Trachoma is a disease caused by repeated eye infection with certain types of C trachomatis. In 1995, nearly 6 million people were blind because of the disease. The World Health Organization (WHO) aims to eliminate trachoma by 2020 through adoption of the SAFE strategy (Surgery for people with trichiasis, Antibiotics to treat C trachomatis infection, Face cleanliness, and Environmental improvement). The A component is designed to treat C trachomatis infection and is currently initiated by the prevalence of clinical signs of trachomatous inflammation (TF). However, TF correlates poorly with the presence of infection.
Helen Lee and Claude-Edouard Michel from the University of Cambridge, UK, together with colleagues from the Kilimanjaro Centre of Community Ophthalmology, Moshi, Tanzania, the London School of Hygiene and Tropical Medicine, UK, and the Johns Hopkins University, Baltimore, MD, USA, compared a newly developed point-of-care (POC) assay for C trachomatis with the standard TF technique. The study involved 664 children from villages in Tanzania. They found that the new test had a higher specificity (proportion of people without infection who have a negative result, 99.4%) and sensitivity (proportion of people with infection who have a positive result, 83.6%) than the TF method.
Dr Lee states: "The POC assay assessed here has substantial advantages over the use of clinical signs. If the POC assay was to become widely available at low cost, it could help programmes reliably identify communities needing mass treatment with antibiotics."
Study collaborator Paul Courtright (Kilimanjaro Centre of Community Ophthalmology, Moshi, Tanzania) said: "The findings from the POC study will likely lead to a major re-think on how we condu
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Contact: Joe Santangelo
j.santangelo@elsevier.com
212-633-3810
Lancet
11-May-2006