Mwale Consity, Mboni Chileshe, Saasa Ngonda, Sikasunge Chummy S, Chelu Chisanga, Moonga Phyllis M, Hameja Grace, Nkhoma Levison, Shamilimo Frank, Kunda Namasiku S, Mulenga Glenda, Naluonde Tabonga, Mutale Nicholas, Boyd Sarah, Pearson-Clarke Rosemary, Bakhtiari Ana, Jimenez Cristina, Harding-Esch Emma M, Dejene Michael, Gass Katherine, Farber Katrina, Bah Mohamed, Mpyet Caleb, Masaninga Freddie, Bakyaita Nathan Nsubuga, Lundamo Mwila, Mutati Grace Chipalo, Mubita Sikufele, Kwendakwema Davison J, Courtright Paul, Solomon Anthony W, Muma Kangwa I M
Kitwe Teaching Eye Hospital, Administration Department, P.O. Box 20969, Kitwe 10101, Zambia.
Lusaka Apex Medical University, Faculty of Medicine, P.O. Box 31909, Lusaka 10101, Zambia.
Int Health. 2025 Aug 26. doi: 10.1093/inthealth/ihaf092.
The evaluation unit comprising Kaoma, Luampa, and Nkeyema districts, Western Province, Zambia, has persistent active trachoma. In 2023, we sought to compare the evaluation unit-level prevalence of the active trachoma sign, trachomatous inflammation-follicular (TF), to that of conjunctival Chlamydia trachomatis (Ct) infection and anti-Chlamydia trachomatis (Ct) seropositivity.
We conducted a cluster-sampled cross-sectional survey. In selected households, we examined all consenting residents ≥1 y of age for trachoma. We collected dried blood spots (DBSs) by finger-prick from children ages 1-9-y and conjunctival swabs from the left eyes of children ages 1-5-y. DBSs were tested for antibodies to the C. trachomatis antigen Pgp3 by lateral flow assay. We tested conjunctival swabs for C. trachomatis DNA by GeneXpert polymerase chain reaction (PCR).
The TF prevalence in children ages 1-9-y was 9.2%. In children ages 1-5-y, anti-Pgp3 seroprevalence was 1.7% and the seroconversion rate was 0.6 per 100 person-years. The prevalence of conjunctival C. trachomatis DNA in children ages 1-5-y was 0%.
Based on TF prevalence, this population qualified for additional antibiotic mass drug administration rounds, but PCR and serology-more specific indicators of current or recent C. trachomatis infection than TF-confirmed an absence of significant current community C. trachomatis transmission, allowing a transition to surveillance. Adding these indicators is helpful in persistent active trachoma.
赞比亚西部省由卡奥马、卢安帕和恩凯耶马区组成的评估单元存在持续性活动性沙眼。2023年，我们试图比较该评估单元层面活动性沙眼体征、沙眼性炎症滤泡型（TF）的患病率与结膜沙眼衣原体（Ct）感染及抗沙眼衣原体（Ct）血清阳性率。
我们开展了一项整群抽样横断面调查。在选定的家庭中，我们对所有年龄≥1岁且同意参与的居民进行沙眼检查。我们通过手指采血为1至9岁儿童采集干血斑（DBS），并为1至5岁儿童采集左眼结膜拭子。通过侧向流动分析法检测DBS中针对沙眼衣原体抗原Pgp3的抗体。我们通过GeneXpert聚合酶链反应（PCR）检测结膜拭子中的沙眼衣原体DNA。
1至9岁儿童的TF患病率为9.2%。在1至5岁儿童中，抗Pgp3血清阳性率为1.7%，血清转化率为每100人年0.6%。1至5岁儿童结膜沙眼衣原体DNA的患病率为0%。
基于TF患病率，该人群有资格进行额外轮次的抗生素群体给药，但PCR和血清学——比TF更能明确当前或近期沙眼衣原体感染的指标——证实目前社区中不存在显著的沙眼衣原体传播，从而可以过渡到监测。增加这些指标对持续性活动性沙眼有帮助。
