Dyer Clare E F, Cowling Carleigh S, Sokana Oliver, Neko Lazarus, Bainivalu Nemia, Pitakaka Freda, Cama Anasaini, Starr Mitchel, Harding-Esch Emma M, Jimenez Cristina, Bakhtiari Ana, Boyd Sarah, Webster Sara, Solomon Anthony W, Kaldor John M, Nery Susana Vaz
The Kirby Institute, University of New South Wales, Sydney, Australia.
Ministry of Health and Medical Services, Honiara, Solomon Islands.
PLoS Negl Trop Dis. 2025 Sep 8;19(9):e0013381. doi: 10.1371/journal.pntd.0013381. eCollection 2025 Sep.
Trachoma, caused by repeated ocular infection with Chlamydia trachomatis, remains a leading infectious cause of blindness globally, with significant implications for public health. The World Health Organization and partners aim to eliminate trachoma as a public health problem by 2030, targeting specific prevalence thresholds for trachomatous trichiasis (TT) and trachomatous inflammation-follicular (TF). Diagnosis is primarily clinical. Studies have shown discrepancies between prevalence estimates of TF and C. trachomatis infection. This study, undertaken in Choiseul, Solomon Islands, evaluated TF, evidence of current C. trachomatis infection (by polymerase chain reaction (PCR) on conjunctival swabs), and evidence of past exposure to that bacterium (using anti-Pgp3 serology on dried blood spots). Among 645 1-9-year-old children, TF prevalence was 17.5% and C. trachomatis prevalence was 8.5%. These findings suggest transmission of sufficient intensity to pose a public health problem. Notably, 59% of children with TF had evidence of neither current nor previous C. trachomatis infection. Increasing age was associated with TF and evidence of past infection, but not current infection. The community had poor water, sanitation, and hygiene conditions. This study highlights the benefit of integrating laboratory testing for guiding effective trachoma elimination as a public health problem. Although our work was limited by imperfect enrolment of resident children and the logistical challenges of collecting samples in a remote region, we believe our data justify continued public health interventions against trachoma in Choiseul.
沙眼由沙眼衣原体反复眼部感染引起，仍是全球失明的主要感染原因，对公共卫生有重大影响。世界卫生组织及其合作伙伴的目标是到2030年消除沙眼这一公共卫生问题，设定了沙眼性倒睫（TT）和沙眼性滤泡性炎症（TF）的特定患病率阈值。诊断主要依靠临床。研究表明TF患病率估计值与沙眼衣原体感染率之间存在差异。这项在所罗门群岛乔伊苏尔开展的研究，评估了TF、当前沙眼衣原体感染证据（通过结膜拭子聚合酶链反应（PCR）检测）以及既往接触该细菌的证据（使用干血斑抗Pgp3血清学检测）。在645名1至9岁儿童中，TF患病率为17.5%，沙眼衣原体患病率为8.5%。这些发现表明传播强度足以构成公共卫生问题。值得注意的是，59%患有TF的儿童既无当前也无既往沙眼衣原体感染证据。年龄增长与TF及既往感染证据相关，但与当前感染无关。该社区的水、环境卫生和个人卫生条件较差。这项研究凸显了整合实验室检测对指导有效消除沙眼这一公共卫生问题的益处。尽管我们的工作因常住儿童登记不完整以及在偏远地区采集样本的后勤挑战而受到限制，但我们认为我们的数据证明在乔伊苏尔继续开展针对沙眼的公共卫生干预是合理的。
