Strategies for control of trachoma: Observational study with quantitative PCR

Anthony W. Solomon, Martin J. Holland, Matthew J. Burton, Sheila K West, Neal D E Alexander, Aura Aguirre, Patrick A. Massae, Harran Mkocha, Beatriz Munoz, Gordon J. Johnson, Rosanna W. Peeling, Robin L. Bailey, Allen Foster, David C W Mabey

Research output: Contribution to journalArticle

Abstract

Background: Antibiotics are an important part of WHO's strategy to eliminate trachoma as a blinding disease by 2020. At present, who needs to be treated is unclear. We aimed to establish the burden of ocular Chlamydia trachomatis in three trachoma-endemic communities in Tanzania and The Gambia with real-time quantitative PCR. Methods: Conjunctival swabs were obtained at examination from 3146 individuals. Swabs were first tested by the qualitative Amplicor PCR, which is known to be highly sensitive. In positive samples, the number of copies of omp1 (a single-copy C trachomatis gene) was measured by quantitative PCR. Findings: Children had the highest ocular loads of C trachomatis, although the amount of pooling in young age groups was less striking at the site with the lowest trachoma frequency. Individuals with intense inflammatory trachoma had higher loads than did those with other conjunctival signs. At the site with the highest prevalence of trachoma, 48 of 93 (52%) individuals with conjunctival scarring but no sign of active disease were positive for ocular chlamydiae. Interpretation: Children younger than 10 years old, and those with intense inflammatory trachoma, probably represent the major source of ocular C trachomatis infection in endemic communities. Success of antibiotic distribution programmes could depend on these groups receiving effective treatment.

Original languageEnglish (US)
Pages (from-to)198-204
Number of pages7
JournalThe Lancet
Volume362
Issue number9379
DOIs
StatePublished - Jul 19 2003

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Trachoma
Observational Studies
Polymerase Chain Reaction
Gambia
Anti-Bacterial Agents
Tanzania
Chlamydia
Chlamydia trachomatis
Cicatrix
Real-Time Polymerase Chain Reaction
Age Groups
Infection
Genes

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Solomon, A. W., Holland, M. J., Burton, M. J., West, S. K., Alexander, N. D. E., Aguirre, A., ... Mabey, D. C. W. (2003). Strategies for control of trachoma: Observational study with quantitative PCR. The Lancet, 362(9379), 198-204. https://doi.org/10.1016/S0140-6736(03)13909-8

Strategies for control of trachoma : Observational study with quantitative PCR. / Solomon, Anthony W.; Holland, Martin J.; Burton, Matthew J.; West, Sheila K; Alexander, Neal D E; Aguirre, Aura; Massae, Patrick A.; Mkocha, Harran; Munoz, Beatriz; Johnson, Gordon J.; Peeling, Rosanna W.; Bailey, Robin L.; Foster, Allen; Mabey, David C W.

In: The Lancet, Vol. 362, No. 9379, 19.07.2003, p. 198-204.

Research output: Contribution to journalArticle

Solomon, AW, Holland, MJ, Burton, MJ, West, SK, Alexander, NDE, Aguirre, A, Massae, PA, Mkocha, H, Munoz, B, Johnson, GJ, Peeling, RW, Bailey, RL, Foster, A & Mabey, DCW 2003, 'Strategies for control of trachoma: Observational study with quantitative PCR', The Lancet, vol. 362, no. 9379, pp. 198-204. https://doi.org/10.1016/S0140-6736(03)13909-8
Solomon AW, Holland MJ, Burton MJ, West SK, Alexander NDE, Aguirre A et al. Strategies for control of trachoma: Observational study with quantitative PCR. The Lancet. 2003 Jul 19;362(9379):198-204. https://doi.org/10.1016/S0140-6736(03)13909-8
Solomon, Anthony W. ; Holland, Martin J. ; Burton, Matthew J. ; West, Sheila K ; Alexander, Neal D E ; Aguirre, Aura ; Massae, Patrick A. ; Mkocha, Harran ; Munoz, Beatriz ; Johnson, Gordon J. ; Peeling, Rosanna W. ; Bailey, Robin L. ; Foster, Allen ; Mabey, David C W. / Strategies for control of trachoma : Observational study with quantitative PCR. In: The Lancet. 2003 ; Vol. 362, No. 9379. pp. 198-204.
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