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Low Prevalence of Conjunctival Infection with Chlamydia trachomatis in a Treatment-Naïve Trachoma-Endemic Region of the Solomon Islands
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 t...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5014345/ https://www.ncbi.nlm.nih.gov/pubmed/27603015 http://dx.doi.org/10.1371/journal.pntd.0004863 |
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author | Butcher, Robert M. R. Sokana, Oliver Jack, Kelvin Macleod, Colin K. Marks, Michael E. Kalae, Eric Sui, Leslie Russell, Charles Tutill, Helena J. Williams, Rachel J. Breuer, Judith Willis, Rebecca Le Mesurier, Richard T. Mabey, David C. W. Solomon, Anthony W. Roberts, Chrissy h. |
author_facet | Butcher, Robert M. R. Sokana, Oliver Jack, Kelvin Macleod, Colin K. Marks, Michael E. Kalae, Eric Sui, Leslie Russell, Charles Tutill, Helena J. Williams, Rachel J. Breuer, Judith Willis, Rebecca Le Mesurier, Richard T. Mabey, David C. W. Solomon, Anthony W. Roberts, Chrissy h. |
author_sort | Butcher, Robert M. R. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-5014345 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-50143452016-09-27 Low Prevalence of Conjunctival Infection with Chlamydia trachomatis in a Treatment-Naïve Trachoma-Endemic Region of the Solomon Islands Butcher, Robert M. R. Sokana, Oliver Jack, Kelvin Macleod, Colin K. Marks, Michael E. Kalae, Eric Sui, Leslie Russell, Charles Tutill, Helena J. Williams, Rachel J. Breuer, Judith Willis, Rebecca Le Mesurier, Richard T. Mabey, David C. W. Solomon, Anthony W. Roberts, Chrissy h. PLoS Negl Trop Dis Research Article 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. Public Library of Science 2016-09-07 /pmc/articles/PMC5014345/ /pubmed/27603015 http://dx.doi.org/10.1371/journal.pntd.0004863 Text en © 2016 Butcher 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 (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Butcher, Robert M. R. Sokana, Oliver Jack, Kelvin Macleod, Colin K. Marks, Michael E. Kalae, Eric Sui, Leslie Russell, Charles Tutill, Helena J. Williams, Rachel J. Breuer, Judith Willis, Rebecca Le Mesurier, Richard T. Mabey, David C. W. Solomon, Anthony W. Roberts, Chrissy h. Low Prevalence of Conjunctival Infection with Chlamydia trachomatis in a Treatment-Naïve Trachoma-Endemic Region of the Solomon Islands |
title | Low Prevalence of Conjunctival Infection with Chlamydia trachomatis in a Treatment-Naïve Trachoma-Endemic Region of the Solomon Islands |
title_full | Low Prevalence of Conjunctival Infection with Chlamydia trachomatis in a Treatment-Naïve Trachoma-Endemic Region of the Solomon Islands |
title_fullStr | Low Prevalence of Conjunctival Infection with Chlamydia trachomatis in a Treatment-Naïve Trachoma-Endemic Region of the Solomon Islands |
title_full_unstemmed | Low Prevalence of Conjunctival Infection with Chlamydia trachomatis in a Treatment-Naïve Trachoma-Endemic Region of the Solomon Islands |
title_short | Low Prevalence of Conjunctival Infection with Chlamydia trachomatis in a Treatment-Naïve Trachoma-Endemic Region of the Solomon Islands |
title_sort | low prevalence of conjunctival infection with chlamydia trachomatis in a treatment-naïve trachoma-endemic region of the solomon islands |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5014345/ https://www.ncbi.nlm.nih.gov/pubmed/27603015 http://dx.doi.org/10.1371/journal.pntd.0004863 |
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