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Characterizing trachoma elimination using serology
Author(s)
University of California, San Francisco
Pearl Anne Ante-Testard
University of California, San Francisco
Sarah Gwyn
Centers for Disease Control and Prevention
Seth Blumberg
University of California, San Francisco
Zeinab Abdalla
Kristen Aiemjoy
Mahidol University
Abdou Amza
Solomon Aragie
University of California, San Francisco
Ahmed M. Arzika
Marcel S Awoussi
Togolese Ministry of Health
Robin L. Bailey
London School of Hygiene & Tropical Medicine
Robert Butcher
London School of Hygiene & Tropical Medicine
E. Kelly Callahan
Carter Center
David Chaima
Kamuzu University of Health Sciences
Adisu Abebe Dawed
Amhara Regional Health Bureau
Martha Idalí Saboyá-Díaz
World Health Organization Regional Office for the Americas
Abou-Bakr Sidik Domingo
Togolese Ministry of Health
Chris Drakeley
London School of Hygiene & Tropical Medicine
Belgesa E Elshafie
Federal Ministry of Health
Paul M. Emerson
International Trachoma Initiative
Kimberly Fornace
National University of Singapore
Katherine Gass
The Task Force for Global Health
E. Brook Goodhew
Centers for Disease Control and Prevention
Jaouad Hammou
Direction de l’Epidémiologie et de Lutte contre les Maladies
Emma M. Harding‐Esch
London School of Hygiene & Tropical Medicine
PJ Hooper
International Trachoma Initiative
Boubacar Kadri
Khumbo Kalua
University of British Columbia
Sarjo Kanyi
Ministry of Health and Social Welfare
Mabula Kasubi
Amir Bedri Kello
World Health Organization Regional Office for Africa
Robert Ko
University of Papua New Guinea
Patrick J. Lammie
The Task Force for Global Health
Andrés G. Lescano
Universidad Peruana Cayetano Heredia
Ramatou Maliki
Michael Masika
Ministry of Health
Stephanie J Migchelsen
London School of Hygiene & Tropical Medicine
Beido Nassirou
John M. Nesemann
University of California, San Francisco
Nishanth Parameswaran
Centers for Disease Control and Prevention
William Pomat
Papua New Guinea Institute of Medical Research
Kristen K. Renneker
International Trachoma Initiative
Chrissy h. Roberts
London School of Hygiene & Tropical Medicine
Prudence Rymil
Eshetu Sata
University of California, Davis
Laura Senyonjo
Sightsavers
Fikre Seife
Federal Ministry of Health
Ansumana Sillah
Ministry of Health and Social Welfare
Oliver Sokana
Ariktha Srivathsan
University of California, San Francisco
Zerihun Tadesse
University of California, Davis
Fasihah Taleo
World Health Organization
Emma Michelle Taylor
Sightsavers
Rabebe Tekeraoi
Kwamy Togbey
Togolese Ministry of Health
Sheila K. West
Johns Hopkins University
Karana Wickens
Centers for Disease Control and Prevention
Timothy William
Subang Jaya Medical Centre
Dionna M. Wittberg
University of California, San Francisco
Dorothy Yeboah‐Manu
University of Ghana
Mohammed Youbi
Direction de l’Epidémiologie et de Lutte contre les Maladies
Tàye Zeru
Amhara National Regional State Public Health Institute
Jeremy D. Keenan
University of California, San Francisco
Thomas M. Lietman
University of California, San Francisco
Anthony W. Solomon
World Health Organization
Scott D. Nash
Carter Center
Diana L. Martin
Centers for Disease Control and Prevention
Benjamin F. Arnold
University of California, San Francisco
Date Issued
1 de julio de 2025
Type
Article
Volume
16
Issue
1
Series/Report No.
Nature Communications
Start Page
5545
End Page
5545
ISSN
2041-1723
Abstract
Trachoma is targeted for global elimination as a public health problem by 2030. Measurement of IgG antibodies in children is being considered for surveillance and programmatic decision-making. There are currently no programmatic guidelines based on serology, which represents a generalizable problem in seroepidemiology and disease elimination. Here, we collate Chlamydia trachomatis Pgp3 and CT694 IgG measurements from 48 serosurveys across Africa, Latin America, and the Pacific Islands (41,168 children ages 1-5 years) and propose a novel approach to estimate the probability that population C. trachomatis transmission is below or above levels requiring ongoing programmatic action. We determine that trachoma programs could halt control measures with >90% certainty when seroconversion rates (SCRs) are ≤2.2 per 100 person-years. Conversely, SCRs ≥4.5 per 100 person-years correspond with >90% certainty that further control interventions are needed. More extreme SCR thresholds correspond with higher levels of confidence of elimination (lower SCR) or ongoing action needed (higher SCR). This study demonstrates a robust approach for using trachoma serosurveys to guide elimination program decisions.
Keywords