A national survey integrating clinical, laboratory, and WASH data to determine the typology of trachoma in Nauru
Background The epidemiology of trachoma in several Pacific Islands differs from other endemic settings, in that there is a high prevalence of clinical signs of trachoma, particularly trachomatous inflammation—follicular (TF), but few cases of trichiasis and limited evidence of ocular chlamydial infe...
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ftdoajarticles:oai:doaj.org/article:bc43e7740760408bb8b1bd025ef9db3a 2023-05-15T15:14:37+02:00 A national survey integrating clinical, laboratory, and WASH data to determine the typology of trachoma in Nauru Kathleen D. Lynch Sue Chen Apadinuwe Stephen B. Lambert Tessa Hillgrove Mitchell Starr Beth Catlett Robert S. Ware Anasaini Cama Sara Webster Emma M. Harding-Esch Ana Bakhtiari Robert Butcher Philip Cunningham Diana Martin Sarah Gwyn Anthony W. Solomon Chandalene Garabwan John M. Kaldor Susana Vaz Nery 2022-04-01T00:00:00Z https://doaj.org/article/bc43e7740760408bb8b1bd025ef9db3a EN eng Public Library of Science (PLoS) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9017947/?tool=EBI https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 https://doaj.org/article/bc43e7740760408bb8b1bd025ef9db3a PLoS Neglected Tropical Diseases, Vol 16, Iss 4 (2022) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2022 ftdoajarticles 2022-12-30T22:19:54Z Background The epidemiology of trachoma in several Pacific Islands differs from other endemic settings, in that there is a high prevalence of clinical signs of trachoma, particularly trachomatous inflammation—follicular (TF), but few cases of trichiasis and limited evidence of ocular chlamydial infection. This so-called “Pacific enigma” has led to uncertainty regarding the appropriate public health response. In 2019 alongside Nauru’s national trachoma population survey, we performed bacteriological and serological assessments of children to better understand the typology of trachoma and to determine whether there is a need for trachoma interventions. Methods We used two-stage cluster sampling, examining residents aged ≥1 year and collecting household-level water, sanitation, and hygiene (WASH) variables. Children aged 1–9 years provided conjunctival swabs and finger-prick dried blood spots to investigate the presence of Chlamydia trachomatis nucleic acid and anti-Pgp3 antibodies, respectively. Principal Findings In 818 participants aged 1–9 years, the age-adjusted TF prevalence was 21.8% (95% CI 15.2–26.2%); ocular C. trachomatis prevalence was 34.5% (95% CI 30.6–38.9), and anti-Pgp3 antibody prevalence was 32.1% (95% CI 28.4%–36.3%). The age- and gender-adjusted prevalence of trichiasis in ≥15-year-olds was 0.3% (95% CI 0.00–0.85), but no individual with trichiasis had trachomatous scarring (TS). Multivariable analysis showed an association between age and both TF (OR per year of age 1.3 [95% CI 1.2–1.4]) and anti-Pgp3 positivity (OR 1.2 [95% CI 1.2–1.3]). There were high rates of access to water and sanitation and no WASH variable was associated with the presence of TF. Conclusions TF, nucleic acid, and age-specific antibody prevalence collectively indicate that high levels of C. trachomatis transmission among children present a high risk of ocular damage due to trachoma. The absence of trichiasis with trachomatous scarring suggest a relatively recent increase in transmission intensity. Author summary In ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Pacific |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Kathleen D. Lynch Sue Chen Apadinuwe Stephen B. Lambert Tessa Hillgrove Mitchell Starr Beth Catlett Robert S. Ware Anasaini Cama Sara Webster Emma M. Harding-Esch Ana Bakhtiari Robert Butcher Philip Cunningham Diana Martin Sarah Gwyn Anthony W. Solomon Chandalene Garabwan John M. Kaldor Susana Vaz Nery A national survey integrating clinical, laboratory, and WASH data to determine the typology of trachoma in Nauru |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background The epidemiology of trachoma in several Pacific Islands differs from other endemic settings, in that there is a high prevalence of clinical signs of trachoma, particularly trachomatous inflammation—follicular (TF), but few cases of trichiasis and limited evidence of ocular chlamydial infection. This so-called “Pacific enigma” has led to uncertainty regarding the appropriate public health response. In 2019 alongside Nauru’s national trachoma population survey, we performed bacteriological and serological assessments of children to better understand the typology of trachoma and to determine whether there is a need for trachoma interventions. Methods We used two-stage cluster sampling, examining residents aged ≥1 year and collecting household-level water, sanitation, and hygiene (WASH) variables. Children aged 1–9 years provided conjunctival swabs and finger-prick dried blood spots to investigate the presence of Chlamydia trachomatis nucleic acid and anti-Pgp3 antibodies, respectively. Principal Findings In 818 participants aged 1–9 years, the age-adjusted TF prevalence was 21.8% (95% CI 15.2–26.2%); ocular C. trachomatis prevalence was 34.5% (95% CI 30.6–38.9), and anti-Pgp3 antibody prevalence was 32.1% (95% CI 28.4%–36.3%). The age- and gender-adjusted prevalence of trichiasis in ≥15-year-olds was 0.3% (95% CI 0.00–0.85), but no individual with trichiasis had trachomatous scarring (TS). Multivariable analysis showed an association between age and both TF (OR per year of age 1.3 [95% CI 1.2–1.4]) and anti-Pgp3 positivity (OR 1.2 [95% CI 1.2–1.3]). There were high rates of access to water and sanitation and no WASH variable was associated with the presence of TF. Conclusions TF, nucleic acid, and age-specific antibody prevalence collectively indicate that high levels of C. trachomatis transmission among children present a high risk of ocular damage due to trachoma. The absence of trichiasis with trachomatous scarring suggest a relatively recent increase in transmission intensity. Author summary In ... |
format |
Article in Journal/Newspaper |
author |
Kathleen D. Lynch Sue Chen Apadinuwe Stephen B. Lambert Tessa Hillgrove Mitchell Starr Beth Catlett Robert S. Ware Anasaini Cama Sara Webster Emma M. Harding-Esch Ana Bakhtiari Robert Butcher Philip Cunningham Diana Martin Sarah Gwyn Anthony W. Solomon Chandalene Garabwan John M. Kaldor Susana Vaz Nery |
author_facet |
Kathleen D. Lynch Sue Chen Apadinuwe Stephen B. Lambert Tessa Hillgrove Mitchell Starr Beth Catlett Robert S. Ware Anasaini Cama Sara Webster Emma M. Harding-Esch Ana Bakhtiari Robert Butcher Philip Cunningham Diana Martin Sarah Gwyn Anthony W. Solomon Chandalene Garabwan John M. Kaldor Susana Vaz Nery |
author_sort |
Kathleen D. Lynch |
title |
A national survey integrating clinical, laboratory, and WASH data to determine the typology of trachoma in Nauru |
title_short |
A national survey integrating clinical, laboratory, and WASH data to determine the typology of trachoma in Nauru |
title_full |
A national survey integrating clinical, laboratory, and WASH data to determine the typology of trachoma in Nauru |
title_fullStr |
A national survey integrating clinical, laboratory, and WASH data to determine the typology of trachoma in Nauru |
title_full_unstemmed |
A national survey integrating clinical, laboratory, and WASH data to determine the typology of trachoma in Nauru |
title_sort |
national survey integrating clinical, laboratory, and wash data to determine the typology of trachoma in nauru |
publisher |
Public Library of Science (PLoS) |
publishDate |
2022 |
url |
https://doaj.org/article/bc43e7740760408bb8b1bd025ef9db3a |
geographic |
Arctic Pacific |
geographic_facet |
Arctic Pacific |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 16, Iss 4 (2022) |
op_relation |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9017947/?tool=EBI https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 https://doaj.org/article/bc43e7740760408bb8b1bd025ef9db3a |
_version_ |
1766345046341189632 |