TY - JOUR
T1 - Diagnosis of Chlamydia trachomatis eye infection in Tanzania by polymerase chain reaction/enzyme immunoassay
AU - Bobo, L.
AU - Viscidi, R.
AU - Quinn, Thomas C
AU - West, Sheila K
AU - Mkocha, H.
AU - Munoz, Beatriz
N1 - Funding Information:
We thank Ms Farifteh Firoozmand and Mr Dan King for laboratory assistance. This study was supported by the Edna McConnell Clark
Funding Information:
Foundation; Public Health Service grants 2 P01 AI 16959-09 and N01 AI 52579 from the National Institute of Allergy and Infectious Disease; and funds from the Blindness Prevention Program of the World Health Organisation. This work was carried out under the auspices of the National Prevention of Blindness Committee on Tanzania. We thank Dr G. L. Upunda, Regional Medical Officer, and Dr B. B. 0. Mmbaga, Assistant Medical Officer of Ophthalmology, Dodoma, for support. We also thank Mr Matthew Lynch, Mr Andrew Kyongoya, and the rest of the Kongwa Trachoma Project team.
PY - 1991/10/5
Y1 - 1991/10/5
N2 - Detection of Chlamydia trachomatis eye infection is largely unsatisfactory by standard laboratory methods. A polymerase chain reaction/enzyme immunoassay (PCR-EIA) that had previously been successful for diagnosis of genital C trachomatisinfection was compared with direct antibody immunofluorescence (DFA) for detection of the organism in conjunctival scrapes. 234 Tanzanian children aged 1-7 years living in a village that had had no previous trachoma control programme were classified clinically as having no sign of trachoma (0) n=97, follicular trachoma (TF) n=100, or intense inflammatory trachoma with or without TF (TI ± TF) n=37. PCR-EIA detected C trachomatis in 24%, 54%, and 95% of subjects, respectively, compared with elementary body (EB) detection by DFA of 1%, 28%, and 60%, respectively. Overall prevalence of chlamydial eye infection was 22% by DFA compared with 48% by PCR-EIA. Of subjects with chlamydial DNA at pretreatment, 103 (92%) had no detectable chlamydial DNA at the end of 4 weeks of ocular tetracycline. The findings show that PCR-EIA is likely to affect trachoma diagnosis and epidemiology because of the increased sensitivity for detection of C trachomatis in all clinical groups; the less stringent requirements for specimen collection and transport make this method suitable for field use. Moreover, the semi-quantitative aspect of PCR-EIA may be useful for monitoring a decrease in chlamydial DNA after treatment.
AB - Detection of Chlamydia trachomatis eye infection is largely unsatisfactory by standard laboratory methods. A polymerase chain reaction/enzyme immunoassay (PCR-EIA) that had previously been successful for diagnosis of genital C trachomatisinfection was compared with direct antibody immunofluorescence (DFA) for detection of the organism in conjunctival scrapes. 234 Tanzanian children aged 1-7 years living in a village that had had no previous trachoma control programme were classified clinically as having no sign of trachoma (0) n=97, follicular trachoma (TF) n=100, or intense inflammatory trachoma with or without TF (TI ± TF) n=37. PCR-EIA detected C trachomatis in 24%, 54%, and 95% of subjects, respectively, compared with elementary body (EB) detection by DFA of 1%, 28%, and 60%, respectively. Overall prevalence of chlamydial eye infection was 22% by DFA compared with 48% by PCR-EIA. Of subjects with chlamydial DNA at pretreatment, 103 (92%) had no detectable chlamydial DNA at the end of 4 weeks of ocular tetracycline. The findings show that PCR-EIA is likely to affect trachoma diagnosis and epidemiology because of the increased sensitivity for detection of C trachomatis in all clinical groups; the less stringent requirements for specimen collection and transport make this method suitable for field use. Moreover, the semi-quantitative aspect of PCR-EIA may be useful for monitoring a decrease in chlamydial DNA after treatment.
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U2 - 10.1016/0140-6736(91)91502-L
DO - 10.1016/0140-6736(91)91502-L
M3 - Article
C2 - 1681215
AN - SCOPUS:0025896199
SN - 0140-6736
VL - 338
SP - 847
EP - 850
JO - The Lancet
JF - The Lancet
IS - 8771
ER -