Characterising trachoma elimination using serology

Summary

While the World Health Organization’s guidance based on prevalence of trachomatous inflammation–follicular (TF) has been central to the success of the global trachoma elimination programme, TF has been shown to be poorly correlated with evidence of conjunctival Chlamydia trachomatis (Ct) infection, especially after mass drug administration. Following increasing evidence of the utility of serology for monitoring Ct transmission intensity for trachoma elimination programmes, there was a need for thresholds to determine when programmatic action is, and is not, needed.

This paper proposes a novel approach to estimate the probability that population Ct transmission is below or above levels requiring ongoing programmatic action.