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.
journal_name
Nat Communjournal_title
Nature communicationsauthors
Pinsent A,Solomon AW,Bailey RL,Bid R,Cama A,Dean D,Goodhew B,Gwyn SE,Jack KR,Kandel RP,Kama M,Massae P,Macleod C,Mabey DCW,Migchelsen S,Müller A,Sandi F,Sokana O,Taoaba R,Tekeraoi R,Martin DL,White MTdoi
10.1038/s41467-018-07852-0subject
Has Abstractpub_date
2018-12-21 00:00:00pages
5444issue
1issn
2041-1723pii
10.1038/s41467-018-07852-0journal_volume
9pub_type
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