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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Active trachoma and ocular Chlamydia trachomatis infection in two gambian regions: On course for elimination by 2020?
PLoS Neglected Tropical Diseases, Volume 3, No. 12, Article e573, Year 2009
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Description
Background: Trachoma has been endemic in The Gambia for decades. National trachoma control activities have been in place since the mid-1980's, but with no mass antibiotic treatment campaign. We aimed to assess the prevalence of active trachoma and of actual ocular Chlamydia trachomatis infection as measured by polymerase chain reaction (PCR) in the two Gambian regions that had had the highest prevalence of trachoma in the last national survey in 1996 prior to planned national mass antibiotic treatment distribution in 2006. Methodology/Principal Findings: Two stage random sampling survey in 61 randomly selected Enumeration Areas (EAs) in North Bank Region (NBR) and Lower River Region (LRR). Fifty randomly selected children aged under 10 years were examined per EA for clinical signs of trachoma. In LRR, swabs were taken to test for ocular C. trachomatis infection. Unadjusted prevalences of active trachoma were calculated, as would be done in a trachoma control programme. The prevalence of trachomatous inflammation, follicular (TF) in the 2777 children aged 1-9 years was 12.3% (95% CI 8.8%-17.0%) in LRR and 10.0% (95% CI 7.7%-13.0%) in NBR, with significant variation within divisions (p<0.01), and a design effect of 3.474. Infection with C. trachomatis was found in only 0.3% (3/940) of children in LRR. Conclusions/Significance: This study shows a large discrepancy between the prevalence of trachoma clinical signs and ocular C. trachomatis infection in two Gambian regions. Assessment of trachoma based on clinical signs alone may lead to unnecessary treatment, since the prevalence of active trachoma remains high but C. trachomatis infection has all but disappeared. Assuming that repeated infection is required for progression to blinding sequelae, blinding trachoma is on course for elimination by 2020 in The Gambia. © 2009 Harding-Esch et al.
Authors & Co-Authors
Harding-Esch, Emma Michele
Unknown Affiliation
Edwards, Tansy
Unknown Affiliation
Sillah, Ansumana
Unknown Affiliation
Sarr, Isatou
Unknown Affiliation
Roberts, Chrissy H.
Unknown Affiliation
Snell, Paul C.
Unknown Affiliation
Aryee, Esther
Unknown Affiliation
Molina, Sandra
Unknown Affiliation
Holland, Martin J.
Unknown Affiliation
Mabey, David C.W.
Unknown Affiliation
Bailey, Robin L.
Unknown Affiliation
Statistics
Citations: 52
Authors: 11
Affiliations: 5
Identifiers
Doi:
10.1371/journal.pntd.0000573
Research Areas
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Gambia