{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T07:56:14Z","timestamp":1772524574393,"version":"3.50.1"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009647","name":"Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009647","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002152","name":"International Trachoma Initiative","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002152","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The evaluation unit comprising Kaoma, Luampa, and Nkeyema districts, Western Province, Zambia, has persistent active trachoma. In 2023, we sought to compare the evaluation unit\u2013level prevalence of the active trachoma sign, trachomatous inflammation\u2013follicular (TF), to that of conjunctival Chlamydia trachomatis (Ct) infection and anti-Chlamydia trachomatis (Ct) seropositivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cluster-sampled cross-sectional survey. In selected households, we examined all consenting residents \u22651\u00a0y of age for trachoma. We collected dried blood spots (DBSs) by finger-prick from children ages 1\u20139-y and conjunctival swabs from the left eyes of children ages 1\u20135-y. DBSs were tested for antibodies to the C. trachomatis antigen Pgp3 by lateral flow assay. We tested conjunctival swabs for C. trachomatis DNA by GeneXpert polymerase chain reaction (PCR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The TF prevalence in children ages 1\u20139-y was 9.2%. In children ages 1\u20135-y, anti-Pgp3 seroprevalence was 1.7% and the seroconversion rate was 0.6 per 100 person-years. The prevalence of conjunctival C. trachomatis DNA in children ages 1\u20135-y was 0%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on TF prevalence, this population qualified for additional antibiotic mass drug administration rounds, but PCR and serology\u2014more specific indicators of current or recent C. trachomatis infection than TF\u2014confirmed an absence of significant current community C. trachomatis transmission, allowing a transition to surveillance. Adding these indicators is helpful in persistent active trachoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/inthealth\/ihaf092","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T11:41:55Z","timestamp":1753962115000},"page":"274-281","source":"Crossref","is-referenced-by-count":0,"title":["Does persistent active trachoma mandate antibiotic mass drug administration? A comparison of prevalence of trachomatous inflammation\u2013follicular with that of conjunctival infection and anti-chlamydial antibodies, Western Province, Zambia"],"prefix":"10.1093","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9555-2227","authenticated-orcid":false,"given":"Consity","family":"Mwale","sequence":"first","affiliation":[{"name":"Kitwe Teaching Eye Hospital , Administration Department, P.O. Box 20969, Kitwe 10101 ,","place":["Zambia"]},{"name":"Lusaka Apex Medical University, Faculty of Medicine , P.O. Box 31909, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chileshe","family":"Mboni","sequence":"additional","affiliation":[{"name":"Kitwe Teaching Eye Hospital , Administration Department, P.O. Box 20969, Kitwe 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ngonda","family":"Saasa","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, University of Zambia Departments of Disease Control and Paraclinical Studies, , P.O. Box 32379, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chummy S","family":"Sikasunge","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, University of Zambia Departments of Disease Control and Paraclinical Studies, , P.O. Box 32379, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chisanga","family":"Chelu","sequence":"additional","affiliation":[{"name":"Kabwe Central Hospital, Eye Unit , P.O Box 80917, Kabwe 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phyllis M","family":"Moonga","sequence":"additional","affiliation":[{"name":"Ministry of Health, Directorates of Public Health and Clinical Care , P.O. Box 30205, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Hameja","sequence":"additional","affiliation":[{"name":"Ministry of Health, Directorates of Public Health and Clinical Care , P.O. Box 30205, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Levison","family":"Nkhoma","sequence":"additional","affiliation":[{"name":"Ministry of Health, Directorates of Public Health and Clinical Care , P.O. Box 30205, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Shamilimo","sequence":"additional","affiliation":[{"name":"Ministry of Health, Directorates of Public Health and Clinical Care , P.O. Box 30205, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Namasiku S","family":"Kunda","sequence":"additional","affiliation":[{"name":"Ministry of Health, Directorates of Public Health and Clinical Care , P.O. Box 30205, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenda","family":"Mulenga","sequence":"additional","affiliation":[{"name":"Sightsavers , P.O. Box 37535, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tabonga","family":"Naluonde","sequence":"additional","affiliation":[{"name":"Lions Aid , P.O. Box 37166, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Mutale","sequence":"additional","affiliation":[{"name":"Lions Aid , P.O. Box 37166, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Boyd","sequence":"additional","affiliation":[{"name":"International Trachoma Initiative, The Task Force for Global Health , 330 West Ponce de Leon Ave., Decatur, GA 30030 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary","family":"Pearson-Clarke","sequence":"additional","affiliation":[{"name":"International Trachoma Initiative, The Task Force for Global Health , 330 West Ponce de Leon Ave., Decatur, GA 30030 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Bakhtiari","sequence":"additional","affiliation":[{"name":"International Trachoma Initiative, The Task Force for Global Health , 330 West Ponce de Leon Ave., Decatur, GA 30030 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Sightsavers Neglected Tropical Diseases Department, , Haywards Heath RH16\u00a03BW ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma M","family":"Harding-Esch","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine Clinical Research Department, , London WC1E\u00a07HT ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Dejene","sequence":"additional","affiliation":[{"name":"Sightsavers Neglected Tropical Diseases Department, , Addis Ababa 495, 1110 ,","place":["Ethiopia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Gass","sequence":"additional","affiliation":[{"name":"Neglected Tropical Diseases Support Centre, Task Force for Global Health , Decatur , GA 30030 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrina","family":"Farber","sequence":"additional","affiliation":[{"name":"Neglected Tropical Diseases Support Centre, Task Force for Global Health , Decatur , GA 30030 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Bah","sequence":"additional","affiliation":[{"name":"Neglected Tropical Diseases Support Centre, Task Force for Global Health , Decatur , GA 30030 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8558-9819","authenticated-orcid":false,"given":"Caleb","family":"Mpyet","sequence":"additional","affiliation":[{"name":"Sightsavers, Nigeria Country Office , Kaduna 930222 ,","place":["Nigeria"]},{"name":"University of Jos Department of Ophthalmology, , Jos 930222 ,","place":["Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freddie","family":"Masaninga","sequence":"additional","affiliation":[{"name":"World Health Organization , Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan Nsubuga","family":"Bakyaita","sequence":"additional","affiliation":[{"name":"World Health Organization , Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mwila","family":"Lundamo","sequence":"additional","affiliation":[{"name":"Lusaka Provincial Health Office , P.O. Box 32573, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace Chipalo","family":"Mutati","sequence":"additional","affiliation":[{"name":"Mainasoko Medical Centre Eye Department, P.O. Box 320091, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sikufele","family":"Mubita","sequence":"additional","affiliation":[{"name":"Zambia Statistics Agency, Population and Demography Division , P.O. Box 31908, Lusaka 10101 ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davison J","family":"Kwendakwema","sequence":"additional","affiliation":[{"name":"Beverly Eye and Dental Clinic , Ndola ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Courtright","sequence":"additional","affiliation":[{"name":"KCCO, Division of Ophthalmology, University of Cape Town , Cape Town 7925 ,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony W","family":"Solomon","sequence":"additional","affiliation":[{"name":"Global Neglected Tropical Diseases Programme, World Health Organization , Geneva 1211 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kangwa I M","family":"Muma","sequence":"additional","affiliation":[{"name":"Phil Eye Hospital , 30 Pamo Avenue, Kitwe 10101 ,","place":["Zambia"]},{"name":"School of Medicine, University of Zambia , P.O. 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