{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T18:04:01Z","timestamp":1785780241394,"version":"3.56.0"},"reference-count":25,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Although trachoma mass drug administration (MDA) programs target ocular <jats:italic>Chlamydia trachomatis<\/jats:italic>, the global trachoma control program does not monitor infection as a measure of impact but instead relies on monitoring clinical indicators. This study aimed to monitor the prevalence of ocular <jats:italic>C. trachomatis<\/jats:italic> among a population-based sample of children ages 1\u20135 years throughout Amhara, Ethiopia, a region that has received approximately 8 years of annual MDA as part of trachoma control. Between 2014 and 2021, trachoma impact surveys and surveillance surveys were conducted in all 156 districts of Amhara using a multistage cluster randomized methodology. Certified graders assessed individuals ages \u2265 1 year for trachomatous inflammation-follicular (TF), and a random subset of children ages 1\u20135 years also provided a conjunctival swab. Polymerase chain reaction was used to test for <jats:italic>C. trachomatis<\/jats:italic>. A total of 28,410 conjunctival swabs were collected from children ages 1\u20135 years across Amhara. The regional <jats:italic>C. trachomatis<\/jats:italic> infection prevalence was 4.7% (95% uncertainty interval: 4.3\u20135.1%). Infection was detected in all 10 zones of the region and ranged from 0.2% in Awi Zone to 11.9% in Waghemra Zone. Infection was detected in 17 (26%) districts with a TF prevalence &lt; 10% and in 7 (21%) districts with a TF prevalence &lt; 5%. Through programmatic monitoring of <jats:italic>C. trachomatis<\/jats:italic> infection, this study demonstrated that considerable infection remained throughout Amhara despite approximately 8 years of trachoma interventions and that enhanced interventions such as more frequent than annual MDA will be needed if elimination thresholds are to be reached.<\/jats:p>","DOI":"10.4269\/ajtmh.22-0535","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T14:36:45Z","timestamp":1673275005000},"page":"261-267","source":"Crossref","is-referenced-by-count":10,"title":["Prevalence of Ocular Chlamydia trachomatis Infection in Amhara Region, Ethiopia, after 8 Years of Trachoma Control Interventions"],"prefix":"10.4269","volume":"108","author":[{"given":"Scott","family":"D. Nash","sequence":"first","affiliation":[{"name":"Trachoma Control Program, The Carter Center, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambahun","family":"Chernet","sequence":"additional","affiliation":[{"name":"Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"W. 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