Volume 97, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Antibody responses to (CT) antigens may be useful tools for surveillance of trachoma by estimating cumulative prevalence of infection within a population. Data were compared from three different platforms—multiplex bead array (MBA), enzyme-linked immunosorbent assay (ELISA), and lateral flow assay (LFA)—measuring antibody responses against the CT antigen protein plasmid gene product 3 (Pgp3). Sensitivity was defined as the proportion of specimens testing antibody positive from a set of dried blood spots from Tanzanian 1–9-year olds who were positive for CT nucleic acid of all nucleic acid amplification test (NAAT)-positive individuals ( = 103). The sensitivity of the LFA could not be determined because of the use of dried blood spots for this test; this specimen type has yet to be adapted to LFA. Specificity was defined as the proportion of sera from U.S. and Bolivian 1–9-year olds that had previously tested negative by the microimmunofluorescence (MIF) assay testing negative to Pgp3-specific antibodies ( = 154). The sensitivity for MBA and ELISA was the same—93.2 (95% confidence interval [CI]: 88.3–98.1). Specificity ranged across platforms from 96.1 (95% CI: 91.8–98.2) to 99.4% (95% CI: 98.2–100). ELISA performance was similar regardless of whether the plates were precoated or freshly coated with antigen. Sensitivity and specificity of control panels were similar if the cutoff was determined using receiver operator curves or a finite mixture model, but the cutoffs themselves differed by approximately 0.5 OD using the different methodologies. These platforms show good sensitivity and specificity and show good agreement between tests at a population level, but indicate variability for ELISA outcomes depending on the cutoff determination methodology.

[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.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. 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]
  2. WHO, 2014. WHO alliance for the elimination of blinding trachoma by the year 2020. Wkly Epidemiol Rec 92: 421428. [Google Scholar]
  3. WHO, 1997. Report of the First Meeting of the WHO Alliance for the Global Elimination of Trachoma. Geneva, Switzerland: World Health Organization.
  4. 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]
  5. Goodhew EB, 2014. Longitudinal analysis of antibody responses to trachoma antigens before and after mass drug administration. BMC Infect Dis 14: 216. [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. Horner PJ, Wills GS, Reynolds R, Johnson AM, Muir DA, Winston A, Broadbent AJ, Parker D, McClure MO, , 2013. Effect of time since exposure to Chlamydia trachomatis on Chlamydia antibody detection in women: a cross-sectional study. Sex Transm Infect 89: 398403. [Google Scholar]
  8. 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]
  9. Horner P, Soldan K, Vieira SM, Wills GS, Woodhall SC, Pebody R, Nardone A, Stanford E, McClure MO, , 2013. C. trachomatis Pgp3 antibody prevalence in young women in England, 1993–2010. PLoS One 8: e72001. [Google Scholar]
  10. Martin DL, 2015. Serology for trachoma surveillance after cessation of mass drug administration. PLoS Negl Trop Dis 9: e0003555. [Google Scholar]
  11. Martin DL, 2015. Serological measures of trachoma transmission intensity. Sci Rep 5: 18532. [Google Scholar]
  12. 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]
  13. Banniettis N, Thumbu S, Szigeti A, Chotikanatis K, Braunstein M, Gadir GAE, Hammerschlag M, Kohlhoff S, , 2015. Seroprevalence of Chlamydia trachomatis (CT) in inner city children and adolescents: implications for vaccine development. Open Forum Infect Dis 2: 1569. [Google Scholar]
  14. Cocks N, 2016. Community seroprevalence survey for yaws and trachoma in the western division of Fiji. Trans R Soc Trop Med Hyg 110: 582587. [Google Scholar]
  15. Migchelsen SJ, 2017. Defining seropositivity thresholds for use in Trachoma Elimination Studies. PLoS Negl Trop Dis 11: e0005230. [Google Scholar]
  16. Bland JM, Altman DG, , 2003. Applying the right statistics: analyses of measurement studies. Ultrasound Obstet Gynecol 22: 8593. [Google Scholar]
  17. Golden A, 2016. Analysis of age-dependent trends in Ov16 IgG4 seroprevalence to onchocerciasis. Parasit Vectors 9: 338. [Google Scholar]
  18. 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]
  19. 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]
  20. Donati M, Laroucau K, Storni E, Mazzeo C, Magnino S, Di Francesco A, Baldelli R, Ceglie L, Renzi M, Cevenini R, , 2009. Serological response to pgp3 protein in animal and human chlamydial infections. Vet Microbiol 135: 181185. [Google Scholar]

Data & Media loading...

  • Received : 09 Apr 2017
  • Accepted : 01 Jul 2017
  • Published online : 25 Sep 2017

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error