The use of serology for trachoma surveillance Current status and priorities for future investigation

摘要

Programs seeking to eliminate the eye disease trachoma use prevalence of the clinical sign tra-chomatous inflammation–follicular (TF) in 1- to 9-year-olds as a proxy for population-leveltransmission of ocular Chlamydia trachomatis (Ct). TF prevalence determines the need for theA, F, and E components of the “SAFE” (surgery, antibiotics, facial cleanliness, environmentalimprovement) strategy. Ocular Ct infection, like its associated signs of conjunctival inflamma-tion, is most common and most intense in young children [1, 2] who are repeatedly infected inareas of active transmission [3]: a model suggests that people can be infected more than 150times in their lifetime [4]. Repeated infection leads to multiple episodes of TF plus moreintense conjunctival inflammation and eventually conjunctival scarring (trachomatous scar-ring [TS])[5, 6]. Contraction of conjunctival scar can, over a period of years or decades, causethe upper eyelid to turn in and the eyelashes to rub against the eyeball (trachomatous trichiasis[TT]), which can lead to corneal opacity (CO) and blindness.