1
|
Abedifar Z, Fallah F, Asadiamoli F, Bourrie B, Doustdar F. Chlamydia trachomatis Serovar Distribution in Patients with Follicular Conjunctivitis in Iran. Turk J Ophthalmol 2023; 53:218-221. [PMID: 37602552 PMCID: PMC10442745 DOI: 10.4274/tjo.galenos.2022.12080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/12/2022] [Indexed: 08/22/2023] Open
Abstract
Objectives Chlamydia trachomatis infects the urogenital tract and eyes. Anatomical tropism is correlated with serovars which are characterized according to the variation in the major outer membrane proteins encoded by the ompA gene. The aim of the present study was to determine the distribution of C. trachomatis serovars among patients with follicular conjunctivitis in Iran. Materials and Methods A total of 68 conjunctival specimens from symptomatic adults were studied for the presence of C. trachomatis using polymerase chain reaction (PCR) analysis. Serovars were determined by Omp1 PCR-RFLP analysis. Results C. trachomatis was detected in 38 (55.9%) of patients with follicular conjunctivitis, with higher C. trachomatis prevalence in the younger age groups. Twenty-six (38.2%) of these patients had a history of urinary tract infection. Four distinct serovars were identified in the conjunctiva samples using molecular genotyping. The most prevalent was serovar E, followed by G, I, and F. Conclusion Our serovar distribution indicated that chlamydial follicular conjunctivitis usually has a genital source. Genital serovars may cause eye diseases, especially in sexually active adults. On the other hand, conjunctivitis might be the only sign of sexually transmitted infection. Therefore, genotyping C. trachomatis in ocular and genital specimens could be beneficial for acquiring more detailed epidemiological information about the etiology of the disease and monitoring treatment success.
Collapse
Affiliation(s)
- Zohreh Abedifar
- Shahid Beheshti University of Medical Sciences Faculty of Medicine, Department of Microbiology, Tehran, Iran
| | - Fatemeh Fallah
- Shahid Beheshti University of Medical Sciences Faculty of Medicine, Department of Microbiology, Tehran, Iran
| | - Fahimeh Asadiamoli
- Tehran University of Medical Sciences Faculty of Medicine, Department of Pathology, Tehran, Iran
| | - Ben Bourrie
- University of Alberta Food, and Nutritional Science, Department of Agricultural, Edmonton, Canada
| | - Farahnoosh Doustdar
- Shahid Beheshti University of Medical Sciences Faculty of Medicine, Department of Microbiology, Tehran, Iran
| |
Collapse
|
2
|
Salami B, Fernandez-Sanchez H, Fouche C, Evans C, Sibeko L, Tulli M, Bulaong A, Kwankye SO, Ani-Amponsah M, Okeke-Ihejirika P, Gommaa H, Agbemenu K, Ndikom CM, Richter S. A Scoping Review of the Health of African Immigrant and Refugee Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073514. [PMID: 33800663 PMCID: PMC8038070 DOI: 10.3390/ijerph18073514] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 12/02/2022]
Abstract
Migration is a growing phenomenon around the world, including within the African continent. Many migrants, especially African children, face challenges related to health and social inclusion and can face increased health risks. A systematic scoping review of available literature on the health of African migrant children across the globe was conducted to offer insight into these health risks. The review was conducted over a 15-month period from January 2019 to April 2020, yielding 6602 articles once duplicates were removed. This search included electronic databases, reference lists of articles reviewed, and searches of libraries of relevant organisations. A total of 187 studies met the inclusion criteria, of which 159 were quantitative, 22 were qualitative, and 6 used mixed methods. The findings reveal decreased health in this population in areas of nutrition, infectious diseases, mental health, birth outcomes, sexual and reproductive health, physical and developmental health, parasitic infections, oral health, respiratory health, preventative health, endocrine disorders, health care services, and haematological conditions. The findings offer insights into factors influencing the health of African immigrant and refugee children. Further studies, especially qualitative studies, are needed to determine barriers to service access after migration and to investigate other underexplored and overlooked health concerns of African migrant children, including pneumonia and child maltreatment.
Collapse
Affiliation(s)
- Bukola Salami
- Faculty of Nursing, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 0Z7, Canada; (H.F.-S.); (M.T.); (A.B.); (S.R.)
- Correspondence:
| | - Higinio Fernandez-Sanchez
- Faculty of Nursing, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 0Z7, Canada; (H.F.-S.); (M.T.); (A.B.); (S.R.)
| | - Christa Fouche
- Faculty of Education and Social Work, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand;
| | - Catrin Evans
- School of Health Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK;
| | - Lindiwe Sibeko
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, 204 Chenoweth Laboratory, Amherst, MA 01003-9282, USA;
| | - Mia Tulli
- Faculty of Nursing, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 0Z7, Canada; (H.F.-S.); (M.T.); (A.B.); (S.R.)
| | - Ashley Bulaong
- Faculty of Nursing, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 0Z7, Canada; (H.F.-S.); (M.T.); (A.B.); (S.R.)
| | - Stephen Owusu Kwankye
- Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Accra GA184, Ghana;
| | - Mary Ani-Amponsah
- School of Nursing, University of Ghana, P.O. Box LG 43, Legon, Accra GA184, Ghana;
| | | | - Hayat Gommaa
- Department of Nursing Science, Ahmadu Bello University, Sokoto Road, PMB 06, Zaria 810107, Nigeria;
| | - Kafuli Agbemenu
- School of Nursing, The State University of New York (SUNY), University at Buffalo, 3435 Main Street, Buffalo, NY 14214, USA;
| | | | - Solina Richter
- Faculty of Nursing, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 0Z7, Canada; (H.F.-S.); (M.T.); (A.B.); (S.R.)
| |
Collapse
|
3
|
Chlamydia trachomatis Mimicking COVID-19 Chronic Follicular Conjunctivitis. Case Rep Ophthalmol Med 2021; 2021:6654347. [PMID: 33604091 PMCID: PMC7868163 DOI: 10.1155/2021/6654347] [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: 12/17/2020] [Revised: 01/04/2021] [Accepted: 01/20/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose To characterize the clinical presentation and report lab findings of Chlamydia trachomatis follicular conjunctivitis in two patients with a positive history of active COVID-19 infection. Participants. Two patients with follicular conjunctivitis with a recent history of COVID-19 infection. Design Retrospective, noncomparative, case report. Methods Demographic data including age, gender, and place of residence were recorded. A full exam with an emphasis on inflammatory characteristics and systematic workup. Sample follicles were surgically excised in selected cases, and molecular and histopathological analyses were performed. Results Both patients were initially treated for viral conjunctivitis. After symptoms failed to resolve, biopsy results indicated that both patients were positive for chlamydia conjunctivitis and treated accordingly. Conclusions These cases illustrate the role of biopsy as an investigative tool in chronic conjunctivitis and the importance of having a broad differential when treating patients with acute conjunctivitis.
Collapse
|
4
|
Meteke S, Stefopulos M, Als D, Gaffey M, Kamali M, Siddiqui FJ, Munyuzangabo M, Jain RP, Shah S, Radhakrishnan A, Ataullahjan A, Bhutta ZA. Delivering infectious disease interventions to women and children in conflict settings: a systematic reviefw. BMJ Glob Health 2020; 5:e001967. [PMID: 32341087 PMCID: PMC7213813 DOI: 10.1136/bmjgh-2019-001967] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 02/19/2020] [Accepted: 03/07/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Conflict has played a role in the large-scale deterioration of health systems in low-income and middle-income countries (LMICs) and increased risk of infections and outbreaks. This systematic review aimed to synthesise the literature on mechanisms of delivery for a range of infectious disease-related interventions provided to conflict-affected women, children and adolescents. METHODS We searched Medline, Embase, CINAHL and PsychINFO databases for literature published in English from January 1990 to March 2018. Eligible publications reported on conflict-affected neonates, children, adolescents or women in LMICs who received an infectious disease intervention. We extracted and synthesised information on delivery characteristics, including delivery site and personnel involved, as well as barriers and facilitators, and we tabulated reported intervention coverage and effectiveness data. RESULTS A majority of the 194 eligible publications reported on intervention delivery in sub-Saharan Africa. Vaccines for measles and polio were the most commonly reported interventions, followed by malaria treatment. Over two-thirds of reported interventions were delivered in camp settings for displaced families. The use of clinics as a delivery site was reported across all intervention types, but outreach and community-based delivery were also reported for many interventions. Key barriers to service delivery included restricted access to target populations; conversely, adopting social mobilisation strategies and collaborating with community figures were reported as facilitating intervention delivery. Few publications reported on intervention coverage, mostly reporting variable coverage for vaccines, and fewer reported on intervention effectiveness, mostly for malaria treatment regimens. CONCLUSIONS Despite an increased focus on health outcomes in humanitarian crises, our review highlights important gaps in the literature on intervention delivery among specific subpopulations and geographies. This indicates a need for more rigorous research and reporting on effective strategies for delivering infectious disease interventions in different conflict contexts. PROSPERO REGISTRATION NUMBER CRD42019125221.
Collapse
Affiliation(s)
- Sarah Meteke
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Marianne Stefopulos
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Daina Als
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michelle Gaffey
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mahdis Kamali
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Fahad J Siddiqui
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Health System and Services Research, Duke-NUS Medical School, Singapore
| | - Mariella Munyuzangabo
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Reena P Jain
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Shailja Shah
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Amruta Radhakrishnan
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anushka Ataullahjan
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| |
Collapse
|
5
|
Sharma VK, Gupta PC, Ram J. Trachoma and Herbert's pits. QJM 2019; 112:457. [PMID: 30590853 DOI: 10.1093/qjmed/hcy296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V K Sharma
- Department of Ophthalmology, Advanced Eye Center, Sector 12, Post-Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - P C Gupta
- Department of Ophthalmology, Advanced Eye Center, Sector 12, Post-Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - J Ram
- Department of Ophthalmology, Advanced Eye Center, Sector 12, Post-Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| |
Collapse
|
6
|
YAGHOOBI G, ANANI SARAB G. The History of Trachoma and Current Prevalence (Spotlight on Iran): A Review Article. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:1458-1465. [PMID: 30524975 PMCID: PMC6277721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Trachoma as a common cause of infectious blindness is caused by Chlamydia trachomatis. This study aimed to review the available data from variety of sources and provide an overview of the epidemiological situation of Trachoma in Iran focused on the past seventy five years. METHODS A literature search of English and Farsi articles regarding trachoma in Iran from the electronic databases and paper documents was performed. Original articles, case reports and letters were included. RESULTS By the early and mid-20th century, trachoma was widely endemic with the prevalence rate of more than 60% in Iran. Currently, trachoma prevalence is significantly lower than in the past and the elimination of trachoma is achievable in the near future. The decline in active disease is mainly attributed to improvement of socio-economic situation and personal and environmental hygiene rather than targeted interventions for epidemic control. CONCLUSION Elimination of trachoma in Iran is achievable. However, trachoma prevalence estimation is required to be interpreted with some caution. Uncertainty around these estimates is partly because of the mismatch between the presence of infection and clinical findings.
Collapse
Affiliation(s)
- Gholamhossein YAGHOOBI
- Dept. of Ophthalmology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Gholamreza ANANI SARAB
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran,Corresponding Author:
| |
Collapse
|
7
|
Bal S, Duckles A, Buttenheim A. Visual Health and Visual Healthcare Access in Refugees and Displaced Persons: A Systematic Review. J Immigr Minor Health 2018; 21:161-174. [DOI: 10.1007/s10903-018-0766-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
8
|
Mohammadpour M, Abrishami M, Masoumi A, Hashemi H. Trachoma: Past, present and future. J Curr Ophthalmol 2016; 28:165-169. [PMID: 27830198 PMCID: PMC5093790 DOI: 10.1016/j.joco.2016.08.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/29/2016] [Accepted: 08/30/2016] [Indexed: 11/19/2022] Open
Abstract
Purpose To review the background, epidemiology and current management of trachoma in endemic areas and worldwide. Methods Review of literature. Results Trachoma is one of the leading causes of preventable blindness in developing countries. It was reported as one of the seven most neglected tropical diseases that can be prevented via drug administration. Its infliction is primarily aimed at those living in areas deprived of clean water and proper sanitation. It is estimated that trachoma is the cause of visual impairment in about 2.2 million people worldwide of which about 1.2 million are completely blind. With implementation of the SAFE (surgery, antibiotics, facial cleanliness, and environmental control) strategy with support from the International Trachoma Initiative (ITI) the incidence of trachoma has decreased significantly in the Middle East and North Africa region. Conclusion With the enhancement of socioeconomic and sanitary status of people, advent of new generations of antibiotics, training of expert ophthalmologists and eye care facilities the prevalence of trachoma is decreasing.
Collapse
Affiliation(s)
- Mehrdad Mohammadpour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author.
| | - Mojtaba Abrishami
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Masoumi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| |
Collapse
|
9
|
Butcher RMR, Sokana O, Jack K, Macleod CK, Marks ME, Kalae E, Sui L, Russell C, Tutill HJ, Williams RJ, Breuer J, Willis R, Le Mesurier RT, Mabey DCW, Solomon AW, Roberts CH. Low Prevalence of Conjunctival Infection with Chlamydia trachomatis in a Treatment-Naïve Trachoma-Endemic Region of the Solomon Islands. PLoS Negl Trop Dis 2016; 10:e0004863. [PMID: 27603015 PMCID: PMC5014345 DOI: 10.1371/journal.pntd.0004863] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 06/29/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Trachoma is endemic in several Pacific Island states. Recent surveys across the Solomon Islands indicated that whilst trachomatous inflammation-follicular (TF) was present at levels warranting intervention, the prevalence of trachomatous trichiasis (TT) was low. We set out to determine the relationship between chlamydial infection and trachoma in this population. METHODS We conducted a population-based trachoma prevalence survey of 3674 individuals from two Solomon Islands provinces. Participants were examined for clinical signs of trachoma. Conjunctival swabs were collected from all children aged 1-9 years. We tested swabs for Chlamydia trachomatis (Ct) DNA using droplet digital PCR. Chlamydial DNA from positive swabs was enriched and sequenced for use in phylogenetic analysis. RESULTS We observed a moderate prevalence of TF in children aged 1-9 years (n = 296/1135, 26.1%) but low prevalence of trachomatous inflammation-intense (TI) (n = 2/1135, 0.2%) and current Ct infection (n = 13/1002, 1.3%) in children aged 1-9 years, and TT in those aged 15+ years (n = 2/2061, 0.1%). Ten of 13 (76.9%) cases of infection were in persons with TF or TI (p = 0.0005). Sequence analysis of the Ct-positive samples yielded 5/13 (38%) complete (>95% coverage of reference) genome sequences, and 8/13 complete plasmid sequences. Complete sequences all aligned most closely to ocular serovar reference strains. DISCUSSION The low prevalence of TT, TI and Ct infection that we observed are incongruent with the high proportion of children exhibiting signs of TF. TF is present at levels that apparently warrant intervention, but the scarcity of other signs of trachoma indicates the phenotype is mild and may not pose a significant public health threat. Our data suggest that, whilst conjunctival Ct infection appears to be present in the region, it is present at levels that are unlikely to be the dominant driving force for TF in the population. This could be one reason for the low prevalence of TT observed during the study.
Collapse
Affiliation(s)
- Robert M. R. Butcher
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Oliver Sokana
- Eye Department, Solomon Islands Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Kelvin Jack
- Eye Department, Solomon Islands Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Colin K. Macleod
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Sightsavers, Haywards Heath, United Kingdom
| | - Michael E. Marks
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Hospital for Tropical Diseases, University College London Hospitals, London, United Kingdom
| | - Eric Kalae
- Primary Care Department, Lata Hospital, Lata, Santa Cruz, Solomon Islands
| | - Leslie Sui
- Primary Care Department, Lata Hospital, Lata, Santa Cruz, Solomon Islands
| | | | - Helena J. Tutill
- Division of Infection & Immunity, Faculty of Medical Sciences, University College London, London, United Kingdom
| | - Rachel J. Williams
- Division of Infection & Immunity, Faculty of Medical Sciences, University College London, London, United Kingdom
| | - Judith Breuer
- Division of Infection & Immunity, Faculty of Medical Sciences, University College London, London, United Kingdom
| | - Rebecca Willis
- Task Force for Global Health, Decatur, Georgia, United States of America
| | - Richard T. Le Mesurier
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - David C. W. Mabey
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Hospital for Tropical Diseases, University College London Hospitals, London, United Kingdom
| | - Anthony W. Solomon
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Chrissy h. Roberts
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| |
Collapse
|
10
|
Human and Pathogen Factors Associated with Chlamydia trachomatis-Related Infertility in Women. Clin Microbiol Rev 2015; 28:969-85. [PMID: 26310245 DOI: 10.1128/cmr.00035-15] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Chlamydia trachomatis is the most common bacterial sexually transmitted pathogen worldwide. Infection can result in serious reproductive pathologies, including pelvic inflammatory disease, ectopic pregnancy, and infertility, in women. However, the processes that result in these reproductive pathologies have not been well defined. Here we review the evidence for the human disease burden of these chlamydial reproductive pathologies. We then review human-based evidence that links Chlamydia with reproductive pathologies in women. We present data supporting the idea that host, immunological, epidemiological, and pathogen factors may all contribute to the development of infertility. Specifically, we review the existing evidence that host and pathogen genotypes, host hormone status, age of sexual debut, sexual behavior, coinfections, and repeat infections are all likely to be contributory factors in development of infertility. Pathogen factors such as infectious burden, treatment failure, and tissue tropisms or ascension capacity are also potential contributory factors. We present four possible processes of pathology development and how these processes are supported by the published data. We highlight the limitations of the evidence and propose future studies that could improve our understanding of how chlamydial infertility in women occurs and possible future interventions to reduce this disease burden.
Collapse
|
11
|
Malamos P, Georgalas I, Rallis K, Andrianopoulos K, Konstantoulakis P, Georgopoulos G, Theodosiadis P, Markomichelakis NN. Evaluation of direct immunofluorescence assay and cytological examination in comparison to polymerase chain reaction of conjunctival swabs in patients with adult inclusion conjunctivitis. Semin Ophthalmol 2013; 28:216-23. [PMID: 23627371 DOI: 10.3109/08820538.2012.760623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate PCR, direct immunofluorescence assay (DIA) and cytological test of conjunctival swabs for the diagnosis of adult follicular conjunctivitis (AFC). METHODS Eighty-three adult patients with chronic conjunctivitis and sixteen healthy individuals were included. Conjunctival scrapings underwent PCR, DIA and cytological analysis. Exams were repeated two weeks after treatment application. Sensitivity, specificity and agreement rate with PCR of DIA and Cytology were evaluated and correlated with clinical symptoms/signs. RESULTS Cytology test was more sensitive than DIA and presented an acceptable agreement with PCR (K=0.44) in treatment-naïve patients, concerning especially the combination of both conventional exams (K = 0.77). Inferior diagnostic performance of was detected post-treatment, considering the combination as well (K=0.40). Negative post-treatment PCR correlated well with significant relief of symptoms/signs. CONCLUSION Combination of Cytology and DIA seems to be a useful diagnostic option for treatment naïve AFC patients. However, PCR remains the most reliable test for post-treatment evaluation.
Collapse
Affiliation(s)
- Panagiotis Malamos
- Department of Ophthalmology, G. Gennimatas General Hospital, Athens, Greece
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Ocular Chlamydia trachomatis infections in patients attending a tertiary eye care hospital in north India: a twelve year study. Indian J Med Res 2012; 136:1004-10. [PMID: 23391797 PMCID: PMC3612304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND & OBJECTIVES Ocular infection with Chlamydia trachomatis is a major public health problem in densely populated countries like India. The true prevalence of such infections is uncertain due to insufficient data available from India. The aim of this study was to do a retrospective analysis of C. trachomatis eye infections in patients attending the outpatient department of Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, over a period of 12 years. METHODS From 1997 to 2008, the Chlamydia laboratory received conjunctival swabs from 1281 consecutive patients for C. trachomatis detection after thorough clinical examination. Specimens were subjected to direct fluorescent antigen detection assay using monoclonal antibody based commercial kit to detect the presence of C. trachomatis antigen. RESULTS Antigen positivity varied between 22-28 per cent. Children below 11 yr and people above the age of 60 yr showed comparatively higher antigen positivity (25.7 and 27.8%, respectively). As compared to males significantly (P<0.05) higher number of females in the age group of 31-60 yr were positive for C. trachomatis antigen. Patients with the clinical diagnosis of follicular/allergic conjunctivitis and trachoma showed higher rate of antigen positivity. INTERPRETATION & CONCLUSIONS Northern India having dry and arid climatic conditions in most parts of the year was considered in the past as one of the trachoma hyper-endemic foci. The study indicated that laboratory proven C. trachomatis eye infection still persisted in this part of the country throughout the study period of 12 years.
Collapse
|
13
|
Lansingh VC, Carter MJ. Trachoma surveys 2000-2005: results, recent advances in methodology, and factors affecting the determination of prevalence. Surv Ophthalmol 2007; 52:535-46. [PMID: 17719375 DOI: 10.1016/j.survophthal.2007.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
With the advent of VISION 2020 and GET 2020 inaugurated by the World Health Organization, it is timely to provide an update of the methodology employed in trachoma surveys, given that a significant number of individuals in many undeveloped and developing countries still suffer from this ophthalmic disease. The advent of Trachoma Rapid Assessment and Asymmetrical Sampling Rapid Trachoma Assessment has enabled faster identification of trachoma-endemic areas, though population-based surveys are still required prior to intervention. Research into factors affecting prevalence determination has shown that mobility, clustering, and seasonality should all be taken into account regarding survey design. In addition, recent advances in laboratory testing have given us new insight into trachoma infection patterns and a better understanding of the disease course. In this review, we examine advances in survey methodology and the results of trachoma surveys since 1999, and other issues relevant to the determination of trachoma prevalence. Based on recent findings, we recommend that pooled nucleic acid amplification testing be used to augment clinical assessment in areas where trachoma prevalence is greater than 20%. Further, we suggest that trachoma follicular and trachoma follicular or trachoma intense, as markers of the disease, be reported separately.
Collapse
|
14
|
de Barbeyrac B, Goldschmidt P, Malembic S, Raherison S, Clerc M, Bodaghi B, Bébéar C, Chaumeil C. Quality assessment of conjunctival specimens for detection of Chlamydia trachomatis by PCR in children with active trachoma. Clin Microbiol Infect 2007; 13:689-94. [PMID: 17441975 DOI: 10.1111/j.1469-0691.2007.01741.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
One component of control programmes to eliminate trachoma is the treatment of Chlamydia trachomatis infection. A diagnosis of trachoma is based on clinical grounds, but the signs of active trachoma do not always correlate with the presence of C. trachomatis. During a therapeutic trial, the level of C. trachomatis infection in children with active trachoma in Guinea and Pakistan was assessed using a qualitative commercially available PCR that targeted the C. trachomatis plasmid. The influence of the quality of specimens on the efficiency of the PCR was investigated using two quantitative real-time PCRs targeting the specific omp1 gene of C. trachomatis and human chromosomal DNA, respectively. C. trachomatis was detected in c. 23% of children (aged 1-10 years) who presented with clinically active trachoma. Controls showed that PCR-related problems did not influence this detection rate. For 14% of the positive samples, C. trachomatis was detected in only one eye, with a significantly lower mean load of bacteria. These results suggest that epidemiological and therapeutic surveys should be conducted by sampling and testing both eyes. Moreover, the high variability of the cell load observed in the conjunctival swabs suggests that the effectiveness of swabbing may be questionable.
Collapse
Affiliation(s)
- B de Barbeyrac
- Laboratoire de Bactériologie, Centre National de Référence des Infections à Chlamydia, Université Victor Segalen, Bordeaux, France.
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Wright HR, Taylor HR. Clinical examination and laboratory tests for estimation of trachoma prevalence in a remote setting: what are they really telling us? THE LANCET. INFECTIOUS DISEASES 2005; 5:313-20. [PMID: 15854887 DOI: 10.1016/s1473-3099(05)70116-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Worldwide, an estimated 84 million people have active trachoma and 7.6 million people have trachomatous trichiasis. WHO's SAFE strategy is an effective tool in the worldwide effort to eliminate blinding trachoma, but its institution and monitoring requires a simple, reliable, and cost-effective method to detect disease. To date, clinical examination has provided the main method of diagnosis. Detection of Chlamydia trachomatis with nucleic acid amplification tests does not always correlate well with clinical findings, which has prompted the suggestion that these methods should replace clinical examination. However, a review of the research carried out in animals and human beings suggests the relation between laboratory tests and clinical examination is due to the kinetics of trachoma and not to an inherent problem in either detection system. Given the increased difficulties of using laboratory tests in parts of the world where trachoma is endemic, we should not abandon clinical grading as a tool to assess the need for, and the effectiveness of, trachoma intervention programmes.
Collapse
|
16
|
Solomon AW, Peeling RW, Foster A, Mabey DCW. Diagnosis and assessment of trachoma. Clin Microbiol Rev 2004; 17:982-1011, table of contents. [PMID: 15489358 PMCID: PMC523557 DOI: 10.1128/cmr.17.4.982-1011.2004] [Citation(s) in RCA: 127] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Trachoma is caused by Chlamydia trachomatis. Clinical grading with the WHO simplified system can be highly repeatable provided graders are adequately trained and standardized. At the community level, rapid assessments are useful for confirming the absence of trachoma but do not determine the magnitude of the problem in communities where trachoma is present. New rapid assessment protocols incorporating techniques for obtaining representative population samples (without census preparation) may give better estimates of the prevalence of clinical trachoma. Clinical findings do not necessarily indicate the presence or absence of C. trachomatis infection, particularly as disease prevalence falls. The prevalence of ocular C. trachomatis infection (at the community level) is important because it is infection that is targeted when antibiotics are distributed in trachoma control campaigns. Methods to estimate infection prevalence are required. While culture is a sensitive test for the presence of viable organisms and nucleic acid amplification tests are sensitive and specific tools for the presence of chlamydial nucleic acids, the commercial assays presently available are all too expensive, too complex, or too unreliable for use in national programs. There is an urgent need for a rapid, reliable test for C. trachomatis to assist in measuring progress towards the elimination of trachoma.
Collapse
Affiliation(s)
- Anthony W Solomon
- Clinical Research Unit, London School of Hygiene & Tropical Medicine, Keppel St., London WC1E 7HT, United Kingdom.
| | | | | | | |
Collapse
|