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Association between Ocular Bacterial Carriage and Follicular Trachoma Following Mass Azithromycin Distribution in The Gambia
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 w...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3723595/ https://www.ncbi.nlm.nih.gov/pubmed/23936573 http://dx.doi.org/10.1371/journal.pntd.0002347 |
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author | Burr, Sarah E. Hart, John D. Edwards, Tansy Baldeh, Ignatius Bojang, Ebrima Harding-Esch, Emma M. Holland, Martin J. Lietman, Thomas M. West, Sheila K. Mabey, David C. W. Sillah, Ansumana Bailey, Robin L. |
author_facet | Burr, Sarah E. Hart, John D. Edwards, Tansy Baldeh, Ignatius Bojang, Ebrima Harding-Esch, Emma M. Holland, Martin J. Lietman, Thomas M. West, Sheila K. Mabey, David C. W. Sillah, Ansumana Bailey, Robin L. |
author_sort | Burr, Sarah E. |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-3723595 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-37235952013-08-09 Association between Ocular Bacterial Carriage and Follicular Trachoma Following Mass Azithromycin Distribution in The Gambia Burr, Sarah E. Hart, John D. Edwards, Tansy Baldeh, Ignatius Bojang, Ebrima Harding-Esch, Emma M. Holland, Martin J. Lietman, Thomas M. West, Sheila K. Mabey, David C. W. Sillah, Ansumana Bailey, Robin L. PLoS Negl Trop Dis Research Article 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. Public Library of Science 2013-07-25 /pmc/articles/PMC3723595/ /pubmed/23936573 http://dx.doi.org/10.1371/journal.pntd.0002347 Text en © 2013 Burr et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Burr, Sarah E. Hart, John D. Edwards, Tansy Baldeh, Ignatius Bojang, Ebrima Harding-Esch, Emma M. Holland, Martin J. Lietman, Thomas M. West, Sheila K. Mabey, David C. W. Sillah, Ansumana Bailey, Robin L. Association between Ocular Bacterial Carriage and Follicular Trachoma Following Mass Azithromycin Distribution in The Gambia |
title | Association between Ocular Bacterial Carriage and Follicular Trachoma Following Mass Azithromycin Distribution in The Gambia |
title_full | Association between Ocular Bacterial Carriage and Follicular Trachoma Following Mass Azithromycin Distribution in The Gambia |
title_fullStr | Association between Ocular Bacterial Carriage and Follicular Trachoma Following Mass Azithromycin Distribution in The Gambia |
title_full_unstemmed | Association between Ocular Bacterial Carriage and Follicular Trachoma Following Mass Azithromycin Distribution in The Gambia |
title_short | Association between Ocular Bacterial Carriage and Follicular Trachoma Following Mass Azithromycin Distribution in The Gambia |
title_sort | association between ocular bacterial carriage and follicular trachoma following mass azithromycin distribution in the gambia |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3723595/ https://www.ncbi.nlm.nih.gov/pubmed/23936573 http://dx.doi.org/10.1371/journal.pntd.0002347 |
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