The World Health Organization Recommendations for Trachoma Surveillance, Experience in Nepal and Added Benefit of Testing for Antibodies to Chlamydia trachomatis pgp3 Protein: NESTS Study.
The World Health Organization Recommendations for Trachoma Surveillance, Experience in Nepal and Added Benefit of Testing for Antibodies to Chlamydia trachomatis pgp3 Protein: NESTS Study.
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DOI：
10.1371/journal.pntd.0005003
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发表时间：
2016-09
影响因子：
3.8
通讯作者：
West SK
中科院分区：
文献类型：
--
作者：
Zambrano AI;Sharma S;Crowley K;Dize L;Muñoz BE;Mishra SK;Rotondo LA;Gaydos CA;West SK
世界卫生组织(WHO)现在要求在影响评估发现滤泡性沙眼(Tf；lt；5%)后进行第二次沙眼监测调查，以确定是否再次出现沙眼。使用新的世卫组织指南，我们在尼泊尔的两个地区进行了监测调查，并确定了感染率和抗体阳性。在每个区内随机抽取20个聚集点，随机抽取15个聚集点进行抗体检测。在每一组中，我们随机选择了50名1-9岁的儿童和100名15岁的成年人≥。对Tf和沙眼倒睫(TT)进行评估。采集结膜拭子，用GenXpert平台检测衣原体感染，用Luminex平台采集干血点，检测沙眼衣原体Pgp3抗体。在这两个地区发现了3例转铁蛋白，1例感染。Pgp3抗体阳性率为2.4%(95%可信区间：1.4%、3.7%)，且不随年龄增长而增加(P=0.24)。未发现社区内抗体阳性的聚集性。TT患病率为1/1000人。根据世卫组织的建议进行的监测调查没有证据表明尼泊尔两个地区再次出现沙眼。沙眼衣原体Pgp3抗体水平较低，且不随年龄增加而显著升高，值得进一步研究，作为阻断传播的标志。一旦地区显示1-9岁儿童滤泡性沙眼(TF)的患病率低于5%，他们必须监测是否再次出现。世界卫生组织(WHO)建议进行第二次监测或“预验证”调查，以确定是否再次出现疫情。使用新的世卫组织指南，我们在尼泊尔的两个地区进行了监测调查，并确定了抗体阳性的流行率。在每个区内随机抽取20个聚集点，随机抽取15个聚集点进行抗体检测。每组随机抽取1~9岁儿童50名和15岁成人≥各100名。对滤泡性沙眼(TF)进行评估，取结膜拭子检测衣原体感染，采集干血点检测儿童Pgp3抗体。对成人进行沙眼倒睫(TT)评估。这两个地区仅发现3例转铁蛋白，1例感染。Pgp3抗体总阳性率较低(2.4%)，随年龄增长呈上升趋势，社区内未见聚集性。TT患病率为1/1000人。根据世卫组织的建议，我们的监测调查没有证据表明尼泊尔两个地区再次出现沙眼。在沙眼衣原体抗体阳性的儿童中，沙眼衣原体抗体水平较低且随年龄增长不明显，值得进一步研究，作为阻断传播的标志。
The World Health Organization (WHO) now requires a second surveillance survey for trachoma after an impact assessment has found follicular trachoma (TF) <5% to determine if re-emergence has occurred. Using new WHO guidelines, we undertook surveillance surveys, and determined the prevalence of infection and antibody positivity, in two districts in Nepal. 20 clusters were randomly selected within each district, 15 were randomly selected for antibody testing. In each cluster, we randomly selected 50 children ages 1–9 years and 100 adults ≥15 years. TF and trachomatous trichiasis (TT) were evaluated. Conjunctival swabs to test for chlamydial infection using GenXpert platform were obtained, and dried blood spots were collected to test for antibodies to Chlamydia Trachomatis pgp3 using the Luminex platform. 3 cases of TF were found in the two districts, and one case of infection. Pgp3 antibody positivity was 2·4% (95% confidence interval: 1·4%, 3·7%), and did not increase with age (P = 0.24). No clustering of antibody positivity within communities was found. TT prevalence was <1/1,000 population. The surveillance surveys, as proposed by WHO, showed no evidence for re-emergence of trachoma in two districts of Nepal. The low level and no significant increase by age in seroprevalence of antibodies to C trachomatis pgp3 antigen deserve further investigation as a marker of interruption of transmission. Once districts have shown that the prevalence of follicular trachoma (TF) in children ages 1–9 years is below 5%, they must monitor for re-emergence. The World Health Organization (WHO) recommends a second surveillance or “pre-validation” survey to determine if re-emergence has occurred. Using new WHO guidelines, we undertook surveillance surveys, and determined the prevalence of antibody positivity, in two districts in Nepal. 20 clusters were randomly selected within each district, 15 were randomly selected for antibody testing. In each cluster, 50 children ages 1–9 years and 100 adults ≥15 years were randomly selected. Follicular trachoma (TF) was evaluated, conjunctival swabs to test for chlamydial infection were obtained, and dried blood spots were collected to test for antibodies to pgp3 in children. Adults were evaluated for trachomatous trichiasis (TT). Only 3 cases of TF were found in the two districts, and one case of infection. Overall Pgp3 antibody positivity was low (2·4%), it increase with age, and no clustering within communities was found. TT prevalence was <1/1,000 population. Our surveillance surveys, as proposed by WHO, showed no evidence for re-emergence of trachoma in two districts of Nepal. The low level and not significant increase by age in children with positive antibodies to Chlamydia trachomatis deserve further investigation as a marker of interruption of transmission.
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影响因子：
13.7
作者：
Hu, Victor H.;Weiss, Helen A.;Burton, Matthew J.
通讯作者：
Burton, Matthew J.
影响因子：
4.1
作者：
BARBER, K;DABBS, T
通讯作者：
DABBS, T
影响因子：
--
作者：
Khandekar, Rajiv
通讯作者：
Khandekar, Rajiv
影响因子：
3.8
作者：
Goodhew EB;Priest JW;Moss DM;Zhong G;Munoz B;Mkocha H;Martin DL;West SK;Gaydos C;Lammie PJ
通讯作者：
Lammie PJ
影响因子：
4.1
作者：
Mariotti, S. P.;Pascolini, D.;Rose-Nussbaumer, J.
通讯作者：
Rose-Nussbaumer, J.