Solomon Anthony W, Holland Martin J, Burton Matthew J, West Sheila K, Alexander Neal D E, Aguirre Aura, Massae Patrick A, Mkocha Harran, Muñoz Beatriz, Johnson Gordon J, Peeling Rosanna W, Bailey Robin L, Foster Allen, Mabey David C W
London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK.
Lancet. 2003 Jul 19;362(9379):198-204. doi: 10.1016/S0140-6736(03)13909-8.
Antibiotics are an important part of WHO's strategy to eliminate trachoma as a blinding disease by 2020. At present, who needs to be treated is unclear. We aimed to establish the burden of ocular Chlamydia trachomatis in three trachoma-endemic communities in Tanzania and The Gambia with real-time quantitative PCR.
Conjunctival swabs were obtained at examination from 3146 individuals. Swabs were first tested by the qualitative Amplicor PCR, which is known to be highly sensitive. In positive samples, the number of copies of omp1 (a single-copy C trachomatis gene) was measured by quantitative PCR.
Children had the highest ocular loads of C trachomatis, although the amount of pooling in young age groups was less striking at the site with the lowest trachoma frequency. Individuals with intense inflammatory trachoma had higher loads than did those with other conjunctival signs. At the site with the highest prevalence of trachoma, 48 of 93 (52%) individuals with conjunctival scarring but no sign of active disease were positive for ocular chlamydiae.
Children younger than 10 years old, and those with intense inflammatory trachoma, probably represent the major source of ocular C trachomatis infection in endemic communities. Success of antibiotic distribution programmes could depend on these groups receiving effective treatment.
抗生素是世界卫生组织到2020年消除沙眼致盲这一战略的重要组成部分。目前，尚不清楚哪些人需要接受治疗。我们旨在通过实时定量聚合酶链反应确定坦桑尼亚和冈比亚三个沙眼流行社区沙眼衣原体眼部感染的负担。
在检查时从3146名个体中获取结膜拭子。拭子首先通过定性的安普立可聚合酶链反应进行检测，该反应已知具有高度敏感性。在阳性样本中，通过定量聚合酶链反应测量omp1（沙眼衣原体单拷贝基因）的拷贝数。
儿童沙眼衣原体眼部感染量最高，不过在沙眼发病率最低的地点，低年龄组的聚集程度不太明显。有严重炎性沙眼的个体感染量高于有其他结膜体征的个体。在沙眼患病率最高的地点，93名有结膜瘢痕但无活动性疾病迹象的个体中有48名（52%）眼部衣原体呈阳性。
10岁以下儿童以及有严重炎性沙眼的个体可能是流行社区沙眼衣原体眼部感染的主要来源。抗生素分发计划的成功可能取决于这些群体获得有效治疗。
