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    Low Prevalence of Conjunctival Infection with Chlamydia trachomatis in a Treatment-Naive Trachoma-Endemic Region of the Solomon Islands

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    Author
    Butcher, RMR; Sokana, O; Jack, K; Macleod, CK; Marks, ME; Kalae, E; Sui, L; Russell, C; Tutill, HJ; Williams, RJ; ...
    Date
    2016-09-01
    Source Title
    PLoS Neglected Tropical Diseases
    Publisher
    PUBLIC LIBRARY SCIENCE
    University of Melbourne Author/s
    Le Mesurier, Richard
    Affiliation
    Ophthalmology (Eye & Ear Hospital)
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Butcher, R. M. R., Sokana, O., Jack, K., Macleod, C. K., Marks, M. E., Kalae, E., Sui, L., Russell, C., Tutill, H. J., Williams, R. J., Breuer, J., Willis, R., Le Mesurier, R. T., Mabey, D. C. W., Solomon, A. W. & Roberts, C. H. (2016). Low Prevalence of Conjunctival Infection with Chlamydia trachomatis in a Treatment-Naive Trachoma-Endemic Region of the Solomon Islands. PLOS NEGLECTED TROPICAL DISEASES, 10 (9), https://doi.org/10.1371/journal.pntd.0004863.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/260211
    DOI
    10.1371/journal.pntd.0004863
    Abstract
    BACKGROUND: Trachoma is endemic in several Pacific Island states. Recent surveys across the Solomon Islands indicated that whilst trachomatous inflammation-follicular (TF) was present at levels warranting intervention, the prevalence of trachomatous trichiasis (TT) was low. We set out to determine the relationship between chlamydial infection and trachoma in this population. METHODS: We conducted a population-based trachoma prevalence survey of 3674 individuals from two Solomon Islands provinces. Participants were examined for clinical signs of trachoma. Conjunctival swabs were collected from all children aged 1-9 years. We tested swabs for Chlamydia trachomatis (Ct) DNA using droplet digital PCR. Chlamydial DNA from positive swabs was enriched and sequenced for use in phylogenetic analysis. RESULTS: We observed a moderate prevalence of TF in children aged 1-9 years (n = 296/1135, 26.1%) but low prevalence of trachomatous inflammation-intense (TI) (n = 2/1135, 0.2%) and current Ct infection (n = 13/1002, 1.3%) in children aged 1-9 years, and TT in those aged 15+ years (n = 2/2061, 0.1%). Ten of 13 (76.9%) cases of infection were in persons with TF or TI (p = 0.0005). Sequence analysis of the Ct-positive samples yielded 5/13 (38%) complete (>95% coverage of reference) genome sequences, and 8/13 complete plasmid sequences. Complete sequences all aligned most closely to ocular serovar reference strains. DISCUSSION: The low prevalence of TT, TI and Ct infection that we observed are incongruent with the high proportion of children exhibiting signs of TF. TF is present at levels that apparently warrant intervention, but the scarcity of other signs of trachoma indicates the phenotype is mild and may not pose a significant public health threat. Our data suggest that, whilst conjunctival Ct infection appears to be present in the region, it is present at levels that are unlikely to be the dominant driving force for TF in the population. This could be one reason for the low prevalence of TT observed during the study.

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