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Sheila K West, Harran Mkocha, Beatriz E Munoz, Kasubi Mabula, Meraf Wolle; The Association of Trachomatous Scarring and Infections with non- C. trachomatis bacteria in Women in Kongwa, Tanzania. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1674.
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© ARVO (1962-2015); The Authors (2016-present)
Trachomatous Scarring is the result of repeated bouts of infection with C. trachomatis in trachoma endemic communities. Women have double the rate of scarring compared to men, attributed to their closer proximity to children who are the community reservoir of infection. Research has suggested that signs of active trachoma may be due to infections with other bacteria as well. However, it is not known if scarring is related to the presence of other, non-C. trachomatis bacteria in the eye. The purpose of this study was to determine the association of scarring and severity of scarring with the presence of other bacteria in the eye.
A cross sectional study of scarring in 4800 randomly selected women age 18 and above was carried out in 48 communities in Kongwa district, Tanzania. Images of the upper conjunctiva of the right eye were taken and graded for presence and severity of scarring using a published scheme. A single eye swab was taken, following strict protocol for avoiding any contamination and processed for the presence of other non-commensal bacteria.
4064 (85%) of the 4800 women selected participated in the study, and photographs have been graded on 651. There were no differences by age or markers of SES between those who participated and those who did not. The rate of scarring overall was 35%, and increased with age (p<0.001). There was not an association between scarring and rate of carriage of other ocular pathogens, with 18% of women with scarring having other ocular pathogens and 16% of women with mild or no scarring with pathogens (age adjusted p=0.51).
Based on these data we found no evidence of a cross sectional association between the presence of non-chlamydial organisms and scarring in women in trachoma endemic communities.
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