Nishanth Parameswaran, Willie Pomat, Kristen K. Renneker, Chrissy Roberts, Prudence Rymil, Eshetu Sata, Laura Senyonjo, Fikre Seife, Ansumana Sillah, Oliver Sokana, Ariktha Srivathsan, Zerihun Tadesse, Fasihah Taleo, Emma Michelle Taylor, Rabebe Tekeraoi, Kwamy Togbey, Sheila K. West, Karana Wickens, Timothy William, Dionna M. Wittberg, Dorothy Yeboah-Manu, Mohammed Youbi, Taye Zeru, Jeremy D. Keenan, Thomas M. Lietman, Anthony W. Solomon, Scott D. Nash, Diana L. Martin and Benjamin F. Arnold
Additional contact information
Everlyn Kamau: University of California San Francisco
Pearl Anne Ante-Testard: University of California San Francisco
Sarah Gwyn: Centers for Disease Control and Prevention
Seth Blumberg: University of California San Francisco
Zeinab Abdalla: The Carter Center
Kristen Aiemjoy: University of California Davis CA
Abdou Amza: Programme National de Lutte Contre la Cecité
Solomon Aragie: University of California San Francisco
Ahmed M. Arzika: CRISP
Marcel S. Awoussi: Ministère de la Santé et de L’Hygiène Publique
Robin L. Bailey: London School of Hygiene & Tropical Medicine
Robert Butcher: London School of Hygiene & Tropical Medicine
E. Kelly Callahan: The Carter Center
David Chaima: Kamuzu University of Health Sciences
Adisu Abebe Dawed: Amhara Regional Health Bureau
Martha Idalí Saboyá Díaz: Pan American Health Organization
Abou-Bakr Sidik Domingo: Ministère de la Santé et de L’Hygiène Publique
Chris Drakeley: London School of Hygiene & Tropical Medicine
Belgesa E. Elshafie: Ministry of Health
Paul M. Emerson: International Trachoma Initiative
Kimberly Fornace: National University of Singapore
Katherine Gass: Task Force for Global Health
E. Brook Goodhew: Centers for Disease Control and Prevention
Jaouad Hammou: Direction de l’Epidemiologie et de Lutte contre les Maladies
Emma M. Harding-Esch: London School of Hygiene & Tropical Medicine
Hooper Pj: International Trachoma Initiative
Boubacar Kadri: The Carter Center
Khumbo Kalua: University of British Columbia
Sarjo Kanyi: Ministry of Health
Mabula Kasubi: Muhimbili Medical Center
Amir B. Kello: World Health Organization Regional Office for Africa
Robert Ko: Port Moresby
Patrick J. Lammie: Task Force for Global Health
Andres G. Lescano: Universidad Peruana Cayetano Heredia
Ramatou Maliki: The Carter Center
Michael Peter Masika: Ministry of Health
Stephanie J. Migchelsen: London School of Hygiene & Tropical Medicine
Beido Nassirou: The Carter Center
John M. Nesemann: University of California San Francisco
Nishanth Parameswaran: Centers for Disease Control and Prevention
Willie Pomat: Port Moresby
Kristen K. Renneker: International Trachoma Initiative
Chrissy Roberts: London School of Hygiene & Tropical Medicine
Prudence Rymil: Ministry of Health
Eshetu Sata: University of California Davis CA
Laura Senyonjo: Sightsavers
Fikre Seife: Federal Ministry of Health
Ansumana Sillah: Ministry of Health
Oliver Sokana: Solomon Islands Ministry of Health and Medical Services
Ariktha Srivathsan: University of California San Francisco
Zerihun Tadesse: University of California Davis CA
Fasihah Taleo: World Health Organization
Emma Michelle Taylor: Sightsavers
Rabebe Tekeraoi: Ministry of Health and Medical Services
Kwamy Togbey: Ministère de la Santé et de L’Hygiène Publique
Sheila K. West: Johns Hopkins University
Karana Wickens: Centers for Disease Control and Prevention
Timothy William: Subang Jaya Medical Centre
Dionna M. Wittberg: University of California San Francisco
Dorothy Yeboah-Manu: University of Ghana
Mohammed Youbi: Direction de l’Epidemiologie et de Lutte contre les Maladies
Taye Zeru: Amhara Public Health Institute
Jeremy D. Keenan: University of California San Francisco
Thomas M. Lietman: University of California San Francisco
Anthony W. Solomon: World Health Organization
Scott D. Nash: The Carter Center
Diana L. Martin: Centers for Disease Control and Prevention
Benjamin F. Arnold: University of California San Francisco

Nature Communications, 2025, vol. 16, issue 1, 1-14

Abstract: Abstract Trachoma is targeted for global elimination as a public health problem by 2030. Measurement of IgG antibodies in children is being considered for surveillance and programmatic decision-making. There are currently no programmatic guidelines based on serology, which represents a generalizable problem in seroepidemiology and disease elimination. Here, we collate Chlamydia trachomatis Pgp3 and CT694 IgG measurements from 48 serosurveys across Africa, Latin America, and the Pacific Islands (41,168 children ages 1–5 years) and propose a novel approach to estimate the probability that population C. trachomatis transmission is below or above levels requiring ongoing programmatic action. We determine that trachoma programs could halt control measures with >90% certainty when seroconversion rates (SCRs) are ≤2.2 per 100 person-years. Conversely, SCRs ≥4.5 per 100 person-years correspond with >90% certainty that further control interventions are needed. More extreme SCR thresholds correspond with higher levels of confidence of elimination (lower SCR) or ongoing action needed (higher SCR). This study demonstrates a robust approach for using trachoma serosurveys to guide elimination program decisions.

Date: 2025
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DOI: 10.1038/s41467-025-60581-z

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