Progression of scarring trachoma in Tanzanian children: A four-year cohort study

Trachoma is a progressive blinding disease initiated by infection of the conjunctiva with Chlamydia trachomatis. Repeated infections are thought to cause chronic inflammation, which drives scarring, leading to in-turning of the eyelids. The relationship between C. trachomatis, clinical inflammation...

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Bibliographic Details
Published in:PLoS neglected tropical diseases 2019-08, Vol.13 (8), p.e0007638-e0007638
Main Authors: Ramadhani, Athumani M, Derrick, Tamsyn, Macleod, David, Massae, Patrick, Mafuru, Elias, Malisa, Aiweda, Mbuya, Kelvin, Roberts, Chrissy H, Makupa, William, Mtuy, Tara, Bailey, Robin L, Mabey, David C W, Holland, Martin J, Burton, Matthew J
Format: Article
Language:English
Subjects:
Antibiotics
Bacteria
Bacterial infections
Biology and Life Sciences
Child
Child development
Children
Chlamydia
Chlamydia infections
Chlamydia trachomatis
Chlamydia trachomatis - isolation & purification
Chlamydia trachomatis - pathogenicity
Cicatrix - epidemiology
Cohort analysis
Cohort Studies
Cohorts
Complications
Conjunctiva
Conjunctiva - diagnostic imaging
Control programs
Correlation analysis
Demographic aspects
Detection
Development and progression
Disease Progression
Female
Genomes
Humans
Hygiene
Incidence
Infection
Infections
Inflammation
Longitudinal Studies
Male
Medical research
Medicine
Medicine and Health Sciences
Odds Ratio
Pediatric diseases
People and Places
Research and Analysis Methods
Risk Factors
Scars
Sexually transmitted diseases
STD
Studies
Supervision
Surgery
Tanzania - epidemiology
Trachoma
Trachoma - epidemiology
Tropical diseases
Tumor necrosis factor-TNF
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Description
Summary:Trachoma is a progressive blinding disease initiated by infection of the conjunctiva with Chlamydia trachomatis. Repeated infections are thought to cause chronic inflammation, which drives scarring, leading to in-turning of the eyelids. The relationship between C. trachomatis, clinical inflammation and scarring development in children is not fully understood due to a paucity of longitudinal studies with infection data at frequent follow-up. This longitudinal cohort study took place in northern Tanzania. Children aged 6-10 years at baseline were eligible for inclusion. Participants were visited every three months for four years. Clinical signs and conjunctival swabs for C. trachomatis detection by qPCR were collected at each time-point. Conjunctival photographs from baseline and final time-points were graded and compared side-by-side to determine scarring incidence and progression. Of the 666 children enrolled in the study, outcome data were obtained for 448. Scarring progression was detected in 103/448 (23%) children; 48 (11%) of which had incident scarring and 55 (12%) had progression of existing scarring. Scarring was strongly associated with increasing episodes of trachomatous papillary inflammation (TP). Weaker associations were found between episodes of C. trachomatis infection and follicular trachoma (TF) with scarring progression in unadjusted models, which were absent in multivariable analysis after adjusting for inflammation (multivariable results: C. trachomatis p = 0.44, TF p = 0.25, TP p =
ISSN:1935-2735
1935-2727
1935-2735
DOI:10.1371/journal.pntd.0007638