Can Clinical Signs of Trachoma Be Used after Multiple Rounds of Mass Antibiotic Treatment to Indicate Infection?
Can Clinical Signs of Trachoma Be Used after Multiple Rounds of Mass Antibiotic Treatment to Indicate Infection?
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DOI：
10.1167/iovs.11-8074
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发表时间：
2011-11-01
影响因子：
4.4
通讯作者：
West, Sheila K.
中科院分区：
文献类型：
--
作者：
Munoz, Beatriz;Stare, Dianne;West, Sheila K.
目的.使用改良的世界卫生组织（WHO）分级方案评估临床体征的组合，以预测至少三轮大规模药物管理（MDA）后社区水平的极低感染率。71个村庄进行了3至7轮MDA。随机抽取7828名5岁及以下儿童进行沙眼检查，并测定沙眼衣原体感染。针对滤泡性沙眼（TF）和炎性沙眼（TI）的所有可能组合，评估感染阳性儿童的比例。感染的高危体征（HRS）定义为表明感染患病率> 20%的体征。检测HRS流行率在识别感染社区中的敏感性和特异性。社区感染率中位数为3.8%四分位距（IQR）（1.8%，7.7%）;沙眼患病率中位数为9.4%，IQR（6.6%，15%）。严重的TI、TF和TI的组合（WHO标准）或严重的TF伴炎症体征是社区感染的预测因素，但这些HRS的缺失并不是低感染率的指标。使用HRS来确定社区的感染状况并不能预测MDA是否可以停止。（Invest Ophthalmol维斯科学。2011;52：8806-8810）DOI：10.1167/iovs.11-8074
PURPOSE. To evaluate combinations of clinical signs, using a modified World Health Organization (WHO) grading scheme, to predict a very low prevalence of infection at the community level after at least three rounds of mass drug administration (MDA).METHODS. Seventy-one villages had three to seven rounds of MDA. A random sample of 7828 children ages 5 years and younger was evaluated for trachoma, and determination of Chlamydia trachomatis infection was made. Proportions of children positive for infection were evaluated against all possible combinations of follicular trachoma (TF) and inflammatory trachoma (TI). High-risk signs (HRS) for infection were defined as those indicating the infection prevalence was >20%. The sensitivity and specificity of prevalence of HRS in identifying communities with infection was examined.RESULTS. The median community infection prevalence was 3.8% interquartile range (IQR) (1.8%, 7.7%); the median trachoma prevalence was 9.4%, IQR (6.6%, 15%). Severe TI, combination of TF and TI (WHO criteria), or severe TF with signs of inflammation were predictive of infection in the community, but the absence of these HRS was not an indicator of low infection rates.CONCLUSIONS. The use of HRS to determine the infection status of a community was not useful in predicting whether MDA could be stopped. (Invest Ophthalmol Vis Sci. 2011;52:8806-8810) DOI:10.1167/iovs.11-8074