Assessing the Prevalence of Trachoma: Lessons from Community Screening with Laboratory Testing in Australia's Torres Strait Islands.

Autor: Lynch KD; Communicable Diseases Branch, Prevention Division, Queensland Health, Brisbane, Australia.; UQ Centre for Clinical Research, the University of Queensland, Brisbane, Australia., Brian G; Communicable Diseases Branch, Prevention Division, Queensland Health, Brisbane, Australia., Ahwang T; Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia., Morotti W; Communicable Diseases Branch, Prevention Division, Queensland Health, Brisbane, Australia., Wharton G; Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia.; Best Practice Eyecare, Golden Beach, Australia., Newie T; Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia., Newie V; Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia., Perrett C; Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia., Ware W; Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia., Mosby L; Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia., Walters S; Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia., Brown A; Primary Health Care Services, Northern Sector, Torres and Cape Hospital and Health Service, Thursday Island, Australia.; Chief Executive, South West Hospital and Health Service, Roma, Australia., Whop LJ; National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia., Lambert SB; Communicable Diseases Branch, Prevention Division, Queensland Health, Brisbane, Australia.; UQ Centre for Clinical Research, the University of Queensland, Brisbane, Australia.; Surveillance, Coverage, Evaluation and Social Science, National Centre for Immunisation Research and Surveillance, Westmead, Australia.
Jazyk: angličtina
Zdroj: Ophthalmic epidemiology [Ophthalmic Epidemiol] 2023 Dec; Vol. 30 (6), pp. 663-670. Date of Electronic Publication: 2022 Oct 24.
DOI: 10.1080/09286586.2022.2136389
Abstrakt: Purpose: We undertook a screening program between 2016 and 2019 to determine if trachoma was endemic in the Torres Strait Islands of Queensland, Australia.
Methods: Eleven screening surveys assessing trachoma prevalence were undertaken in seven communities using the World Health Organization (WHO) simplified grading tool. Additionally, an ophthalmologist performed a detailed clinical assessment including examination for Herbert's pits and corneal pannus and, where clinically indicated, collection of conjunctival specimens to investigate the presence of Chlamydia trachomatis nucleic acid.
Results: Prevalence of trachomatous inflammation-follicular (TF) in children aged 5-9 years for the aggregated first survey across all communities was 6% (17/284). No child had trachomatous inflammation-intense, trachomatous scarring, corneal pannus, or Herbert's pits. Of the 66 times any child was tested for C. trachomatis by polymerase chain reaction (PCR), the result was negative. No cicatricial trachoma was identified amongst the adults (n = 186) who were opportunistically offered examination.
Conclusion: Whilst TF was present, the lack of intense inflammatory thickening in any child examined, the lack of end-stage trachomatous disease, and the lack of ocular C. trachomatis detection by PCR indicate trachoma is not endemic in the Torres Strait Islands, and no ongoing public health intervention is required. These findings add to a growing body of evidence suggesting that use of the WHO simplified grading tool alone in the peri-elimination setting may overestimate the community burden of trachoma.
Databáze: MEDLINE
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