Cocks Naomi, Rainima-Qaniuci Merelesita, Yalen Chelsea, Macleod Colin, Nakolinivalu Apisalome, Migchelsen Stephanie, Roberts Chrissy H, Butcher Robert, Kama Mike, Mabey David, Marks Michael
Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
World Health Organization, Fiji Country Office, Fiji.
Trans R Soc Trop Med Hyg. 2016 Dec;110(10):582-587. doi: 10.1093/trstmh/trw069. Epub 2016 Nov 16.
Both yaws and trachoma are endemic in several countries in the Pacific. In co-endemic countries there may be potential synergies between both control programmes.
We undertook a cluster randomised trachoma and yaws seroprevalence survey of children in the Western Division of Fiji. Children were examined for skin lesions consistent with active yaws. A dried blood spot was collected which was tested using the Treponema pallidum particle agglutination (TPPA) test and an ELISA to detect antibodies against Pgp3.
A total of 607 children from 305 households across 23 villages were recruited into the survey. On skin examination, no child had clinical evidence of yaws, and the TPPA assay was negative in all children (0%, 95% CI 0.0-0.6). The seroprevalence of Pgp3 antibodies was 20.9% (95% CI 17.8-24.6%).
In this study there was neither clinical nor serological evidence that transmission of yaws was ongoing. The Pgp3 seroprevalence pattern was consistent with either low level transmission of ocular Chlamydia trachomatis or exposure to C. trachomatis in the birth canal which is consistent with a survey conducted in the same region in 2013. These data suggest neither yaws nor ocular chlamydia infection are a significant public health problem in the Western Division of Fiji.
雅司病和沙眼在太平洋地区的几个国家均为地方病。在两种疾病共同流行的国家,两种控制项目之间可能存在潜在协同效应。
我们在斐济西部省对儿童进行了一项沙眼和雅司病血清流行率整群随机调查。检查儿童是否有与活动性雅司病相符的皮肤病变。采集干血斑,使用梅毒螺旋体颗粒凝集试验(TPPA)和酶联免疫吸附测定(ELISA)检测抗Pgp3抗体。
共招募了来自23个村庄305户家庭的607名儿童参与调查。皮肤检查时,没有儿童有雅司病的临床证据,所有儿童的TPPA检测均为阴性(0%,95%置信区间0.0 - 0.6)。Pgp3抗体的血清流行率为20.9%(95%置信区间17.8 - 24.6%)。
在本研究中,既没有临床证据也没有血清学证据表明雅司病正在传播。Pgp3血清流行率模式与沙眼衣原体低水平传播或在产道中接触沙眼衣原体一致,这与2013年在同一地区进行的一项调查结果相符。这些数据表明,雅司病和眼部衣原体感染在斐济西部省均不是重大的公共卫生问题。