{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:04:35Z","timestamp":1767179075148,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009343","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000}}],"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T00:00:00Z","timestamp":1618531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002152","name":"International Trachoma Initiative","doi-asserted-by":"publisher","award":["THE TASK FORCE FOR GLOBAL HEALTH, INC. P.O #1491"],"award-info":[{"award-number":["THE TASK FORCE FOR GLOBAL HEALTH, INC. P.O #1491"]}],"id":[{"id":"10.13039\/100002152","id-type":"DOI","asserted-by":"publisher"}]},{"name":"El-Maghraby Chair at Wilmer Eye Institute"},{"DOI":"10.13039\/100000053","name":"National Eye Institute","doi-asserted-by":"crossref","award":["EY001765-45"],"award-info":[{"award-number":["EY001765-45"]}],"id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To eliminate trachoma as a public health problem, countries must achieve a district-level prevalence of trachomatous inflammation\u2014follicular (TF) &lt;5% in children ages 1\u20139 years. Re-emergence of TF could trigger additional rounds of mass drug\/antibiotic administration (MDA), so accurate tools for use in surveys assessing trachoma prevalence are essential.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology &amp; principal findings<\/jats:title>\n                    <jats:p>\n                      We surveyed 2401 children ages 1\u20139 years from 50 villages in Kongwa, Tanzania, 2 years post-MDA and 1.5 years after an impact survey found TF &lt;5% in the same villages. Our survey included multiple tools: clinical determination of TF, Cepheid testing for\n                      <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                      infection, and testing for anti-pgp3 antibodies via multiplex bead array. Photographs of the upper tarsal conjunctiva were taken in a subset of children to corroborate the field grades.\n                    <\/jats:p>\n                    <jats:p>\n                      Overall TF prevalence in 1\u20139 year olds was 7.1% (\n                      <jats:italic>95% CI<\/jats:italic>\n                      : 5.6%-8.9%), which decreased with age (p = &lt;0.0001). TF prevalence by village was heterogeneous, with 19 villages having TF &lt;5% and 16 villages having TF &gt;10%. There was a strong correlation between field and photo grading of TF (kappa = 0.69;\n                      <jats:italic>95% CI<\/jats:italic>\n                      : 0.60\u20130.78) and between TF and infection, with 21.5% of TF-positive children also testing positive for infection, as compared to only 1.6% of TF-negative children (p = 0.0010). Overall seroprevalence was 18.2% (\n                      <jats:italic>95% CI<\/jats:italic>\n                      : 14.8%-22.1%), which increased with age (p = &lt;0.0001). Notably, 1\u20132 year olds, who were born after the cessation of MDA and theoretically should not have had exposure to\n                      <jats:italic>C<\/jats:italic>\n                      .\n                      <jats:italic>trachomatis<\/jats:italic>\n                      in the absence of transmission, had an average seroprevalence of 6.7%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions &amp; significance<\/jats:title>\n                    <jats:p>\n                      Field TF prevalence, supported by photographic review and infection data, suggested re-emergence of trachoma in Kongwa. Moreover, seropositivity in the children born after cessation of MDA indicated exposure to\n                      <jats:italic>C<\/jats:italic>\n                      .\n                      <jats:italic>trachomatis<\/jats:italic>\n                      despite a previous survey finding of TF &lt;5%. Examining seropositivity in specific age groups expected to have limited exposure to\n                      <jats:italic>C<\/jats:italic>\n                      .\n                      <jats:italic>trachomatis<\/jats:italic>\n                      can be used to detect re-emergence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0009343","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T14:42:07Z","timestamp":1618584127000},"page":"e0009343","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Serology, infection, and clinical trachoma as tools in prevalence surveys for re-emergence of trachoma in a formerly hyperendemic district"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4510-1887","authenticated-orcid":true,"given":"Michelle","family":"Odonkor","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6106-3177","authenticated-orcid":true,"given":"Fahd","family":"Naufal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Munoz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harran","family":"Mkocha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8303-7295","authenticated-orcid":true,"given":"Mabula","family":"Kasubi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meraf","family":"Wolle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0818-8100","authenticated-orcid":true,"given":"Sheila","family":"West","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,4,16]]},"reference":[{"key":"pntd.0009343.ref001","unstructured":"Trachoma. 2020 Aug 11 [cited 1 November 2020]. In: World Health Organization Fact Sheets [Internet]. Geneva: WHO 2020. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/trachoma."},{"key":"pntd.0009343.ref002","unstructured":"World Health Organization. Validation of elimination of trachoma as a public health problem. World Health Organization. 2016. Document number: WHO\/HTM\/NTD\/2016.8. Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/208901."},{"key":"pntd.0009343.ref003","unstructured":"World Health Organization. Report of the 4th global scientific meeting on trachoma: Geneva, 27\u201329 November 2018. World Health Organization. 2019. Document number: WHO\/CDS\/NTD\/PCT\/2019.03. Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/325121."},{"issue":"2","key":"pntd.0009343.ref004","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":"DL Martin","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"issue":"6","key":"pntd.0009343.ref005","doi-asserted-by":"crossref","first-page":"e2115","DOI":"10.1371\/journal.pntd.0002115","article-title":"Mass treatment with azithromycin for trachoma: when is one round enough? Results from the PRET Trial in the Gambia.","volume":"7","author":"EM Harding-Esch","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0009343.ref006","doi-asserted-by":"crossref","first-page":"e0004352","DOI":"10.1371\/journal.pntd.0004352","article-title":"Can We Use Antibodies to Chlamydia trachomatis as a Surveillance Tool for National Trachoma Control Programs? Results from a District Survey","volume":"10","author":"SK West","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"issue":"9467","key":"pntd.0009343.ref007","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1016\/S0140-6736(05)61029-X","article-title":"Re-emergence of Chlamydia trachomatis infection after mass antibiotic treatment of a trachoma-endemic Gambian community: a longitudinal study","volume":"365","author":"MJ Burton","year":"2005","journal-title":"Lancet"},{"issue":"1","key":"pntd.0009343.ref008","doi-asserted-by":"crossref","first-page":"3520","DOI":"10.1038\/s41598-018-21127-0","article-title":"Longitudinal change in the serology of antibodies to Chlamydia trachomatis pgp3 in children residing in a trachoma area","volume":"8","author":"SK West","year":"2018","journal-title":"Sci Rep"},{"key":"pntd.0009343.ref009","unstructured":"World Health Organization. Report of the third global scientific meeting on trachoma: Baltimore, USA, 19\u201320 July 2010. World Health Organization. 2010. Document number: WHO\/PBD\/2.10. Available from: https:\/\/www.who.int\/trachoma\/resources\/who_pbd_2.10\/en\/."},{"key":"pntd.0009343.ref010","unstructured":"World Health Organization. Design parameters for population-based trachoma prevalence surveys. World Health Organization. 2018. Document number: WHO\/HTM\/NTD\/PCT\/2018.07. Available from https:\/\/apps.who.int\/iris\/handle\/10665\/275523."},{"issue":"4","key":"pntd.0009343.ref011","first-page":"477","article-title":"A simple system for the assessment of trachoma and its complications","volume":"65","author":"B Thylefors","year":"1987","journal-title":"Bull World Health Organ"},{"issue":"2","key":"pntd.0009343.ref012","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.diagmicrobio.2014.11.010","article-title":"Evaluation of pooled ocular and vaginal swabs by the Cepheid GeneXpert CT\/NG assay for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae compared to the GenProbe Aptima Combo 2 Assay","volume":"81","author":"L Dize","year":"2015","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"11","key":"pntd.0009343.ref013","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":"EB Goodhew","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"issue":"21","key":"pntd.0009343.ref014","first-page":"6211","article-title":"Development of a dual label fluorescence technique that can be utilized to elucidate the mechanism of action of monoclonal antibody-drug conjugates","volume":"48","author":"JJ Starling","year":"1988","journal-title":"Cancer Res"},{"key":"pntd.0009343.ref015","unstructured":"Humanitarian OpenStreetMap Team (HOT). 2012 Census Tanzania Wards Shapefiles; 2012 [cited 2020 Oct 9]. Database: Humanitarian Data Exchange (HDX) [Internet]. Available from: https:\/\/data.humdata.org\/dataset\/2012-census-tanzania-wards-shapefiles."},{"issue":"6","key":"pntd.0009343.ref016","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1080\/09286586.2016.1238947","article-title":"Surveillance and Azithromycin Treatment for Newcomers and Travelers Evaluation (ASANTE) Trial: Design and Baseline Characteristics","volume":"23","author":"AM Ervin","year":"2016","journal-title":"Ophthalmic Epidemiol."},{"issue":"4","key":"pntd.0009343.ref017","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1093\/infdis\/146.4.530","article-title":"Serology of Chlamydia trachomatis in infants","volume":"146","author":"J Schachter","year":"1982","journal-title":"J Infect Dis"},{"issue":"6","key":"pntd.0009343.ref018","first-page":"601","article-title":"Detection of IgM antibodies to Chlamydia trachomatis, Chlamydia pneumoniae, and Chlamydia psittaci from Japanese infants and children with pneumonia","volume":"6","author":"K Numazaki","year":"1992","journal-title":"In Vivo"},{"issue":"4","key":"pntd.0009343.ref019","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/tropej\/42.4.233","article-title":"Chlamydial infection in infants","volume":"42","author":"D Dereli","year":"1996","journal-title":"J Trop Pediatr."},{"issue":"9","key":"pntd.0009343.ref020","doi-asserted-by":"crossref","first-page":"e0005003","DOI":"10.1371\/journal.pntd.0005003","article-title":"The World Health Organization Recommendations for Trachoma Surveillance, Experience in Nepal and Added Benefit of Testing for Antibodies to Chlamydia trachomatis pgp3 Protein: NESTS Study","volume":"10","author":"AI Zambrano","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009343.ref021","article-title":"Population-Based Prevalence of Chlamydia trachomatis Infection and Antibodies in four Districts with Varying Levels of Trachoma Endemicity in Amhara, Ethiopia","author":"SD Nash","year":"2020","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"pntd.0009343.ref022","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1167\/iovs.05-0326","article-title":"Spatial clustering of ocular chlamydial infection over time following treatment, among households in a village in Tanzania","volume":"47","author":"AT Broman","year":"2006","journal-title":"Invest Ophthalmol Vis Sci"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0009343","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0009343","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T17:05:44Z","timestamp":1619629544000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0009343"}},"subtitle":[],"editor":[{"given":"Jeremiah M.","family":"Ngondi","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,4,16]]},"references-count":22,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0009343","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,16]]}}}