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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Association between Ocular Bacterial Carriage and Follicular Trachoma Following Mass Azithromycin Distribution in The Gambia
PLoS Neglected Tropical Diseases, Volume 7, No. 7, Article e2347, Year 2013
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Description
Background:Trachoma, caused by ocular Chlamydia trachomatis infection, is the leading infectious cause of blindess, but its prevalence is now falling in many countries. As the prevalence falls, an increasing proportion of individuals with clinical signs of follicular trachoma (TF) is not infected with C. trachomatis. A recent study in Tanzania suggested that other bacteria may play a role in the persistence of these clinical signs.Methodology/Principal Findings:We examined associations between clinical signs of TF and ocular colonization with four pathogens commonly found in the nasopharnyx, three years after the initiation of mass azithromycin distribution. Children aged 0 to 5 years were randomly selected from 16 Gambian communitites. Both eyes of each child were examined and graded for trachoma according to the World Health Organization (WHO) simplified system. Two swabs were taken from the right eye: one swab was processed for polymerase chain reaction (PCR) using the Amplicor test for detection of C. trachomatis DNA and the second swab was processed by routine bacteriology to assay for the presence of viable Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus and Moraxella catarrhalis. Prevalence of TF was 6.2% (96/1538) while prevalence of ocular C. trachomatis infection was 1.0% (16/1538). After adjustment, increased odds of TF were observed in the presence of C. trachomatis (OR = 10.4, 95%CI 1.32-81.2, p = 0.03), S. pneumoniae (OR = 2.14, 95%CI 1.03-4.44, p = 0.04) and H. influenzae (OR = 4.72, 95% CI 1.53-14.5, p = 0.01).Conclusions/Significance:Clinical signs of TF can persist in communities even when ocular C. trachomatis infection has been controlled through mass azithromycin distribution. In these settings, TF may be associated with ocular colonization with bacteria commonly carried in the nasopharnyx. This may affect the interpretation of impact surveys and the determinations of thresholds for discontinuing mass drug administration. © 2013 Burr et al.
Authors & Co-Authors
Burr, Sarah
Unknown Affiliation
Hart, John
Unknown Affiliation
Edwards, Tansy
Unknown Affiliation
Baldeh, Ignatius
Unknown Affiliation
Bojang, Ebrima
Unknown Affiliation
Harding-Esch, Emma Michele
Unknown Affiliation
Holland, Martin J.
Unknown Affiliation
Lietman, Thomas M.
Unknown Affiliation
Vos, Theo K.
Unknown Affiliation
Mabey, David C.W.
Unknown Affiliation
Sillah, Ansumana
Unknown Affiliation
Bailey, Robin L.
Unknown Affiliation
Statistics
Citations: 35
Authors: 12
Affiliations: 6
Identifiers
Doi:
10.1371/journal.pntd.0002347
ISSN:
19352727
e-ISSN:
19352735
Research Areas
Genetics And Genomics
Health System And Policy
Maternal And Child Health
Study Design
Cross Sectional Study
Study Locations
Gambia
Tanzania