학술논문

Monitoring transmission intensity of trachoma with serology.
Document Type
article
Source
Nature communications. 14(1)
Subject
Humans
Chlamydia trachomatis
Trachoma
Antibodies
Bacterial
Antigens
Bacterial
Prevalence
Seroepidemiologic Studies
Child
Child
Preschool
Infant
Pediatric Research Initiative
Eye Disease and Disorders of Vision
Infectious Diseases
Detection
screening and diagnosis
Aetiology
2.2 Factors relating to the physical environment
4.1 Discovery and preclinical testing of markers and technologies
Infection
Good Health and Well Being
Language
Abstract
Trachoma, caused by ocular Chlamydia trachomatis infection, is targeted for global elimination as a public health problem by 2030. To provide evidence for use of antibodies to monitor C. trachomatis transmission, we collated IgG responses to Pgp3 antigen, PCR positivity, and clinical observations from 19,811 children aged 1-9 years in 14 populations. We demonstrate that age-seroprevalence curves consistently shift along a gradient of transmission intensity: rising steeply in populations with high levels of infection and active trachoma and becoming flat in populations near elimination. Seroprevalence (range: 0-54%) and seroconversion rates (range: 0-15 per 100 person-years) correlate with PCR prevalence (r: 0.87, 95% CI: 0.57, 0.97). A seroprevalence threshold of 13.5% (seroconversion rate 2.75 per 100 person-years) identifies clusters with any PCR-identified infection at high sensitivity ( >90%) and moderate specificity (69-75%). Antibody responses in young children provide a robust, generalizable approach to monitor population progress toward and beyond trachoma elimination.