{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T14:00:45Z","timestamp":1784815245262,"version":"3.55.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000053","name":"National Eye Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100023619","name":"UCGHI","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100023619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Trachoma mapping in Latin America is incomplete, especially in indigenous communities of the Amazon thought to be at highest risk. The aim of this study was to determine the prevalence of clinical, microbiological, and serologic evidence of trachoma in a remote area of the Peruvian Amazon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A population-based sample of households from rural communities in Alto Amazonas province was selected using 2-stage cluster sampling. In children aged 1\u20139 years, conjunctival photographs, conjunctival swabs, and dried blood spots were collected. Photographs were graded for trachomatous inflammation\u2014follicular (TF). Swabs were processed for Chlamydia trachomatis with a nucleic acid amplification test. Dried blood spots were assessed for antibody responses to C. trachomatis with a multiplex bead assay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 778 children aged 1\u20139 years from 21 communities participated. The age-adjusted prevalence of TF among 1\u20139-year-old children was 25.4% (95% CI 21.3%\u201329.5%), compared with 0.8% (95% CI 0.5%\u20131.0%) for ocular C. trachomatis and 6.6% (95% CI 4.5%\u20139.0%) for Pgp3-specific antibodies to C. trachomatis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This region of the Peruvian Amazon had a high burden of clinical trachoma but low levels of C. trachomatis ocular infection and seropositivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf506","type":"journal-article","created":{"date-parts":[[2025,9,14]],"date-time":"2025-09-14T11:38:00Z","timestamp":1757849880000},"page":"131-138","source":"Crossref","is-referenced-by-count":1,"title":["Discrepancy Between Active Trachoma and Tests of Chlamydial Infection in Alto Amazonas, Peru"],"prefix":"10.1093","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9948-6498","authenticated-orcid":false,"given":"John M","family":"Nesemann","sequence":"first","affiliation":[{"name":"Francis I Proctor Foundation, University of California San Francisco , San Francisco, California ,","place":["USA"]},{"name":"Department of Ophthalmology, University of California San Francisco , San Francisco, California ,","place":["USA"]},{"name":"Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia , Lima ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2286-7022","authenticated-orcid":false,"given":"Noelia","family":"Morocho-Alburqueque","sequence":"additional","affiliation":[{"name":"Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia , Lima ,","place":["Peru"]},{"name":"Piura Medical School , Piura ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3556-0086","authenticated-orcid":false,"given":"Alvaro","family":"Quincho-Lopez","sequence":"additional","affiliation":[{"name":"Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia , Lima ,","place":["Peru"]},{"name":"Medical School, Universidad Nacional Mayor de San Marcos , Lima ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9887-5993","authenticated-orcid":false,"given":"Dionna M","family":"Wittberg","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California San Francisco , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2661-9971","authenticated-orcid":false,"given":"Harvy A","family":"Honorio-Morales","sequence":"additional","affiliation":[{"name":"Centro de Salud Ocular, Ministerio de Salud , Lima ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5923-8879","authenticated-orcid":false,"given":"Salom\u00f3n","family":"Durand","sequence":"additional","affiliation":[{"name":"\u00c1rea de Epidemiolog\u00eda, Direcci\u00f3n Regional de Salud Loreto , Iquitos ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4324-9618","authenticated-orcid":false,"given":"Martha","family":"Idal\u00ed Saboy\u00e1-D\u00edaz","sequence":"additional","affiliation":[{"name":"Communicable Diseases Prevention, Control, and Elimination Department, Pan American Health Organization , Washington D.C. ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8188-9598","authenticated-orcid":false,"given":"Silver K","family":"Vargas","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Interdisciplinaria en Sexualidad SIDA y Sociedad, Universidad Peruana Cayetano Heredia , Lima ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6139-5980","authenticated-orcid":false,"given":"Fisseha","family":"Admassu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University of Gondar , Gondar ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4083-7115","authenticated-orcid":false,"given":"Ana","family":"Bakthiari","sequence":"additional","affiliation":[{"name":"International Trachoma Initiative, Task Force for Global Health , Decatur, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Tropical Data Programme, Sightsavers, Haywards Heath ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1432-8109","authenticated-orcid":false,"given":"Emma M","family":"Harding-Esch","sequence":"additional","affiliation":[{"name":"Clinical Research Department, London School of Hygiene and Tropical Medicine , London ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0494-2017","authenticated-orcid":false,"given":"Sandra L","family":"Talero","sequence":"additional","affiliation":[{"name":"Communicable Diseases Prevention, Control, and Elimination Department, Pan American Health Organization , Washington D.C. ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Departmento de Epidemiologia, Red de Salud Alto Amazonas , Yurimaguas ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7101-6649","authenticated-orcid":false,"given":"Anthony W","family":"Solomon","sequence":"additional","affiliation":[{"name":"Global Neglected Tropical Diseases Programme, World Health Organization , Geneva ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D","family":"Klausner","sequence":"additional","affiliation":[{"name":"Division of Disease Prevention, Policy and Global Health, Department of Preventive Medicine, University of Southern California Keck School of Medicine , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9779-633X","authenticated-orcid":false,"given":"Andres G","family":"Lescano","sequence":"additional","affiliation":[{"name":"Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia , Lima ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7118-1457","authenticated-orcid":false,"given":"Jeremy D","family":"Keenan","sequence":"additional","affiliation":[{"name":"Francis I Proctor Foundation, University of California San Francisco , San Francisco, California ,","place":["USA"]},{"name":"Department of Ophthalmology, University of California San Francisco , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"2026072309025418500_ciaf506-B1","doi-asserted-by":"crossref","first-page":"e1221","DOI":"10.1016\/S2214-109X(17)30393-5","article-title":"Global causes of blindness and distance vision impairment 1990\u20132020: a systematic review and meta-analysis","volume":"5","author":"Flaxman","year":"2017","journal-title":"Lancet Glob Health"},{"key":"2026072309025418500_ciaf506-B2","first-page":"363","article-title":"WHO alliance for the global elimination of trachoma: progress report on elimination of trachoma, 2023","volume":"99","author":"World Health Organization","year":"2024","journal-title":"Wkly Epidemiol Record"},{"key":"2026072309025418500_ciaf506-B3","doi-asserted-by":"crossref","first-page":"e0004116","DOI":"10.1371\/journal.pntd.0004116","article-title":"Historical aspects of endemic trachoma in Peru: 1895\u20132000","volume":"10","author":"Maco","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"2026072309025418500_ciaf506-B4","doi-asserted-by":"crossref","first-page":"e93","DOI":"10.26633\/RPSP.2019.93","article-title":"Trachoma elimination in Latin America: prioritization of municipalities for surveillance activities","volume":"43","author":"Saboya-Diaz","year":"2019","journal-title":"Rev Panam Salud Publica"},{"key":"2026072309025418500_ciaf506-B5","doi-asserted-by":"crossref","first-page":"e0010532","DOI":"10.1371\/journal.pntd.0010532","article-title":"Associated factors of the co-occurrence of trachoma and soil-transmitted helminthiases in children 1 to 9 years old in rural communities of the Amazon basin in Loreto Department, Peru: results from a population-based survey","volume":"16","author":"Saboya-Diaz","year":"2022","journal-title":"PLoS Negl Trop Dis"},{"key":"2026072309025418500_ciaf506-B6","author":"Instituto Nacional de Estadistica e Inform\u00e1tica"},{"key":"2026072309025418500_ciaf506-B7","volume-title":"Design parameters for population-based trachoma prevalence surveys","author":"World Health Organization Strategic and Technical Advisory Group for Neglected Tropical Diseases Working Group on Monitoring and Evaluation","year":"2018"},{"key":"2026072309025418500_ciaf506-B8","author":"OpenStreetMap Wiki contributors"},{"key":"2026072309025418500_ciaf506-B9","doi-asserted-by":"crossref","first-page":"e0010272","DOI":"10.1371\/journal.pntd.0010272","article-title":"Community-level trachoma ecological associations and the use of geospatial analysis methods: a systematic review","volume":"16","author":"Burgert-Brucker","year":"2022","journal-title":"PLoS Negl Trop Dis"},{"key":"2026072309025418500_ciaf506-B10","doi-asserted-by":"crossref","first-page":"214","DOI":"10.3109\/09286586.2015.1037401","article-title":"The global trachoma mapping project: methodology of a 34-country population-based study","volume":"22","author":"Solomon","year":"2015","journal-title":"Ophthalmic Epidemiol"},{"key":"2026072309025418500_ciaf506-B11","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1080\/09286586.2023.2249546","article-title":"Tropical data: approach and methodology as applied to trachoma prevalence surveys","volume":"30","author":"Harding-Esch","year":"2023","journal-title":"Ophthalmic Epidemiol"},{"key":"2026072309025418500_ciaf506-B12","doi-asserted-by":"crossref","first-page":"698","DOI":"10.2471\/BLT.19.248708","article-title":"The simplified trachoma grading system, amended","volume":"98","author":"Solomon","year":"2020","journal-title":"Bull World Health Organ"},{"key":"2026072309025418500_ciaf506-B13","volume-title":"Report of the 4th global scientific meeting on trachoma, Geneva, 27-29 November 2018","author":"World Health Organization","year":"2019"},{"key":"2026072309025418500_ciaf506-B14","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1001\/jamaophthalmol.2014.335","article-title":"Novel telemedicine device for diagnosis of corneal abrasions and ulcers in resource-poor settings","volume":"132","author":"Maamari","year":"2014","journal-title":"JAMA Ophthalmol"},{"key":"2026072309025418500_ciaf506-B15","doi-asserted-by":"crossref","first-page":"e1873","DOI":"10.1371\/journal.pntd.0001873","article-title":"CT694 and pgp3 as serological tools for monitoring trachoma programs","volume":"6","author":"Goodhew","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"key":"2026072309025418500_ciaf506-B16","doi-asserted-by":"crossref","first-page":"e0003555","DOI":"10.1371\/journal.pntd.0003555","article-title":"Serology for trachoma surveillance after cessation of mass drug administration","volume":"9","author":"Martin","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"key":"2026072309025418500_ciaf506-B17","doi-asserted-by":"crossref","first-page":"e0005230","DOI":"10.1371\/journal.pntd.0005230","article-title":"Defining seropositivity thresholds for use in trachoma elimination studies","volume":"11","author":"Migchelsen","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"2026072309025418500_ciaf506-B18","first-page":"477","article-title":"A simple system for the assessment of trachoma and its complications","volume":"65","author":"Thylefors","year":"1987","journal-title":"Bull World Health Organ"},{"key":"2026072309025418500_ciaf506-B19","doi-asserted-by":"crossref","first-page":"2488","DOI":"10.4269\/ajtmh.20-0386","article-title":"Comparison of smartphone photography, single-Lens reflex photography, and field-grading for trachoma","volume":"103","author":"Nesemann","year":"2020","journal-title":"Am J Trop Med Hyg"},{"key":"2026072309025418500_ciaf506-B20","doi-asserted-by":"crossref","first-page":"e0007104","DOI":"10.1371\/journal.pntd.0007104","article-title":"3D images as a field grader training tool for trachomatous trichiasis: a diagnostic accuracy study in Ethiopia","volume":"13","author":"Hoffman","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"key":"2026072309025418500_ciaf506-B21","volume-title":"Design parameters for population-based trachoma prevalence survey: strategic and technical advisory group for neglected tropical diseases, working group on monitoring and evaluation","author":"World Health Organization","year":"2018"},{"key":"2026072309025418500_ciaf506-B22","author":"Hartig"},{"key":"2026072309025418500_ciaf506-B23","doi-asserted-by":"crossref","first-page":"3269","DOI":"10.1038\/s41467-023-38940-5","article-title":"Monitoring transmission intensity of trachoma with serology","volume":"14","author":"Tedijanto","year":"2023","journal-title":"Nat Commun"},{"key":"2026072309025418500_ciaf506-B24","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1590\/S0100-879X2002001000007","article-title":"Trachoma among the yanomami Indians","volume":"35","author":"Paula","year":"2002","journal-title":"Braz J Med Biol Res"},{"key":"2026072309025418500_ciaf506-B25","doi-asserted-by":"crossref","first-page":"354","DOI":"10.3109\/09286586.2015.1131305","article-title":"Trachoma in indigenous settlements in Brazil, 2000\u20132008","volume":"23","author":"Freitas","year":"2016","journal-title":"Ophthalmic Epidemiol"},{"key":"2026072309025418500_ciaf506-B26","doi-asserted-by":"crossref","first-page":"e0229297","DOI":"10.1371\/journal.pone.0229297","article-title":"Prevalence of trachoma and associated factors in the rural area of the department of Vaupes, Colombia","volume":"15","author":"Miller","year":"2020","journal-title":"PLoS One"},{"key":"2026072309025418500_ciaf506-B27","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.26633\/RPSP.2024.19","article-title":"Prevalence of trachoma in indigenous and non-indigenous areas, nNortheastern Brazil, 2019\u20132021","volume":"48","author":"Gomez","year":"2024","journal-title":"Rev Panam Salud Publica"},{"key":"2026072309025418500_ciaf506-B28","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1093\/aje\/kwz196","article-title":"Estimating the intracluster correlation coefficient for the clinical sign \u201ctrachomatous inflammation-follicular\u201d in population-based trachoma prevalence surveys: results from a meta-regression analysis of 261 standardized preintervention surveys carried out in Ethiopia, Mozambique, and Nigeria","volume":"189","author":"Macleod","year":"2020","journal-title":"Am J Epidemiol"},{"key":"2026072309025418500_ciaf506-B29","first-page":"358.e1","volume-title":"Cornea","author":"Lindquist","year":"2022","edition":"5th ed"},{"key":"2026072309025418500_ciaf506-B30","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1167\/iovs.11-8493","article-title":"Diagnostic characteristics of tests for ocular Chlamydia after mass azithromycin distributions","volume":"53","author":"Keenan","year":"2012","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2026072309025418500_ciaf506-B31","doi-asserted-by":"crossref","first-page":"6012","DOI":"10.1167\/iovs.11-7326","article-title":"What is causing active trachoma? The role of nonchlamydial bacterial pathogens in a low prevalence setting","volume":"52","author":"Burton","year":"2011","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2026072309025418500_ciaf506-B32","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1080\/09286586.2018.1500616","article-title":"A diagnostic instrument to help field graders evaluate active trachoma","volume":"25","author":"Solomon","year":"2018","journal-title":"Ophthalmic Epidemiol"},{"key":"2026072309025418500_ciaf506-B33","first-page":"24","article-title":"Harnessing photography and image recognition technology to aid in the elimination of trachoma","volume":"35","author":"Jimenez","year":"2022","journal-title":"Community Eye Health"},{"key":"2026072309025418500_ciaf506-B34","author":"Weather Underground"},{"key":"2026072309025418500_ciaf506-B35","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1128\/JCM.02235-16","article-title":"Stability studies on dry swabs and wet mailed swabs for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in aptima assays","volume":"55","author":"Moncada","year":"2017","journal-title":"J Clin Microbiol"},{"key":"2026072309025418500_ciaf506-B36","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1186\/1475-2875-7-195","article-title":"Dried blood spots as a source of anti-malarial antibodies for epidemiological studies","volume":"7","author":"Corran","year":"2008","journal-title":"Malar J"},{"key":"2026072309025418500_ciaf506-B37","doi-asserted-by":"crossref","first-page":"207","DOI":"10.4269\/ajtmh.20-0777","article-title":"Population-based prevalence of Chlamydia trachomatis infection and antibodies in four districts with varying levels of trachoma endemicity in amhara, Ethiopia","volume":"104","author":"Nash","year":"2021","journal-title":"Am J Trop Med Hyg"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaf506\/64275922\/ciaf506.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/83\/1\/131\/64275922\/ciaf506.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/83\/1\/131\/64275922\/ciaf506.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T13:03:02Z","timestamp":1784811782000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/83\/1\/131\/8254614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,9,15]]},"published-print":{"date-parts":[[2026,7,23]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaf506","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7,15]]},"published":{"date-parts":[[2025,9,15]]}}}