Volume 98, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



The target end date for the global elimination of trachoma as a public health problem is 2020. As countries begin the process for submitting their dossier for the validation of elimination of trachoma as a public health problem, strategies for post-validation surveillance must be considered. Seroprevalence of antibodies against antigens from the causative bacteria () in young children has been shown to reflect trachomatous inflammation–follicular (TF) rates in both endemic and previously endemic settings. However, none of these studies has directly compared age seroprevalence in the same communities before and after mass drug administration (MDA) for trachoma. Here we report a marked shift in age seroprevalence curves in four villages in Kapilvastu District, Nepal, before and after MDA. Clinical examinations were performed and blood was taken before ( = 659) and 5 years after ( = 646) MDA. Rates of TF decreased from 17.6% in ≤ 9-year-olds before MDA ( = 52) to 0% in ≤ 9-year-olds ( = 73) after MDA. Positive antibody responses to in the entire population decreased from 82.1% pre-MDA to 35.8% post-MDA, whereas those among ≤ 9-year-olds decreased from 59.6% to 4.1%. These data show that the postintervention decrease in TF was reflected in a drop in anti- antibody responses, suggesting that antibody responses could be useful indicators for post-validation surveillance.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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  1. Burton MJ, Hu VH, Massae P, Burr SE, Chevallier C, Afwamba IA, Courtright P, Weiss HA, Mabey DC, Bailey RL, , 2011. What is causing active trachoma? The role of nonchlamydial bacterial pathogens in a low prevalence setting. Invest Ophthalmol Vis Sci 52: 60126017. [Google Scholar]
  2. Bailey R, Duong T, Carpenter R, Whittle H, Mabey D, , 1999. The duration of human ocular Chlamydia trachomatis infection is age dependent. Epidemiol Infect 123: 479486. [Google Scholar]
  3. See CW, Alemayehu W, Melese M, Zhou Z, Porco TC, Shiboski S, Gaynor BD, Eng J, Keenan JD, Lietman TM, , 2011. How reliable are tests for trachoma?–a latent class approach. Invest Ophthalmol Vis Sci 52: 61336137. [Google Scholar]
  4. Solomon AW, Peeling RW, Foster A, Mabey DC, , 2004. Diagnosis and assessment of trachoma. Clin Microbiol Rev 17: 9821011 . [Google Scholar]
  5. Wright HR, Taylor HR, , 2005. Clinical examination and laboratory tests for estimation of trachoma prevalence in a remote setting: what are they really telling us? Lancet Infect Dis 5: 313320. [Google Scholar]
  6. Goodhew EB, Priest JW, Moss DM, Zhong G, Munoz B, Mkocha H, Martin DL, West SK, Gaydos C, Lammie PJ, , 2012. CT694 and pgp3 as serological tools for monitoring trachoma programs. PLoS Negl Trop Dis 6: e1873. [Google Scholar]
  7. Martin DL, 2015. Serology for trachoma surveillance after cessation of mass drug administration. PLoS Negl Trop Dis 9: e0003555. [Google Scholar]
  8. Martin DL, 2015. Serological measures of trachoma transmission intensity. Sci Rep 5: 18532. [Google Scholar]
  9. West SK, Munoz B, Weaver J, Mrango Z, Dize L, Gaydos C, Quinn TC, Martin DL, , 2016. Can we use antibodies to Chlamydia trachomatis as a surveillance tool for National Trachoma Control Programs? Results from a District Survey. PLoS Negl Trop Dis 10: e0004352. [Google Scholar]
  10. Zambrano AI, Sharma S, Crowley K, Dize L, Munoz BE, Mishra SK, Rotondo LA, Gaydos CA, West SK, , 2016. 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. PLoS Negl Trop Dis 10: e0005003. [Google Scholar]
  11. Thylefors B, Dawson CR, Jones BR, West SK, Taylor HR, , 1987. A simple system for the assessment of trachoma and its complications. Bull World Health Organ 65: 477483. [Google Scholar]
  12. Goodhew EB, 2014. Longitudinal analysis of antibody responses to trachoma antigens before and after mass drug administration. BMC Infect Dis 14: 216. [Google Scholar]
  13. Pant BP, 2016. Control of trachoma from Achham district, Nepal: a cross-sectional study from the Nepal National Trachoma Program. PLoS Negl Trop Dis 10: e0004462. [Google Scholar]
  14. Chen D, Lei L, Lu C, Galaleldeen A, Hart PJ, Zhong G, , 2010. Characterization of Pgp3, a Chlamydia trachomatis plasmid-encoded immunodominant antigen. J Bacteriol 192: 60176024. [Google Scholar]
  15. Comanducci M, Manetti R, Bini L, Santucci A, Pallini V, Cevenini R, Sueur JM, Orfila J, Ratti G, , 1994. Humoral immune response to plasmid protein pgp3 in patients with Chlamydia trachomatis infection. Infect Immun 62: 54915497. [Google Scholar]
  16. Wang J, Zhang Y, Lu C, Lei L, Yu P, Zhong G, , 2010. A genome-wide profiling of the humoral immune response to Chlamydia trachomatis infection reveals vaccine candidate antigens expressed in humans. J Immunol 185: 16701680. [Google Scholar]
  17. Wills GS, Horner PJ, Reynolds R, Johnson AM, Muir DA, Brown DW, Winston A, Broadbent AJ, Parker D, McClure MO, , 2009. Pgp3 antibody enzyme-linked immunosorbent assay, a sensitive and specific assay for seroepidemiological analysis of Chlamydia trachomatis infection. Clin Vaccine Immunol 16: 835843. [Google Scholar]
  18. Gao XB, Xiao M, Wang J, Liu YJ, Liu QZ, Qi ML, , 2015. Optimization of candidate proteins for serological screening of Chlamydia trachomatis infection. Genet Mol Res 14: 1224012246. [Google Scholar]
  19. Gwyn S, Mitchell A, Dean D, Mkocha H, Handali S, Martin DL, , 2016. Lateral flow-based antibody testing for Chlamydia trachomatis. J Immunol Methods 435: 2731. [Google Scholar]

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  • Received : 10 Feb 2017
  • Accepted : 14 Sep 2017
  • Published online : 06 Nov 2017

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