PT  - JOURNAL ARTICLE
AU  - Robert Butcher
AU  - Oliver Sokana
AU  - Kelvin Jack
AU  - Diana L Martin
AU  - Matthew J Burton
AU  - Anthony W Solomon
AU  - David CW Mabey
AU  - Chrissy h. Roberts
TI  - Age-specific prevalence of anti-Pgp3 antibodies and severe conjunctival scarring in the Solomon Islands
AID  - 10.1101/141135
DP  - 2017 Jan 01
TA  - bioRxiv
PG  - 141135
4099  - http://biorxiv.org/content/early/2017/05/30/141135.short
4100  - http://biorxiv.org/content/early/2017/05/30/141135.full
AB  - Background Trachomatous trichiasis (TT) and ocular Chlamydia trachomatis (Ct) infection in the Solomon Islands are scarce, whereas trachomatous inflammation–follicular (TF) is prevalent.Methods We enrolled 1511 people aged ≥1 year from randomly selected households in 13 villages in which >10% of the population had TF prior to a single round of azithromycin MDA undertaken six months previously. Blood was collected from people of all ages to be screened for anti-Pgp3 antibodies. Photographs were collected from people of all ages for analysis of scarring severity.Results Conjunctival scars were visible in 13.1% of photographs. Mild (p<0.0001) but not severe (p=0.149) scars increased in prevalence with age. Anti-Pgp3 antibody seroprevalence was 18% in 1–9 year olds, increased sharply around the age of sexual debut, and reached 69% in those over 25 years. Anti-Pgp3 seropositivity did not increase significantly between the ages of 1–9 years, and was not associated with scarring in children (p=0.472) or TF in children (p=0.581).Conclusions Signs of trachoma are common in the Solomon Islands but occur frequently in individuals who have no serological evidence of prior ocular infection with Ct. WHO recommendations for directing MDA provision based on signs alone may not be suitable in this context.