Researchers in Mozambique have found that trachoma, a leading infectious cause of blindness, is still being transmitted in districts where the disease was previously thought to be under control. The study, which incorporated testing for Chlamydia trachomatis infection and antibodies, revealed that even districts with low rates of the clinical signs of trachoma still had evidence of ongoing transmission of the bacteria. This highlights the importance of using multiple indicators, beyond just clinical signs, to accurately assess the progress towards eliminating trachoma as a public health problem.
Trachoma Elimination Efforts in Mozambique
Mozambique has been working towards eliminating trachoma, a neglected tropical disease, as a public health problem. The country has implemented the SAFE strategy, which includes Surgery for trichiasis, Antibiotics through mass drug administration, Facial cleanliness, and Environmental improvements. This strategy has helped to significantly reduce the prevalence of trachoma in many districts.
However, the researchers found that in four districts in Mozambique, trachoma transmission was still ongoing, even in areas where the clinical signs of the disease had dropped below the 5% threshold for elimination. By incorporating additional tests for trachomatis’>Chlamydia trachomatis infection in the community. In some districts, they found that the prevalence of actual ocular Chlamydia trachomatis infection was higher than the TF prevalence, suggesting that transmission was still ongoing even though the clinical signs had improved.
To get a more complete picture, the researchers also measured antibody levels to Chlamydia trachomatis in the population. This allowed them to estimate the rate of new infections (seroconversion rate) in each district. They found that even in districts where TF prevalence was below the 5% elimination threshold, the seroconversion rates were still high, indicating that transmission was still happening.
Implications for Trachoma Elimination
These findings highlight the importance of using multiple indicators, beyond just clinical signs, to accurately assess the progress towards eliminating trachoma. Relying solely on TF prevalence may not give the full picture, as it can lag behind the actual level of infection in the community.
The researchers recommend that trachoma programs should incorporate testing for sanitationandhygiene’>water, sanitation, and hygiene services.
By using a more comprehensive set of indicators, trachoma programs can better monitor progress towards elimination and ensure that they are targeting the right areas for intervention. This will be crucial for Mozambique and other countries working to eliminate trachoma as a public health problem by 2030.
Author credit: This article is based on research by Henis Mior Sitoe, William E. Oswald, Felizmina Zita, Mawo Fall, Tamimo Momade, Molly W. Adams, Rebecca M. Flueckiger, Scott McPherson, Sabrina Eyob, Thuy Doan, Thomas M. Lietman, Benjamin F. Arnold, Karana Wickens, Sarah Gwyn, Diana L. Martin, Mabula Kasubi, Sarah Boyd, Ana Bakhtiari, Cristina Jimenez, Anthony W. Solomon, Emma M. Harding-Esch, Upendo J. Mwingira, Jeremiah M. Ngondi.
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![trachomatis’>Chlamydia trachomatis](https://en.wikipedia.org/wiki/Chlamydia<em>trachomatis’>Chlamydia trachomatis</a> infection and antibodies, the researchers were able to get a more comprehensive understanding of the true burden of trachoma in these districts.</p>
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<p><h3>Measuring Trachoma Transmission</h3>
<p>The traditional way of measuring trachoma progress has been to look at the prevalence of trachomatous inflammation-follicular (TF) in children aged 1-9 years. A TF prevalence of less than 5% in this age group is the target for eliminating trachoma as a public health problem.</p>
<p>However, the researchers found that this clinical sign of trachoma doesn’t always reflect the underlying level of <a href=){kind=link}