Validation of elimination of trachoma as a public health problem is based on clinical indicators, which is increasingly problematic. Alternative indicators (antibody and infection) were integrated into the pre-validation trachoma surveys conducted in Ghana in 2015 and 2016.
This study shows that elimination of trachoma as a public health problem does not equate to the absence of ocular ‘Chlamydia trachomatis’ (Ct) infection, nor cessation in acquisition of anti-Ct antibodies. Infection and serological data provide useful information to aid in understanding Ct transmission dynamics and identify communities at potential risk of recrudescence.
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