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.
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.
Authors: Victor H Hu; Patrick Massae; Helen A Weiss; Caroline Chevallier; Jecinta J Onyango; Isaac A Afwamba; David C W Mabey; Robin L Bailey; Matthew J Burton Journal: Invest Ophthalmol Vis Sci Date: 2011-04-06 Impact factor: 4.799
Authors: Anthony W Solomon; Zeena Mohammed; Patrick A Massae; John F Shao; Allen Foster; David C W Mabey; Rosanna W Peeling Journal: Antimicrob Agents Chemother Date: 2005-11 Impact factor: 5.191
Authors: Emma M Harding-Esch; Tansy Edwards; Ansumana Sillah; Isatou Sarr; Chrissy H Roberts; Paul Snell; Esther Aryee; Sandra Molina; Martin J Holland; David C W Mabey; Robin L Bailey Journal: PLoS Negl Trop Dis Date: 2009-12-22
Authors: Isobel M Blake; Matthew J Burton; Anthony W Solomon; Sheila K West; María-Gloria Basáñez; Manoj Gambhir; Robin L Bailey; David C W Mabey; Nicholas C Grassly Journal: PLoS Negl Trop Dis Date: 2010-11-02
Authors: Manoj Gambhir; Maria-Gloria Basáñez; Matthew J Burton; Anthony W Solomon; Robin L Bailey; Martin J Holland; Isobel M Blake; Christl A Donnelly; Ibrahim Jabr; David C Mabey; Nicholas C Grassly Journal: PLoS Negl Trop Dis Date: 2009-06-16