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Incidence and progression of trachomatous scarring in a cohort of children in a formerly hyper-endemic district of Tanzania
Trachoma is the leading infectious cause of blindness. Repeated or persistent ocular infection with Chlamydia trachomatis in childhood leads to conjunctival scarring, usually in adulthood but often earlier in areas with greater disease burden. There are limited longitudinal data examining change in...
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| Published in: | PLoS neglected tropical diseases 2020-10, Vol.14 (10), p.e0008708-e0008708 |
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| creator | Kashaf, Michael Saheb Muñoz, Beatriz E Mkocha, Harran Wolle, Meraf A Naufal, Fahd West, Sheila K |
| description | Trachoma is the leading infectious cause of blindness. Repeated or persistent ocular infection with Chlamydia trachomatis in childhood leads to conjunctival scarring, usually in adulthood but often earlier in areas with greater disease burden. There are limited longitudinal data examining change in scarring in children, especially where trachoma rates are low.
A cohort of children, ages 1-9 years, were randomly selected at baseline from 38 communities in Kongwa, Tanzania and followed for 2 years. Rates of trachomatous inflammation-follicular (TF) were |
| doi_str_mv | 10.1371/journal.pntd.0008708 |
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A cohort of children, ages 1-9 years, were randomly selected at baseline from 38 communities in Kongwa, Tanzania and followed for 2 years. Rates of trachomatous inflammation-follicular (TF) were <5% over the survey period. At baseline, 1,496 children were recruited and 1,266 (85%) were followed-up. Photographs were obtained at baseline and follow-up and graded for the presence and severity of scarring using a four-point scale ranging between S1-S4. In children without scarring at baseline, 1.6% (20/1,246) were found to have incident scarring, and incident scarring was more common among girls compared to boys. Among children with scarring at baseline, 21% (4/19) demonstrated progression.
In this formerly hyper-endemic district, the incidence of new scarring in children ages 1-9 years is low, although 21% of those who had scarring at baseline progressed in severity over the 2-year follow-up period. These data provide support for the thesis that while incident scarring more closely reflects ongoing exposure, progression may involve factors independent of ongoing transmission of trachoma.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0008708</identifier><identifier>PMID: 33017417</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Antibiotics ; Biology and Life Sciences ; Blindness ; Care and treatment ; Child ; Child, Preschool ; Children ; Chlamydia ; Chlamydia trachomatis ; Chlamydia trachomatis - isolation & purification ; Chlamydia trachomatis - pathogenicity ; Cicatrix - epidemiology ; Cohort Studies ; Cohorts ; Community ; Conjunctiva - diagnostic imaging ; Development and progression ; Disease Progression ; Diseases ; Female ; Humans ; Incidence ; Infant ; Infections ; Inflammation ; Logistic Models ; Male ; Management ; Medical research ; Medicine and Health Sciences ; Medicine, Experimental ; People and Places ; Prevalence studies (Epidemiology) ; Risk Factors ; Scars ; Sexually transmitted diseases ; STD ; Supervision ; Surveying ; Tanzania - epidemiology ; Trachoma ; Trachoma - epidemiology ; Transmission ; Tropical diseases</subject><ispartof>PLoS neglected tropical diseases, 2020-10, Vol.14 (10), p.e0008708-e0008708</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Kashaf et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Kashaf et al 2020 Kashaf et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c624t-715edbcdbe2a637cd7166324da6d3ab64bb1ba86951de09a78a5bf49af52fe493</citedby><cites>FETCH-LOGICAL-c624t-715edbcdbe2a637cd7166324da6d3ab64bb1ba86951de09a78a5bf49af52fe493</cites><orcidid>0000-0003-0818-8100 ; 0000-0001-6106-3177</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2460998167/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2460998167?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33017417$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Bentwich, Zvi</contributor><creatorcontrib>Kashaf, Michael Saheb</creatorcontrib><creatorcontrib>Muñoz, Beatriz E</creatorcontrib><creatorcontrib>Mkocha, Harran</creatorcontrib><creatorcontrib>Wolle, Meraf A</creatorcontrib><creatorcontrib>Naufal, Fahd</creatorcontrib><creatorcontrib>West, Sheila K</creatorcontrib><title>Incidence and progression of trachomatous scarring in a cohort of children in a formerly hyper-endemic district of Tanzania</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>Trachoma is the leading infectious cause of blindness. Repeated or persistent ocular infection with Chlamydia trachomatis in childhood leads to conjunctival scarring, usually in adulthood but often earlier in areas with greater disease burden. There are limited longitudinal data examining change in scarring in children, especially where trachoma rates are low.
A cohort of children, ages 1-9 years, were randomly selected at baseline from 38 communities in Kongwa, Tanzania and followed for 2 years. Rates of trachomatous inflammation-follicular (TF) were <5% over the survey period. At baseline, 1,496 children were recruited and 1,266 (85%) were followed-up. Photographs were obtained at baseline and follow-up and graded for the presence and severity of scarring using a four-point scale ranging between S1-S4. In children without scarring at baseline, 1.6% (20/1,246) were found to have incident scarring, and incident scarring was more common among girls compared to boys. Among children with scarring at baseline, 21% (4/19) demonstrated progression.
In this formerly hyper-endemic district, the incidence of new scarring in children ages 1-9 years is low, although 21% of those who had scarring at baseline progressed in severity over the 2-year follow-up period. These data provide support for the thesis that while incident scarring more closely reflects ongoing exposure, progression may involve factors independent of ongoing transmission of trachoma.</description><subject>Age</subject><subject>Antibiotics</subject><subject>Biology and Life Sciences</subject><subject>Blindness</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Chlamydia</subject><subject>Chlamydia trachomatis</subject><subject>Chlamydia trachomatis - isolation & purification</subject><subject>Chlamydia trachomatis - pathogenicity</subject><subject>Cicatrix - epidemiology</subject><subject>Cohort Studies</subject><subject>Cohorts</subject><subject>Community</subject><subject>Conjunctiva - diagnostic imaging</subject><subject>Development and progression</subject><subject>Disease Progression</subject><subject>Diseases</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infections</subject><subject>Inflammation</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Management</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Medicine, Experimental</subject><subject>People and Places</subject><subject>Prevalence studies (Epidemiology)</subject><subject>Risk Factors</subject><subject>Scars</subject><subject>Sexually transmitted diseases</subject><subject>STD</subject><subject>Supervision</subject><subject>Surveying</subject><subject>Tanzania - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kashaf, Michael Saheb</au><au>Muñoz, Beatriz E</au><au>Mkocha, Harran</au><au>Wolle, Meraf A</au><au>Naufal, Fahd</au><au>West, Sheila K</au><au>Bentwich, Zvi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence and progression of trachomatous scarring in a cohort of children in a formerly hyper-endemic district of Tanzania</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>14</volume><issue>10</issue><spage>e0008708</spage><epage>e0008708</epage><pages>e0008708-e0008708</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>Trachoma is the leading infectious cause of blindness. Repeated or persistent ocular infection with Chlamydia trachomatis in childhood leads to conjunctival scarring, usually in adulthood but often earlier in areas with greater disease burden. There are limited longitudinal data examining change in scarring in children, especially where trachoma rates are low.
A cohort of children, ages 1-9 years, were randomly selected at baseline from 38 communities in Kongwa, Tanzania and followed for 2 years. Rates of trachomatous inflammation-follicular (TF) were <5% over the survey period. At baseline, 1,496 children were recruited and 1,266 (85%) were followed-up. Photographs were obtained at baseline and follow-up and graded for the presence and severity of scarring using a four-point scale ranging between S1-S4. In children without scarring at baseline, 1.6% (20/1,246) were found to have incident scarring, and incident scarring was more common among girls compared to boys. Among children with scarring at baseline, 21% (4/19) demonstrated progression.
In this formerly hyper-endemic district, the incidence of new scarring in children ages 1-9 years is low, although 21% of those who had scarring at baseline progressed in severity over the 2-year follow-up period. These data provide support for the thesis that while incident scarring more closely reflects ongoing exposure, progression may involve factors independent of ongoing transmission of trachoma.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33017417</pmid><doi>10.1371/journal.pntd.0008708</doi><orcidid>https://orcid.org/0000-0003-0818-8100</orcidid><orcidid>https://orcid.org/0000-0001-6106-3177</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age Antibiotics Biology and Life Sciences Blindness Care and treatment Child Child, Preschool Children Chlamydia Chlamydia trachomatis Chlamydia trachomatis - isolation & purification Chlamydia trachomatis - pathogenicity Cicatrix - epidemiology Cohort Studies Cohorts Community Conjunctiva - diagnostic imaging Development and progression Disease Progression Diseases Female Humans Incidence Infant Infections Inflammation Logistic Models Male Management Medical research Medicine and Health Sciences Medicine, Experimental People and Places Prevalence studies (Epidemiology) Risk Factors Scars Sexually transmitted diseases STD Supervision Surveying Tanzania - epidemiology Trachoma Trachoma - epidemiology Transmission Tropical diseases |
| title | Incidence and progression of trachomatous scarring in a cohort of children in a formerly hyper-endemic district of Tanzania |
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