Journal Article

The utility of serology for elimination surveillance of trachoma

Bailey, Robin L., Macleod, Colin, Pinsent, Amy, Solomon, Anthony W., Cama, Anaseini, Taoaba, Raebwebwe, Müller, Andreas, Tekeraoi, Rabebe, Martin, Diana L., Dean, Deborah, Gwyn, Sarah E., Kandel, Ram Prasad, Mabey, David C. W., Jack, Kelvin R., Bid, Rhiannon, Massae, Patrick, Sokana, Oliver, Sandi, Frank, Migchelsen, Stephanie, White, Michael. T., Goodhew, Brook, Kama, Mike

2018

Overview

Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. Here, we analyse data from nine trachoma-endemic populations and provide operational thresholds for interpretation of serological data in low-transmission and post-elimination settings. Analyses with sero-catalytic and antibody acquisition models provide insights into transmission history within each population. To accurately estimate sero-conversion rates (SCR) for trachoma in populations with high-seroprevalence in adults, the model accounts for secondary exposure to Chlamydia trachomatis due to urogenital infection. We estimate the population half-life of sero-reversion for anti-Pgp3 antibodies to be 26 (95% credible interval (CrI): 21–34) years. We show SCRs below 0.015 (95% confidence interval (CI): 0.0–0.049) per year correspond to a prevalence of trachomatous inflammation—follicular below 5%, the current threshold for elimination of active trachoma as a public health problem. As global trachoma prevalence declines, we may need cross-sectional serological survey data to inform programmatic decisions. Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. Here, Pinsent et al. analyse data from nine trachoma-endemic populations and provide operational thresholds for interpretation of serological data in low transmission and post-elimination settings.

• Publisher: Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• Subject: 631/114/2397 / 692/699/255/1318 / 692/700/1538 / 692/700/478/174 / Adolescent / Adult / Adults / Africa South of the Sahara - epidemiology / Age Factors / Antibodies / Bacteria / Catalysis / Child / Child, Preschool / Chlamydia trachomatis - immunology / Confidence intervals / Data processing / Female / Humanities and Social Sciences / Humans / Infant / Models, Statistical / multidisciplinary / Nepal - epidemiology / Pacific Islands - epidemiology / Populations / Public health / Public Health Surveillance / Reversion / Science / Science (multidisciplinary) / Seroepidemiologic Studies / Serology / Sexually transmitted diseases / STD / Surveillance / Trachoma / Trachoma - epidemiology / Trachoma - immunology / Trachoma - transmission / Young Adult