September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Evaluation of Surveillance Tools for Trachoma in Two Districts in Nepal
Author Affiliations & Notes
  • Andrea Isabela Zambrano
    Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Beatriz E Munoz
    Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Shekhar Sharma
    Nepal Netra Jyoti Sangh, Kathmandu, Nepal
  • Sailesh Mishra
    Nepal Netra Jyoti Sangh, Kathmandu, Nepal
  • Laura Dize
    Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Katherine Crowley
    RTI International, Washington, District of Columbia, United States
  • Lisa Rotondo
    RTI International, Washington, District of Columbia, United States
  • Sheila K West
    Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Andrea Zambrano, None; Beatriz Munoz, None; Shekhar Sharma, None; Sailesh Mishra, None; Laura Dize, None; Katherine Crowley, None; Lisa Rotondo, None; Sheila West, None
  • Footnotes
    Support  Grant from the Bill and Melinda Gates Foundation to the NTD Support Center; surveys were conducted with assistance from RTI International with funding from the US Agency for International Development and the ENVISION project. International Trachoma Initiative supplied the Cepheid machine for use in Nepal.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2349. doi:
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      Andrea Isabela Zambrano, Beatriz E Munoz, Shekhar Sharma, Sailesh Mishra, Laura Dize, Katherine Crowley, Lisa Rotondo, Sheila K West; Evaluation of Surveillance Tools for Trachoma in Two Districts in Nepal. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2349.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : As more countries achieve elimination goals for active trachoma, surveillance is necessary for verification of absence of re-emergence. In Nepal, surveillance surveys in all formerly endemic districts have started. During these pre-validation surveillance surveys, we added a test of infection processed locally, and antibody detection in young children, to the clinical grading of active trachoma to evaluate the possible role of these tools in surveillance programs.

Methods : 15 randomly selected clusters within two districts were chosen (30 clusters). In each cluster, 50 randomly selected children ages 1-9 year olds and 100 adults ≥15 years old were examined for TF±TI and TT respectively (1500 children and 3000 adults). Eye swabs were taken from all children to test for C. trachomatis (CT) using the Cepheid GeneXpert platform (Cepheid, Sunnyvale, CA). Dried blood spots were collected from children 1-4 and 9 years (794 children) to determine antibody positivity to the C. trachomatis antigen pgp3. Blood spots were processed on the Luminex-100 platform following standard procedures. Data were analyzed as simple frequencies, and age stratified proportions.

Results : Districts were 2 and 4 years from last program activities. In the sampled 1500 children, only 2 TF cases and one CT infection were found. Overall antibody positivity was found in 2.4% of samples with no increase in frequency by age. There was no evidence for clustering of antibody positivity by community.

Conclusions : There is no evidence of re-emergence in those two districts in Nepal. The absence of an increase in age seroprevalence suggests interruption of transmission of C. trachomatis.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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