The utility of serology for elimination surveillance of trachoma

Amy Pinsent (), Anthony W. Solomon, Robin L. Bailey, Rhiannon Bid, Anaseini Cama, Deborah Dean, Brook Goodhew, Sarah E. Gwyn, Kelvin R. Jack, Ram Prasad Kandel, Mike Kama, Patrick Massae, Colin Macleod, David C. W. Mabey, Stephanie Migchelsen, Andreas Müller, Frank Sandi, Oliver Sokana, Raebwebwe Taoaba, Rabebe Tekeraoi, Diana L. Martin and Michael. T. White
Additional contact information
Amy Pinsent: Monash University
Anthony W. Solomon: World Health Organization
Robin L. Bailey: London School of Hygiene & Tropical Medicine
Rhiannon Bid: London School of Hygiene & Tropical Medicine
Anaseini Cama: International Agency for the Prevention of Blindness, Western Pacific Region
Deborah Dean: UCSF Benioff Children’s Hospital Oakland Research Institute
Brook Goodhew: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention
Sarah E. Gwyn: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention
Kelvin R. Jack: Ministry of Health
Ram Prasad Kandel: Lumini Eye Hospital
Mike Kama: Ministry of Health
Patrick Massae: Kilimanjaro Christian Medical Centre
Colin Macleod: London School of Hygiene & Tropical Medicine
David C. W. Mabey: London School of Hygiene & Tropical Medicine
Stephanie Migchelsen: London School of Hygiene & Tropical Medicine
Andreas Müller: Centre for Eye Research Australia
Frank Sandi: Kilimanjaro Christian Medical Centre
Oliver Sokana: Ministry of Health
Raebwebwe Taoaba: Ministry of Health and Medical Services
Rabebe Tekeraoi: Ministry of Health and Medical Services
Diana L. Martin: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention
Michael. T. White: Malaria: Parasites & Hosts, Department of Parasites and Insect Vectors, Institut Pasteur

Nature Communications, 2018, vol. 9, issue 1, 1-9

Abstract: Abstract Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. Here, we analyse data from nine trachoma-endemic populations and provide operational thresholds for interpretation of serological data in low-transmission and post-elimination settings. Analyses with sero-catalytic and antibody acquisition models provide insights into transmission history within each population. To accurately estimate sero-conversion rates (SCR) for trachoma in populations with high-seroprevalence in adults, the model accounts for secondary exposure to Chlamydia trachomatis due to urogenital infection. We estimate the population half-life of sero-reversion for anti-Pgp3 antibodies to be 26 (95% credible interval (CrI): 21–34) years. We show SCRs below 0.015 (95% confidence interval (CI): 0.0–0.049) per year correspond to a prevalence of trachomatous inflammation—follicular below 5%, the current threshold for elimination of active trachoma as a public health problem. As global trachoma prevalence declines, we may need cross-sectional serological survey data to inform programmatic decisions.

Date: 2018
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DOI: 10.1038/s41467-018-07852-0

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