Ocular Chlamydia trachomatis infection and infectious load among pre-school aged children within trachoma hyperendemic districts receiving the SAFE strategy, Amhara region, Ethiopia

Scott D. Nash, Ambahun Chernet, Jeanne Moncada, Aisha E. P. Stewart, Tigist Astale, Eshetu Sata, Mulat Zerihun, Demelash Gessese, Berhanu Melak, Gedefaw Ayenew, Zebene Ayele, Melsew Chanyalew (+5 others)
2020 PLoS Neglected Tropical Diseases  
After approximately 5 years of SAFE (surgery, antibiotics, facial cleanliness, environmental improvement) interventions for trachoma, hyperendemic (trachomatous inflammation-follicular (TF) ≥30%) districts remained in Amhara, Ethiopia. This study's aim was to characterize the epidemiology of Chlamydia trachomatis (Ct) infection and load among pre-school aged children living under the SAFE strategy. Conjunctival swabs from a population-based sample of children aged 1-5 years collected between
more » ... ollected between 2011 and 2015 were assayed to provide Ct infection data from 4 endemic zones (comprised of 58 districts). Ct load was determined using a calibration curve. Children were graded for TF and trachomatous inflammation-intense (TI). 7,441 children were swabbed in 4 zones. TF and TI prevalence were 39.9% (95% confidence Interval [CI]: 37.5%, 42.4%), and 9.2% (95% CI: 8.1%, 10.3%) respectively. Ct infection prevalence was 6.0% (95% CI: 5.0%, 7.2%). Infection was highest among children aged 2 to 4 years (6.6%-7.0%). Approximately 10% of infection occurred among children aged 1 year. Ct load decreased with age (P = 0.002), with the highest loads observed in children aged 1 year (P = 0.01) vs. aged 5 years. Participants with TF (P = 0.20) and TI (P<0.01) had loads greater than individuals without active trachoma. In this hyperendemic setting, it appears that the youngest children may contribute in meaningful ways towards persistent active trachoma.
doi:10.1371/journal.pntd.0008226 pmid:32421719 fatcat:afir2px5sjf5jlhqmgo6d5oevy