+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Profound and sustained reduction in Chlamydia trachomatis in The Gambia: a five-year longitudinal study of trachoma endemic communities



Profound and sustained reduction in Chlamydia trachomatis in The Gambia: a five-year longitudinal study of trachoma endemic communities



Plos Neglected Tropical Diseases 4(10):



The elimination of blinding trachoma focuses on controlling Chlamydia trachomatis infection through mass antibiotic treatment and measures to limit transmission. As the prevalence of disease declines, uncertainty increases over the most effective strategy for treatment. There are little long-term data on the effect of treatment on infection, especially in low prevalence settings, on which to base guidelines. The population of a cluster of 14 Gambian villages with endemic trachoma was examined on seven occasions over five years (baseline, 2, 6, 12, 17, 30 and 60 months). Mass antibiotic treatment was given at baseline only. All families had accessible clean water all year round. New latrines were installed in each household after 17 months. Conjunctival swab samples were collected and tested for C. trachomatis by PCR. Before treatment the village-level prevalence of follicular trachoma in 1 to 9 year olds (TF(%1-9)) was 15.4% and C. trachomatis was 9.7%. Antibiotic treatment coverage was 83% of the population. In 12 villages all baseline infection cleared and few sporadic cases were detected during the following five years. In the other two villages treatment was followed by increased infection at two months, which was associated with extensive contact with other untreated communities. The prevalence of infection subsequently dropped to 0% in these 2 villages and 0.6% for the whole population by the end of the study in the absence of any further antibiotic treatment. However, several villages had a TF(%1-9) of >10%, the threshold for initiating or continuing mass antibiotic treatment, in the absence of any detectable C. trachomatis. A single round of mass antibiotic treatment may be sufficient in low prevalence settings to control C. trachomatis infection when combined with environmental conditions, which suppress transmission, such as a good water supply and sanitation.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 055207102

Download citation: RISBibTeXText

PMID: 20957147

DOI: 10.1371/journal.pntd.0000835


Related references

Trachoma and ocular Chlamydia trachomatis rates in children in trachoma-endemic communities enrolled for at least three years in the Tanzania National Trachoma Control Programme. Tanzania Journal of Health Research 11(3): 103-110, 2009

Re-emergence of Chlamydia trachomatis infection after mass antibiotic treatment of a trachoma-endemic Gambian community: a longitudinal study. Lancet 365(9467): 1321-1328, 2005

Genotyping of Chlamydia trachomatis from a trachoma-endemic village in the Gambia by a nested polymerase chain reaction: identification of strain variants. Journal of Infectious Diseases 166(5): 1173-1177, 1992

Detection of Chlamydia trachomatis ocular infection in trachoma-endemic communities by rRNA amplification. Investigative Ophthalmology and Visual Science 50(1): 90-94, 2009

Failure to detect HLA-A*6802-restricted CD8+ T cells specific for Chlamydia trachomatis antigens in subjects from trachoma-endemic communities. Clinical and Experimental Immunology 123(1): 68-72, 2001

Population-based analysis of ocular Chlamydia trachomatis in trachoma-endemic West African communities identifies genomic markers of disease severity. Genome Medicine 10(1): 15, 2018

Infectious with chlamydia trachomatis immunotype j associated with trachoma in children in an area previously endemic for trachoma. Journal of Infectious Diseases 151(6): 1034-1036, 1985

Costs of testing for ocular Chlamydia trachomatis infection compared to mass drug administration for trachoma in the Gambia: application of results from the PRET study. Plos Neglected Tropical Diseases 9(4): E0003670, 2015

Infection with Chlamydia trachomatis after mass treatment of a trachoma hyperendemic community in Tanzania: a longitudinal study. Lancet 366(9493): 1296-1300, 2005

Risk factors for active trachoma and ocular Chlamydia trachomatis infection in treatment-naïve trachoma-hyperendemic communities of the Bijagós Archipelago, Guinea Bissau. Plos Neglected Tropical Diseases 8(6): E2900, 2014

The impact of a single round of community mass treatment with azithromycin on disease severity and ocular Chlamydia trachomatis load in treatment-naïve trachoma-endemic island communities in West Africa. Parasites and Vectors 10(1): 624, 2017

Seroprevalence of chlamydia trachomatis serovars in a trachoma endemic area of nepal. Abstracts of the Annual Meeting of the American Society for Microbiology 89: 409, 1989

Chlamydia trachomatis serovars of endemic trachoma had been predominantly existed in Japan?. Journal of Applied Science and Environmental Management 8(2): 67-69, 2004

Extra ocular infections in children in areas with endemic trachoma chlamydia trachomatis. Journal of Infectious Diseases 143(6): 853, 1981

Serum and local secretory antibodies to chlamydia trachomatis in a community with endemic trachoma. Oriel, D , Et Al (Ed ) Chlamydial Infections; Sixth International Symposium on Human Chlamydial Infections, Sanderstead, Surrey, England, Uk, June 15-21, Xvii+583p Cambridge University Press: New York, New York, Usa; Cambridge, England, Uk Illus 149-153, 1986