Zambrano Andrea I, Muñoz Beatriz E, Mkocha Harran, Dize Laura, Gaydos Charlotte A, Quinn Thomas, West Sheila K
Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, United States.
Kongwa Trachoma Project, Kongwa, Tanzania.
Invest Ophthalmol Vis Sci. 2017 Feb 1;58(2):997-1000. doi: 10.1167/iovs.16-20421.
Clinical trachoma is the current measure of effectiveness of antibiotic and environmental improvements in trachoma endemic communities. Impact assessments measure only trachomatous inflammation-follicular (TF). Trachomatous inflammation-intense (TI) is not used for decisions on stopping mass drug administration (MDA) or achieving intervention goals. We tested the supposition that TI was not associated with Chlamydia trachomatis when disease prevalence is low.
In 35 communities undergoing MDA as part of a larger project, 110 children ages 1 to 9 years were randomly selected in each community for surveys at baseline, 6, and 12 months. Both eyelids were graded for TF and TI, and a swab for detection of C. trachomatis infection was taken.
Overall TF prevalence was 5% at baseline. Cases of TI alone constituted 15% of trachoma; 37% of TI cases had infection. At 6 and 12 months, the proportion of trachoma cases that had TI only was 13% and 20%; infection rates were similar to the rates in cases with TF alone.
Despite low prevalence of trachoma, infection rates for TF alone and TI alone were similar at each time point. The exclusion of cases of TI alone when reporting trachoma prevalence discards additional information on infection. Trachomatous inflammation-intense could be considered as part of impact surveys.
临床沙眼是衡量沙眼流行社区抗生素治疗效果和环境改善效果的当前指标。影响评估仅衡量滤泡性沙眼炎症（TF）。重度沙眼炎症（TI）不用于决定停止大规模药物给药（MDA）或实现干预目标。我们检验了在疾病患病率较低时TI与沙眼衣原体无关的假设。
在作为一个更大项目一部分正在接受MDA的35个社区中，每个社区随机选取110名1至9岁儿童在基线、6个月和12个月时进行调查。对双眼睑进行TF和TI分级，并采集拭子检测沙眼衣原体感染。
基线时总体TF患病率为5%。仅TI病例占沙眼病例的15%；37%的TI病例有感染。在6个月和12个月时，仅患有TI的沙眼病例比例分别为13%和20%；感染率与仅患有TF的病例相似。
尽管沙眼患病率较低，但在每个时间点，仅TF和仅TI的感染率相似。在报告沙眼患病率时排除仅TI的病例会丢弃有关感染的额外信息。重度沙眼炎症可被视为影响调查的一部分。
