Monitoring transmission intensity of trachoma with serology

Christine Tedijanto, Anthony W. Solomon, Diana L. Martin, Scott D. Nash, Jeremy D. Keenan, Thomas M. Lietman, Patrick J. Lammie, Kristen Aiemjoy, Abdou Amza, Solomon Aragie, Ahmed M. Arzika, E. Kelly Callahan, Sydney Carolan, Adisu Abebe Dawed, E. Brook Goodhew, Sarah Gwyn, Jaouad Hammou, Boubacar Kadri, Khumbo Kalua, Ramatou Maliki, Beido Nassirou, Fikre Seife, Zerihun Tadesse, Sheila K. West, Dionna M. Wittberg, Taye Zeru Tadege and Benjamin F. Arnold ()
Additional contact information
Christine Tedijanto: University of California San Francisco
Anthony W. Solomon: World Health Organization
Diana L. Martin: Centers for Disease Control and Prevention
Scott D. Nash: The Carter Center
Jeremy D. Keenan: University of California San Francisco
Thomas M. Lietman: University of California San Francisco
Patrick J. Lammie: Task Force for Global Health
Kristen Aiemjoy: University of California Davis School of Medicine
Abdou Amza: Programme National de Santé Oculaire
Solomon Aragie: University of California San Francisco
Ahmed M. Arzika: The Carter Center Niger
E. Kelly Callahan: The Carter Center
Sydney Carolan: University of California San Francisco
Adisu Abebe Dawed: Amhara Regional Health Bureau
E. Brook Goodhew: Centers for Disease Control and Prevention
Sarah Gwyn: Centers for Disease Control and Prevention
Jaouad Hammou: Ministry of Health
Boubacar Kadri: Programme National de Santé Oculaire
Khumbo Kalua: Blantyre Institute for Community Outreach
Ramatou Maliki: The Carter Center Niger
Beido Nassirou: Programme National de Santé Oculaire
Fikre Seife: Federal Ministry of Health
Zerihun Tadesse: The Carter Center Ethiopia
Sheila K. West: Wilmer Eye Institute
Dionna M. Wittberg: University of California San Francisco
Taye Zeru Tadege: Amhara Public Health Institute
Benjamin F. Arnold: University of California San Francisco

Nature Communications, 2023, vol. 14, issue 1, 1-12

Abstract: Abstract Trachoma, caused by ocular Chlamydia trachomatis infection, is targeted for global elimination as a public health problem by 2030. To provide evidence for use of antibodies to monitor C. trachomatis transmission, we collated IgG responses to Pgp3 antigen, PCR positivity, and clinical observations from 19,811 children aged 1–9 years in 14 populations. We demonstrate that age-seroprevalence curves consistently shift along a gradient of transmission intensity: rising steeply in populations with high levels of infection and active trachoma and becoming flat in populations near elimination. Seroprevalence (range: 0–54%) and seroconversion rates (range: 0–15 per 100 person-years) correlate with PCR prevalence (r: 0.87, 95% CI: 0.57, 0.97). A seroprevalence threshold of 13.5% (seroconversion rate 2.75 per 100 person-years) identifies clusters with any PCR-identified infection at high sensitivity ( >90%) and moderate specificity (69–75%). Antibody responses in young children provide a robust, generalizable approach to monitor population progress toward and beyond trachoma elimination.

Date: 2023
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DOI: 10.1038/s41467-023-38940-5

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