Ongoing transmission of trachoma in low prevalence districts in Mozambique: results from four cross-sectional enhanced impact surveys, 2022

Mozambique is making progress towards elimination of trachoma as a public health problem, but in some districts trachomatous inflammation—follicular (TF) prevalence remains above the 5% elimination threshold despite years of various interventions, including antibiotic mass drug administration. To ch...

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Published in:	Scientific reports Vol. 14; no. 1; pp. 22842 - 10
Main Authors:	Sitoe, Henis Mior, Oswald, William E., Zita, Felizmina, Fall, Mawo, Momade, Tamimo, Adams, Molly W., Flueckiger, Rebecca M., McPherson, Scott, Eyob, Sabrina, Doan, Thuy, Lietman, Thomas M., Arnold, Benjamin F., Wickens, Karana, Gwyn, Sarah, Martin, Diana L., Kasubi, Mabula, Boyd, Sarah, Bakhtiari, Ana, Jimenez, Cristina, Solomon, Anthony W., Harding-Esch, Emma M., Mwingira, Upendo J., Ngondi, Jeremiah M.
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 15-10-2024 Nature Publishing Group Nature Portfolio
Subjects:	692/53/2421 692/699/255/1318 692/699/3161/3162 692/700/478/174 692/700/478/2772 Antibodies, Bacterial - blood Child Child, Preschool Children Chlamydia trachomatis Cross-Sectional Studies Female Humanities and Social Sciences Humans Hygiene Infant Male Mozambique - epidemiology multidisciplinary Nucleic acids Prevalence Public health Sanitation Science Science (multidisciplinary) Seroconversion Seroepidemiologic Studies Serology Sexually transmitted diseases STD Surveys Trachoma Trachoma - epidemiology Trachoma - transmission Mozambique
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Summary:	Mozambique is making progress towards elimination of trachoma as a public health problem, but in some districts trachomatous inflammation—follicular (TF) prevalence remains above the 5% elimination threshold despite years of various interventions, including antibiotic mass drug administration. To characterize transmission in four districts, we incorporated testing of ocular infection and serology into routine trachoma impact surveys (TIS) in August 2022. We examined residents aged ≥ 1 year for trachoma and collected information on household water, sanitation, and hygiene. Among children aged 1–9 years, we tested conjunctival swabs for Chlamydia trachomatis nucleic acid and dried blood spots for C. trachomatis antibodies. We modeled age-dependent seroprevalence to estimate seroconversion rate (SCR). We examined 4841 children aged 1–9 years. TF prevalence ranged between 1.1 and 6.0% with three districts below the 5% threshold. PCR-confirmed infection prevalence ranged between 1.1 and 4.8%, and Pgp3 seroprevalence ranged between 8.8 and 24.3%. Pgp3 SCR was 1.9 per 100 children per year in the district with the lowest TF prevalence. Two other districts with TF < 5% had SCR of 5.0 and 4.7. The district with TF ≥ 5% had a SCR of 6.0. This enhanced TIS furthered understanding of transmission in these districts and provides information on additional indicators for monitoring trachoma programs.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2045-2322 2045-2322
DOI:	10.1038/s41598-024-71201-z