{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T08:28:25Z","timestamp":1793780905660,"version":"4.6.1"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Mozambique is making progress towards elimination of trachoma as a public health problem, but in some districts trachomatous inflammation\u2014follicular (TF) prevalence remains above the 5% elimination threshold despite years of various interventions, including antibiotic mass drug administration. To characterize transmission in four districts, we incorporated testing of ocular infection and serology into routine trachoma impact surveys (TIS) in August 2022. We examined residents aged \u2265\u20091 year for trachoma and collected information on household water, sanitation, and hygiene. Among children aged 1\u20139 years, we tested conjunctival swabs for\n                    <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                    nucleic acid and dried blood spots for\n                    <jats:italic>C. trachomatis<\/jats:italic>\n                    antibodies. We modeled age-dependent seroprevalence to estimate seroconversion rate (SCR). We examined 4841 children aged 1\u20139 years. TF prevalence ranged between 1.1 and 6.0% with three districts below the 5% threshold. PCR-confirmed infection prevalence ranged between 1.1 and 4.8%, and Pgp3 seroprevalence ranged between 8.8 and 24.3%. Pgp3 SCR was 1.9 per 100 children per year in the district with the lowest TF prevalence. Two other districts with TF\u2009&lt;\u20095% had SCR of 5.0 and 4.7. The district with TF\u2009\u2265\u20095% had a SCR of 6.0. This enhanced TIS furthered understanding of transmission in these districts and provides information on additional indicators for monitoring trachoma programs.\n                  <\/jats:p>","DOI":"10.1038\/s41598-024-71201-z","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T06:02:28Z","timestamp":1728972148000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Ongoing transmission of trachoma in low prevalence districts in Mozambique: results from four cross-sectional enhanced impact surveys, 2022"],"prefix":"10.1038","volume":"14","author":[{"given":"Henis Mior","family":"Sitoe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E.","family":"Oswald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felizmina","family":"Zita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mawo","family":"Fall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamimo","family":"Momade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly W.","family":"Adams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca M.","family":"Flueckiger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"McPherson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Eyob","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy","family":"Doan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Lietman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin F.","family":"Arnold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karana","family":"Wickens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Gwyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana L.","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mabula","family":"Kasubi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Boyd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Bakhtiari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Jimenez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony W.","family":"Solomon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma M.","family":"Harding-Esch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Upendo J.","family":"Mwingira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremiah M.","family":"Ngondi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,15]]},"reference":[{"key":"71201_CR1","doi-asserted-by":"publisher","first-page":"e1221","DOI":"10.1016\/S2214-109X(17)30393-5","volume":"5","author":"SR Flaxman","year":"2017","unstructured":"Flaxman, S. R. et al. Global causes of blindness and distance vision impairment 1990\u20132020: A systematic review and meta-analysis. Lancet Glob. Health 5, e1221\u2013e1234 (2017).","journal-title":"Lancet Glob. Health"},{"key":"71201_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41572-022-00359-5","volume":"8","author":"AW Solomon","year":"2022","unstructured":"Solomon, A. W. et al. Trachoma. Nat. Rev. Dis. Primers 8, 1\u201320 (2022).","journal-title":"Nat. Rev. Dis. Primers"},{"key":"71201_CR3","unstructured":"WHO. Ending the Neglect to Attain the Sustainable Development Goals: A Road Map for Neglected Tropical Diseases 2021\u20132030. https:\/\/www.who.int\/publications\/i\/item\/9789240010352 (2021)."},{"key":"71201_CR4","unstructured":"WHO. Global Elimination of Blinding Trachoma. https:\/\/iris.who.int\/handle\/10665\/79806 (1998)."},{"key":"71201_CR5","doi-asserted-by":"publisher","first-page":"18","DOI":"10.4269\/ajtmh.2003.69.18","volume":"69","author":"SK West","year":"2003","unstructured":"West, S. K. Blinding trachoma: Prevention with the safe strategy. Am. J. Trop. Med. Hygiene 69, 18\u201323 (2003).","journal-title":"Am. J. Trop. Med. Hygiene"},{"key":"71201_CR6","unstructured":"Francis, V. & Turner, V. Achieving Community Support for Trachoma Control. https:\/\/www.who.int\/publications\/i\/item\/WHO-PBL-93.36 (1995)."},{"key":"71201_CR7","first-page":"297","volume":"98","author":"WHO","year":"2023","unstructured":"WHO. WHO Alliance for the Global Elimination of Trachoma: Progress report on elimination of trachoma, 2022. Weekly Epidemiol. Rec. 98, 297\u2013314 (2023).","journal-title":"Weekly Epidemiol. Rec."},{"key":"71201_CR8","unstructured":"WHO. Iraq eliminates trachoma as a public health problem. https:\/\/www.who.int\/news\/item\/31-07-2023-iraq-eliminates-trachoma-as-a-public-health-problem (2023)."},{"key":"71201_CR9","unstructured":"WHO. Validation of Elimination of Trachoma as a Public Health Problem. https:\/\/www.who.int\/publications\/i\/item\/who-htm-ntd-2016.8 (2016)."},{"key":"71201_CR10","first-page":"477","volume":"65","author":"B Thylefors","year":"1987","unstructured":"Thylefors, B., Dawson, C. R., Jones, B. R., West, S. K. & Taylor, H. R. A simple system for the assessment of trachoma and its complications. Bull. World Health Organ. 65, 477\u2013483 (1987).","journal-title":"Bull. World Health Organ."},{"key":"71201_CR11","doi-asserted-by":"publisher","first-page":"698","DOI":"10.2471\/BLT.19.248708","volume":"98","author":"AW Solomon","year":"2020","unstructured":"Solomon, A. W. et al. The simplified trachoma grading system, amended. Bull. World Health Organ. 98, 698\u2013705 (2020).","journal-title":"Bull. World Health Organ."},{"key":"71201_CR12","unstructured":"WHO. Informal Consultation on End-Game Challenges for Trachoma Elimination, Task Force for Global Health, Decatur, United States of America, 7\u20139 December 2021. https:\/\/apps.who.int\/iris\/handle\/10665\/363591 (2022)."},{"key":"71201_CR13","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1016\/j.trstmh.2008.11.023","volume":"103","author":"J Ngondi","year":"2009","unstructured":"Ngondi, J. et al. Evaluation of three years of the SAFE strategy (Surgery, Antibiotics, Facial cleanliness and Environmental improvement) for trachoma control in five districts of Ethiopia hyperendemic for trachoma. Trans. R. Soc. Trop. Med. Hygiene 103, 1001\u20131010 (2009).","journal-title":"Trans. R. Soc. Trop. Med. Hygiene"},{"key":"71201_CR14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001873","volume":"6","author":"EB Goodhew","year":"2012","unstructured":"Goodhew, E. B. et al. CT694 and pgp3 as serological tools for monitoring trachoma programs. PLoS Negl. Trop. Dis. 6, e1873 (2012).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"71201_CR15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003555","volume":"9","author":"DL Martin","year":"2015","unstructured":"Martin, D. L. et al. Serology for trachoma surveillance after cessation of mass drug administration. PLoS Negl. Trop. Dis. 9, e0003555 (2015).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"71201_CR16","doi-asserted-by":"publisher","first-page":"18532","DOI":"10.1038\/srep18532","volume":"5","author":"DL Martin","year":"2015","unstructured":"Martin, D. L. et al. Serological measures of trachoma transmission intensity. Sci. Rep. 5, 18532 (2015).","journal-title":"Sci. Rep."},{"key":"71201_CR17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0004352","volume":"10","author":"SK West","year":"2016","unstructured":"West, S. K. et al. Can we use antibodies to chlamydia trachomatis as a surveillance tool for national trachoma control programs? Results from a district survey. PLOS Neglect. Trop. Diseases 10, e0004352 (2016).","journal-title":"PLOS Neglect. Trop. Diseases"},{"key":"71201_CR18","doi-asserted-by":"publisher","first-page":"5444","DOI":"10.1038\/s41467-018-07852-0","volume":"9","author":"A Pinsent","year":"2018","unstructured":"Pinsent, A. et al. The utility of serology for elimination surveillance of trachoma. Nat. Commun. 9, 5444 (2018).","journal-title":"Nat. Commun."},{"key":"71201_CR19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0007749","volume":"13","author":"SE Burr","year":"2019","unstructured":"Burr, S. E. et al. Pgp3 seroprevalence and associations with active trachoma and ocular Chlamydia trachomatis infection in Malawi: Cross-sectional surveys in six evaluation units. PLoS Negl. Trop. Dis. 13, e0007749 (2019).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"71201_CR20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0007027","volume":"12","author":"LG Senyonjo","year":"2018","unstructured":"Senyonjo, L. G. et al. Serological and PCR-based markers of ocular Chlamydia trachomatis transmission in northern Ghana after elimination of trachoma as a public health problem. PLoS Negl. Trop. Dis. 12, e0007027 (2018).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"71201_CR21","doi-asserted-by":"publisher","first-page":"7225","DOI":"10.1038\/s41598-021-86639-8","volume":"11","author":"S Gwyn","year":"2021","unstructured":"Gwyn, S. et al. Comparison of platforms for testing antibodies to Chlamydia trachomatis antigens in the Democratic Republic of the Congo and Togo. Sci. Rep. 11, 7225 (2021).","journal-title":"Sci. Rep."},{"key":"71201_CR22","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1080\/09286586.2017.1351996","volume":"25","author":"M Abdala","year":"2018","unstructured":"Abdala, M. et al. The epidemiology of trachoma in Mozambique: Results of 96 population-based prevalence surveys. Ophthalm. Epidemiol. 25, 201\u2013210 (2018).","journal-title":"Ophthalm. Epidemiol."},{"key":"71201_CR23","unstructured":"WHO. Design Parameters for Population-Based Trachoma Prevalence Surveys: Strategic and Technical Advisory Group for Neglected Tropical Diseases, Working Group on Monitoring and Evaluation. https:\/\/apps.who.int\/iris\/handle\/10665\/275523 (2018)."},{"key":"71201_CR24","unstructured":"Solomon, A. W. et al. Trachoma Control: A Guide for Programme Managers. https:\/\/www.who.int\/publications\/i\/item\/9241546905 (2006)."},{"key":"71201_CR25","unstructured":"Courtright, P. et al. Tropical Data: Training System for Trachoma Prevalence Surveys (Version 3). https:\/\/dyzz9obi78pm5.cloudfront.net\/app\/image\/id\/609bd439ec161cdf5109624d\/n\/td-trainingmanual-may21-v31-en-lrc.pdf (2019)."},{"key":"71201_CR26","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1080\/09286586.2018.1500616","volume":"25","author":"AW Solomon","year":"2018","unstructured":"Solomon, A. W., Le Mesurier, R. T. & Williams, W. J. A diagnostic instrument to help field graders evaluate active trachoma. Ophthalm. Epidemiol. 25, 399\u2013402 (2018).","journal-title":"Ophthalm. Epidemiol."},{"key":"71201_CR27","doi-asserted-by":"publisher","first-page":"86","DOI":"10.3109\/09286586.2014.884600","volume":"21","author":"KJ Ray","year":"2014","unstructured":"Ray, K. J. et al. Estimating community prevalence of ocular Chlamydia trachomatis infection using pooled polymerase chain reaction testing. Ophthalm. Epidemiol. 21, 86\u201391 (2014).","journal-title":"Ophthalm. Epidemiol."},{"key":"71201_CR28","doi-asserted-by":"publisher","first-page":"214","DOI":"10.3109\/09286586.2015.1037401","volume":"22","author":"AW Solomon","year":"2015","unstructured":"Solomon, A. W. et al. The global trachoma mapping project: Methodology of a 34-country population-based study. Ophthalm. Epidemiol. 22, 214\u2013225 (2015).","journal-title":"Ophthalm. Epidemiol."},{"key":"71201_CR29","doi-asserted-by":"publisher","first-page":"3269","DOI":"10.1038\/s41467-023-38940-5","volume":"14","author":"C Tedijanto","year":"2023","unstructured":"Tedijanto, C. et al. Monitoring transmission intensity of trachoma with serology. Nat. Commun. 14, 3269 (2023).","journal-title":"Nat. Commun."},{"key":"71201_CR30","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/S0140-6736(03)13909-8","volume":"362","author":"AW Solomon","year":"2003","unstructured":"Solomon, A. W. et al. Strategies for control of trachoma: Observational study with quantitative PCR. Lancet 362, 198\u2013204 (2003).","journal-title":"Lancet"},{"key":"71201_CR31","unstructured":"WHO\/UNICEF. Core Questions on Drinking Water, Sanitation and Hygiene for Household Surveys: 2018 Update. https:\/\/washdata.org\/sites\/default\/files\/documents\/reports\/2019-03\/JMP-2018-core-questions-for-household-surveys.pdf (2018)."},{"key":"71201_CR32","first-page":"1189","volume":"34","author":"MQ Patton","year":"1999","unstructured":"Patton, M. Q. Enhancing the quality and credibility of qualitative analysis. Health Serv. Res. 34, 1189\u20131208 (1999).","journal-title":"Health Serv. Res."},{"key":"71201_CR33","doi-asserted-by":"publisher","first-page":"261","DOI":"10.4269\/ajtmh.22-0535","volume":"108","author":"SD Nash","year":"2023","unstructured":"Nash, S. D. et al. Prevalence of ocular chlamydia trachomatis infection in Amhara Region, Ethiopia, after 8 Years of Trachoma Control Interventions. Am. J. Trop. Med. Hyg. 108, 261\u2013267 (2023).","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"71201_CR34","unstructured":"WHO\/UNICEF. Core Questions on Drinking-Water and Sanitation for Household Surveys. (2006)."},{"key":"71201_CR35","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/S0035-9203(00)90427-9","volume":"94","author":"PM Emerson","year":"2000","unstructured":"Emerson, P. M., Bailey, R. L., Mahdi, O. S., Walraven, G. E. & Lindsay, S. W. Transmission ecology of the fly Musca sorbens, a putative vector of trachoma. Trans. R. Soc. Trop. Med. Hygiene 94, 28\u201332 (2000).","journal-title":"Trans. R. Soc. Trop. Med. Hygiene"},{"key":"71201_CR36","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1046\/j.0269-283x.2001.00318.x","volume":"15","author":"PM Emerson","year":"2001","unstructured":"Emerson, P. M., Bailey, R. L., Walraven, G. E. & Lindsay, S. W. Human and other faeces as breeding media of the trachoma vector Musca sorbens. Med. Vet. Entomol. 15, 314\u2013320 (2001).","journal-title":"Med. Vet. Entomol."},{"key":"71201_CR37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0008120","volume":"14","author":"A Last","year":"2020","unstructured":"Last, A. et al. Detecting extra-ocular Chlamydia trachomatis in a trachoma-endemic community in Ethiopia: Identifying potential routes of transmission. PLOS Negl. Trop. Diseases 14, e0008120 (2020).","journal-title":"PLOS Negl. Trop. Diseases"},{"key":"71201_CR38","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1016\/j.ijheh.2017.05.007","volume":"220","author":"MC Freeman","year":"2017","unstructured":"Freeman, M. C. et al. The impact of sanitation on infectious disease and nutritional status: A systematic review and meta-analysis. Int. J. Hygiene Environ. Health 220, 928\u2013949 (2017).","journal-title":"Int. J. Hygiene Environ. Health"},{"key":"71201_CR39","doi-asserted-by":"publisher","first-page":"250","DOI":"10.2471\/BLT.16.177758","volume":"95","author":"WE Oswald","year":"2017","unstructured":"Oswald, W. E. et al. Active trachoma and community use of sanitation, Ethiopia. Bull. World Health Organ. 95, 250\u2013260 (2017).","journal-title":"Bull. World Health Organ."},{"key":"71201_CR40","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0006110","volume":"12","author":"JV Garn","year":"2018","unstructured":"Garn, J. V. et al. Sanitation and water supply coverage thresholds associated with active trachoma: Modeling cross-sectional data from 13 countries. PLoS Negl. Trop. Diseases 12, e0006110 (2018).","journal-title":"PLoS Negl. Trop. Diseases"},{"key":"71201_CR41","first-page":"71","volume":"67","author":"S West","year":"1989","unstructured":"West, S. et al. Water availability and trachoma. Bull. World Health Organ. 67, 71\u201375 (1989).","journal-title":"Bull. World Health Organ."},{"key":"71201_CR42","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1111\/j.1365-3156.2005.01553.x","volume":"11","author":"RF Baggaley","year":"2006","unstructured":"Baggaley, R. F. et al. Distance to water source and altitude in relation to active trachoma in Rombo district, Tanzania. Trop. Med. Int. Health 11, 220\u2013227 (2006).","journal-title":"Trop. Med. Int. Health"},{"key":"71201_CR43","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1080\/14787210.2019.1577136","volume":"17","author":"MA Wolle","year":"2019","unstructured":"Wolle, M. A. & West, S. K. Ocular Chlamydia trachomatis infection: Elimination with mass drug administration. Exp. Rev. Anti-infective Therapy 17, 189\u2013200 (2019).","journal-title":"Exp. Rev. Anti-infective Therapy"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-71201-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-71201-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-71201-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T06:14:20Z","timestamp":1728972860000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-71201-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,15]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["71201"],"URL":"https:\/\/doi.org\/10.1038\/s41598-024-71201-z","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3900674\/v1","asserted-by":"object"}]},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,15]]},"assertion":[{"value":"26 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 October 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"AB and SB are employees of the International Trachoma Initiative (ITI), a program of The Task Force for Global Health, which receives an operating budget and research funds from Pfizer Inc., the manufacturers of Zithromax (azithromycin). EMHE receives salary support from ITI. The other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"22842"}}