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Atekem K, Harding-Esch EM, Martin DL, Downs P, Palmer SL, Kaboré A, Kelly M, Bovary A, Sarr A, Nguessan K, James F, Gwyn S, Wickens K, Bakhtiari A, Boyd S, Aba A, Senyonjo L, Courtright P, Meite A. High prevalence of trachomatous inflammation-follicular with no trachomatous trichiasis: can alternative indicators explain the epidemiology of trachoma in Côte d'Ivoire? Int Health 2023; 15:ii3-ii11. [PMID: 38048384 PMCID: PMC10695457 DOI: 10.1093/inthealth/ihad069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 12/06/2023] Open
Abstract
Baseline trachoma surveys in Côte d'Ivoire (2019) identified seven evaluation units (EUs) with a trachomatous inflammation-follicular (TF) prevalence ≥10%, but a trachomatous trichiasis (TT) prevalence in individuals ≥15 y of age below the elimination threshold (0.2%). Two of these EUs, Bondoukou 1 and Bangolo 2, were selected for a follow-up survey to understand the epidemiology of trachoma using additional indicators of Chlamydia trachomatis infection (DNA from conjunctival swabs) and exposure (anti-Pgp3 and Ct694 antibodies from dried blood spots [DBSs]). A two-stage cluster sampling methodology was used to select villages and households. All individuals 1-9 y of age from each selected household were recruited, graded for trachoma and had a conjunctival swab and DBS collected. Conjunctival swabs and DBSs were tested using Cepheid GeneXpert and a multiplex bead assay, respectively. The age-adjusted TF and infection prevalence in 1- to 9-year-olds was <1% and <0.3% in both EUs. Age-adjusted seroprevalence was 5.3% (95% confidence interval [CI] 1.5 to 15.6) in Bondoukou 1 and 8.2% (95% CI 4.3 to 13.7) in Bangolo 2. The seroconversion rate for Pgp3 was low, at 1.23 seroconversions/100 children/year (95% CI 0.78 to 1.75) in Bondoukou 1 and 1.91 (95% CI 1.58 to 2.24) in Bangolo 2. Similar results were seen for CT694. These infection, antibody and clinical data provide strong evidence that trachoma is not a public health problem in either EU.
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Affiliation(s)
- Kareen Atekem
- Department of Entomology, Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA,USA
- Sightsavers
| | | | - Diana L Martin
- Centers for Disease Control and Prevention, Atlanta, GA,USA
| | | | | | | | | | | | | | | | | | - Sarah Gwyn
- Centers for Disease Control and Prevention, Atlanta, GA,USA
| | - Karana Wickens
- Oak Ridge Institute for Science and Education, Atlanta, GA,USA
| | - Ana Bakhtiari
- International Trachoma Initiative, Task Force for Global Health, Decatur, GA,USA
| | - Sarah Boyd
- International Trachoma Initiative, Task Force for Global Health, Decatur, GA,USA
| | | | | | - Paul Courtright
- Sightsavers
- Kilimanajaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
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Lynch KD, Brian G, Ahwang T, Morotti W, Wharton G, Newie T, Newie V, Perrett C, Ware W, Mosby L, Walters S, Brown A, Whop LJ, Lambert SB. Assessing the Prevalence of Trachoma: Lessons from Community Screening with Laboratory Testing in Australia's Torres Strait Islands. Ophthalmic Epidemiol 2023; 30:663-670. [PMID: 36281525 DOI: 10.1080/09286586.2022.2136389] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 10/08/2022] [Indexed: 10/31/2022]
Abstract
PURPOSE We undertook a screening program between 2016 and 2019 to determine if trachoma was endemic in the Torres Strait Islands of Queensland, Australia. METHODS Eleven screening surveys assessing trachoma prevalence were undertaken in seven communities using the World Health Organization (WHO) simplified grading tool. Additionally, an ophthalmologist performed a detailed clinical assessment including examination for Herbert's pits and corneal pannus and, where clinically indicated, collection of conjunctival specimens to investigate the presence of Chlamydia trachomatis nucleic acid. RESULTS Prevalence of trachomatous inflammation-follicular (TF) in children aged 5-9 years for the aggregated first survey across all communities was 6% (17/284). No child had trachomatous inflammation-intense, trachomatous scarring, corneal pannus, or Herbert's pits. Of the 66 times any child was tested for C. trachomatis by polymerase chain reaction (PCR), the result was negative. No cicatricial trachoma was identified amongst the adults (n = 186) who were opportunistically offered examination. CONCLUSION Whilst TF was present, the lack of intense inflammatory thickening in any child examined, the lack of end-stage trachomatous disease, and the lack of ocular C. trachomatis detection by PCR indicate trachoma is not endemic in the Torres Strait Islands, and no ongoing public health intervention is required. These findings add to a growing body of evidence suggesting that use of the WHO simplified grading tool alone in the peri-elimination setting may overestimate the community burden of trachoma.
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Affiliation(s)
- Kathleen D Lynch
- Communicable Diseases Branch, Prevention Division, Queensland Health, Brisbane, Australia
- UQ Centre for Clinical Research, the University of Queensland, Brisbane, Australia
| | - Garry Brian
- Communicable Diseases Branch, Prevention Division, Queensland Health, Brisbane, Australia
| | - Tomisina Ahwang
- Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia
| | - Wendy Morotti
- Communicable Diseases Branch, Prevention Division, Queensland Health, Brisbane, Australia
| | - Ghislaine Wharton
- Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia
- Best Practice Eyecare, Golden Beach, Australia
| | - Tomi Newie
- Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia
| | - Victoria Newie
- Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia
| | - Christine Perrett
- Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia
| | - Wagie Ware
- Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia
| | - Lucy Mosby
- Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia
| | - Shelley Walters
- Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia
| | - Anthony Brown
- Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia
- Chief Executive, South West Hospital and Health Service, Roma, Australia
| | - Lisa J Whop
- National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia
| | - Stephen B Lambert
- Communicable Diseases Branch, Prevention Division, Queensland Health, Brisbane, Australia
- UQ Centre for Clinical Research, the University of Queensland, Brisbane, Australia
- Surveillance, Coverage, Evaluation and Social Science, National Centre for Immunisation Research and Surveillance, Westmead, Australia
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Sasanami M, Amoah B, Diori AN, Amza A, Souley ASY, Bakhtiari A, Kadri B, Szwarcwald CL, Ferreira Gomez DV, Almou I, Lopes MDFC, Masika MP, Beidou N, Boyd S, Harding-Esch EM, Solomon AW, Giorgi E. Using model-based geostatistics for assessing the elimination of trachoma. PLoS Negl Trop Dis 2023; 17:e0011476. [PMID: 37506060 PMCID: PMC10381061 DOI: 10.1371/journal.pntd.0011476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Trachoma is the commonest infectious cause of blindness worldwide. Efforts are being made to eliminate trachoma as a public health problem globally. However, as prevalence decreases, it becomes more challenging to precisely predict prevalence. We demonstrate how model-based geostatistics (MBG) can be used as a reliable, efficient, and widely applicable tool to assess the elimination status of trachoma. METHODS We analysed trachoma surveillance data from Brazil, Malawi, and Niger. We developed geostatistical Binomial models to predict trachomatous inflammation-follicular (TF) and trachomatous trichiasis (TT) prevalence. We proposed a general framework to incorporate age and gender in the geostatistical models, whilst accounting for residual spatial and non-spatial variation in prevalence through the use of random effects. We also used predictive probabilities generated by the geostatistical models to quantify the likelihood of having achieved the elimination target in each evaluation unit (EU). RESULTS TF and TT prevalence varied considerably by country, with Brazil showing the lowest prevalence and Niger the highest. Brazil and Malawi are highly likely to have met the elimination criteria for TF in each EU, but, for some EUs, there was high uncertainty in relation to the elimination of TT according to the model alone. In Niger, the predicted prevalence varied significantly across EUs, with the probability of having achieved the elimination target ranging from values close to 0% to 100%, for both TF and TT. CONCLUSIONS We demonstrated the wide applicability of MBG for trachoma programmes, using data from different epidemiological settings. Unlike the standard trachoma prevalence survey approach, MBG provides a more statistically rigorous way of quantifying uncertainty around the achievement of elimination prevalence targets, through the use of spatial correlation. In addition to the analysis of existing survey data, MBG also provides an approach to identify areas in which more sampling effort is needed to improve EU classification. We advocate MBG as the new standard method for analysing trachoma survey outputs.
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Affiliation(s)
- Misaki Sasanami
- Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Benjamin Amoah
- Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Adam Nouhou Diori
- Ophtalmologie de l’Hôpital Amirou Boubacar Diallo de Niamey, Niamey, Niger
| | - Abdou Amza
- Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
| | | | - Ana Bakhtiari
- International Trachoma Initiative, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Boubacar Kadri
- Programme National de Sante Oculaire (PNSO), Niamey, Niger
| | - Célia L. Szwarcwald
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Ibrahim Almou
- Programme National de Sante Oculaire (PNSO), Niamey, Niger
| | | | | | | | - Sarah Boyd
- International Trachoma Initiative, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Emma M. Harding-Esch
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Anthony W. Solomon
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - Emanuele Giorgi
- Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
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Lynch KD, Morotti W, Brian G, Ketchup L, Kingston K, Starr M, Ware RS, Everill B, Asgar N, O'Keefe A, Whop LJ, Kaldor JM, Lambert SB. Clinical signs of trachoma and laboratory evidence of ocular Chlamydia trachomatis infection in a remote Queensland community: a serial cross-sectional study. Med J Aust 2022; 217:538-543. [PMID: 36180097 PMCID: PMC9827872 DOI: 10.5694/mja2.51735] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/03/2022] [Accepted: 08/15/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To compare the findings of standard clinical assessments and of complementary clinical and laboratory methods for determining whether community-wide treatment for trachoma is warranted in a remote Queensland community. DESIGN Three cross-sectional screening surveys, 2019-2021, complemented by laboratory pathology testing. SETTING Small community in northwest Queensland with geographic and cultural ties to Northern Territory communities where trachoma persists. PARTICIPANTS Children aged 1-14 years; opportunistic screening of people aged 15 years or more. MAIN OUTCOME MEASURES Prevalence of clinical signs of trachoma, Chlamydia trachomatis infection, ocular non-chlamydial infections, and seropositivity for antibodies to the C. trachomatis Pgp3 protein. RESULTS During the three surveys, 73 examinations of 58 children aged 1-4 years, 309 of 171 aged 5-9 years, and 142 of 105 aged 10-14 years for trachoma were undertaken, as were 171 examinations of 164 people aged 15 years or more; 691 of 695 examinations were of Aboriginal or Torres Strait Islander people (99%), 337 were of girls or young women (48%). Clinical signs consistent with trachomatous inflammation-follicular were identified in 5-9-year-old children 23 times (7%), including in eleven with non-chlamydial infections and one with a C. trachomatis infection. One child (10-14 years) met the criteria for trachomatous scarring. Two of 272 conjunctival swab samples (all ages) were polymerase chain reaction-positive for C. trachomatis (0.7%). Two of 147 people aged 15 years or more examined in 2019 had trichiasis, both aged 40 years or more. Seven of 53 children aged 1-9 years in 2019 and seven of 103 in 2021 were seropositive for anti-Pgp3 antibodies. CONCLUSIONS Despite the prevalence of clinical signs consistent with trachomatous inflammation-follicular among 5-9-year-old children exceeding the 5% threshold for community-wide treatment, laboratory testing indicated that childhood exposure to ocular C. trachomatis is rare in this community. Laboratory testing should be integrated into Australian trachoma guidelines.
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Affiliation(s)
- Kathleen D Lynch
- UQ Centre for Clinical ResearchUniversity of QueenslandBrisbaneQLD,Communicable Diseases Branch, Queensland HealthBrisbaneQLD
| | - Wendy Morotti
- Communicable Diseases Branch, Queensland HealthBrisbaneQLD
| | - Garry Brian
- Communicable Diseases Branch, Queensland HealthBrisbaneQLD
| | | | | | - Mitchell Starr
- St Vincent’s Centre for Applied Medical Research, St Vincent's HospitalSydneyNSW
| | - Robert S Ware
- Menzies Health Institute QueenslandGriffith UniversityBrisbaneQLD
| | - Beth Everill
- Queensland Department of Education and TrainingBrisbaneQLD
| | | | - Anne O'Keefe
- North West Hospital and Health ServiceMount IsaQLD
| | - Lisa J Whop
- National Centre for Epidemiology and Population HealthAustralian National UniversityCanberraACT
| | - John M Kaldor
- Kirby InstituteUniversity of New South WalesSydneyNSW
| | - Stephen B Lambert
- UQ Centre for Clinical ResearchUniversity of QueenslandBrisbaneQLD,Communicable Diseases Branch, Queensland HealthBrisbaneQLD,National Centre for Immunisation Research and Surveillance, Sydney Children's Hospitals NetworkSydneyNSW
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Kang Y, Zhou H, Jin W. Rothia nasimurium as a Cause of Disease: First Isolation from Farmed Geese. Vet Sci 2022; 9:vetsci9050197. [PMID: 35622725 PMCID: PMC9145032 DOI: 10.3390/vetsci9050197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 11/29/2022] Open
Abstract
Rothia nasimurium was known previously as an opportunistic pathogen of animals. However, there are few reports regarding the pathogenicity of Rothia nasimurium. In September 2020, geese contracted a disease of unknown cause which brought economic losses to a farm in Jiangsu Province, China, prompting a series of investigations. The bacterium was isolated, cultured, and purified, and then identified using Gram staining, biochemical tests, matrix-assisted laser desorption/ionization time of flight mass spectrometry, and 16S rRNA sequence analysis. After determining the obtained bacteria species, antibiotic susceptibility tests and animal regression experiments were carried out. A strain of bacterium was successfully isolated from the livers of the diseased geese, which was identified as a strain of the Gram-positive bacterium Rothia nasimurium according to the 16S rRNA sequencing results. By indexing references, no goose was reported to have been infected with Rothia nasimurium. The antibiotic susceptibility testing showed that only four antibiotics (amikacin, cefazolin, fosfomycin, and ampicillin/sulbactam) could effectively inhibit the growth of the Rothia nasimurium strain. The animal regression experiments showed that the novel isolated strain could infect goslings, and it also causes serious depilation of goslings. The results of the manuscript expanded the range of pathogenic microorganisms in geese, which is helpful to develop methods for avian endemic control.
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Affiliation(s)
- Yuhui Kang
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (Y.K.); (H.Z.)
| | - Hongshan Zhou
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (Y.K.); (H.Z.)
| | - Wenjie Jin
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (Y.K.); (H.Z.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonosis, Yangzhou 225009, China
- Ministry of Education Key Laboratory of Poultry Preventive Medicine, Yangzhou 225009, China
- Correspondence:
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