{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T06:29:20Z","timestamp":1792218560763,"version":"4.4.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005527","name":"The Carter Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005527","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI158884"],"award-info":[{"award-number":["R01AI158884"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01EY025350"],"award-info":[{"award-number":["R01EY025350"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Programmatic decisions regarding surveillance and intervention for trachoma are made at the district level, reflecting an implicit assumption that transmission within districts is sufficiently homogeneous. However, as transmission declines, residual pockets of transmission may become spatially heterogeneous at subdistrict scales. Using cluster-level data from 12 districts in Amhara, Ethiopia (2019\u20132023), we assess the spatial structure of Pgp3 antibody responses, a sensitive measure of infection transmission. Spatial clustering was evident in higher prevalence districts but diminished as populations approached elimination. We show that as districts approach elimination subdistrict heterogeneity likely disappears, and district-level summaries may be sufficient to guide decision-making.<\/jats:p>","DOI":"10.1093\/infdis\/jiag375","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:45:44Z","timestamp":1784288744000},"source":"Crossref","is-referenced-by-count":1,"title":["Subdistrict Spatial Heterogeneity in Trachoma Seroprevalence as Populations Approach Elimination"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3477-1757","authenticated-orcid":false,"given":"Ariktha","family":"Srivathsan","sequence":"first","affiliation":[{"name":"Francis I. Proctor Foundation, University of California San Francisco , San Francisco, California ,","place":["USA"]},{"name":"Department of Epidemiology and Biostatistics, University of California San Francisco , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4285-2255","authenticated-orcid":false,"given":"Everlyn","family":"Kamau","sequence":"additional","affiliation":[{"name":"Francis I. Proctor Foundation, University of California San Francisco , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambahun","family":"Chernet","sequence":"additional","affiliation":[{"name":"Trachoma Control Program, The Carter Center , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Getahun","family":"Ayenew","sequence":"additional","affiliation":[{"name":"Trachoma Control Program, The Carter Center , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania A","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Trachoma Control Program, The Carter Center , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eshetu","family":"Sata","sequence":"additional","affiliation":[{"name":"Trachoma Control Program, The Carter Center , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adisu","family":"Abebe","sequence":"additional","affiliation":[{"name":"Health Promotion and Disease Prevention, Amhara Regional Health Bureau , Bahir Dar ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zerihun","family":"Tadesse","sequence":"additional","affiliation":[{"name":"Trachoma Control Program, The Carter Center , Addis Ababa ,","place":["Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4057-9411","authenticated-orcid":false,"given":"E Kelly","family":"Callahan","sequence":"additional","affiliation":[{"name":"Trachoma Control Program, The Carter Center , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1437-4321","authenticated-orcid":false,"given":"Karana","family":"Wickens","sequence":"additional","affiliation":[{"name":"Division of Parasitic Diseases and Malaria, US Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1856-3165","authenticated-orcid":false,"given":"Sarah","family":"Gwyn","sequence":"additional","affiliation":[{"name":"Division of Parasitic Diseases and Malaria, US Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana L","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Parasitic Diseases and Malaria, US Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pearl Anne","family":"Ante-Testard","sequence":"additional","affiliation":[{"name":"Francis I. Proctor Foundation, University of California San Francisco , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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"}]},{"given":"Thomas M","family":"Lietman","sequence":"additional","affiliation":[{"name":"Francis I. Proctor Foundation, University of California San Francisco , San Francisco, California ,","place":["USA"]},{"name":"Department of Epidemiology and Biostatistics, 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":"Institute for Global Health Sciences, University of California San Francisco, San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5741-8537","authenticated-orcid":false,"given":"Scott D","family":"Nash","sequence":"additional","affiliation":[{"name":"Trachoma Control Program, The Carter Center , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6105-7295","authenticated-orcid":false,"given":"Benjamin F","family":"Arnold","sequence":"additional","affiliation":[{"name":"Francis I. 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