Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-22T16:16:40.717Z Has data issue: false hasContentIssue false
  • English
  • Français

A longitudinal study of trachoma in a Gambian village: implications concerning the pathogenesis of chlamydial infection

Published online by Cambridge University Press:  15 May 2009

D. C. W. Mabey ,
R. L. Bailey ,
M. E. Ward  and
H. C. Whittle
D. C. W. Mabey
Affiliation:
Department of Clinical Sciences, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT
R. L. Bailey
Affiliation:
Department of Clinical Sciences, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT
M. E. Ward
Affiliation:
Department of Microbiology, Southampton University Medical School
H. C. Whittle
Affiliation:
Medical Research Council Laboratories, Fajara, The Gambia
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

In order to investigate risk factors for the acquisition of trachoma, and to study the effect of continued exposure to ocular chlamydial infection on the severity of inflammatory trachoma and its cicatricial sequelae, a longitudinal study was conducted in a Gambian village. Over a 20-month period, the incidence of active (inflammatory) trachoma was significantly higher among those sharing a bedroom with an active case (64/561, 11·4%) than among those who were not exposed in this way (37/658, 5·6%) (relative risk 1·97, 95% confidence interval 1·33–2.90). There was a positive trend in the odds ratio for severe to moderate inflammatory disease versus mild disease as the number of active cases in the bedroom increased, but this failed to achieve statistical significance (P = 0·0506). Individuals with inflammatory trachoma of moderate or severe intensity at one survey were significantly more likely than others to have moderate or severe inflammatory changes at a previous or subsequent survey (odds ratio 14·9, 95% confidence interval 3·9–68·0), implying that host factors may be more important determinants of severity than the frequency of exposure to reinfection.

Type
Research Article
Information
Epidemiology & Infection , Volume 108 , Issue 2 , April 1992 , pp. 343 - 351
Copyright
Copyright © Cambridge University Press 1992

References

REFERENCES

1.Thompson, SE, Washington, AE. Epidemiology of sexually transmitted Chlamydia trachomatis infections. Epidemiol Rev 1983; 5: 96–123.CrossRefGoogle ScholarPubMed
2.Dawson, CR, Jones, BR, Tarizzo, ML. Guide to trachoma control in programmes for the prevention of blindness. Geneva: World Health Organisation. 1981.Google Scholar
3.Watkins, NG, Hadlow, WJ, Moos, AB, Caldwell, HD. Ocular delayed hypersensitivity: a pathogenetic mechanism of chlamydial conjunctivitis in guinea-pigs. Proc Natl Acad Sci 1986; 83: 7480–4.CrossRefGoogle ScholarPubMed
4.Taylor, HR, Johnson, SL, Schachter, J, Caldwell, HD, Prendergast, RA. Pathogenesis of trachoma: the stimulus for inflammation. J Immunol 1987; 138: 3023–7.CrossRefGoogle ScholarPubMed
5.Morrison, RP, Lyng, K, Caldwell, HD. Chlamydial disease pathogenesis. Ocular delayed hypersensitivity elicited by a genus-specific 57kD protein. J Exp Med 1989; 169: 663–75.CrossRefGoogle ScholarPubMed
6.Dawson, CR, Marx, R, Daghfous, T, Juster, R, Schachter, J. What clinical signs are critical in evaluating the impact of intervention in trachoma? In: Bowie, WR, Caldwell, HD. Jones, RP et al. . eds. Chlamydial infections. Cambridge: Cambridge University Press. 1990: 271–8.Google Scholar
7.Grayston, JT, Wang, S-P, Yeh, L-J, Kuo, C-C. Importance of reinfection in the pathogenesis of trachoma. Rev Infect Dis 1985; 7: 717–25.CrossRefGoogle ScholarPubMed
8.Nicholas, RL, Bobb, AA, Haddad, NA, MeComb, DE. Immunofluorescent studies of the microbiologic epidemiology of trachoma in Saudi Arabis. Am J Ophthalmol 1967; 63: 1372–408.CrossRefGoogle Scholar
9.Dawson, CR, Daghfous, T, Messadi, M, Hoshiwara, I, Schachter, J. Severe endemic trachoma in Tunisia. Br J Ophthalmol 1976; 60: 245–52.CrossRefGoogle ScholarPubMed
10.Bailey, R, Osmond, C, Mabey, DCW, Whittle, HC, Ward, ME. Analysis of the household distribution of trachoma in a Gambian village using a Monte Carlo simulation procedure. Int J Epidemiol 1989; 18: 944–51.CrossRefGoogle Scholar
11.Thompson, B. Marriage, childbirth and early childhood in a Gambian village: a sociomedical study. PhD thesis. University of Aberdeen. 1965.Google Scholar
12.Billewicz, WZ, McGregor, IA. The demography of two West African (Gambian) villages 1951–75. J Biosoc Sci. 1981; 13: 219–40.CrossRefGoogle ScholarPubMed
13.Wilkins, HA, Goll, PH, Marshall, TFdeC, Moore, PJ. Dynamics of Schistosoma haematobium in a Gambian community. I. The pattern of human infection in the study area. Trans R Soc Trop Med Hyg 1984; 78: 216–21.CrossRefGoogle Scholar
14.Mabey, DCW, Robertson, JN, Ward, ME. The detection of Chlamydia trachomatis by enzyme immunoassay in patients with trachoma. Lancet 1987; ii: 1491–2.CrossRefGoogle Scholar
15.Ripa, KT, Mardh, PA. New simplified culture techniques for Chlamydia trachomatis. Hobson, D. Holmes, KK, eds. Non-gonococcal urethritis and related infections. Washington, DC: American Society for Microbiology, 1977: 323–7.Google Scholar
16.Schlesselman, A. Case control studies. New York: Oxford University Press, 1982: 203–6.Google Scholar
17.Barenfanger, J. Studies on the role of the family unit in the transmission of trachoma. Am J Trop Med Hyg 1975; 24: 509–15.CrossRefGoogle ScholarPubMed
18.Treharne, JD. Seroepidemiological studies of trachoma. In: Mardh, P-A, ed. Chlamydial infections. Amsterdam: Elsevier Biomedical Press, 1982: 83–6.Google Scholar
19.Taylor, HR, West, SK, Mmbaga, BBO et al. , Hygiene factors and increased risk of trachoma in central Tanzania. Arch Ophthalmol 1989; 107: 1821–5.CrossRefGoogle ScholarPubMed
20.Bailey, R, Osmond, C, Mabey, DCW, Ward, ME. Household clustering of trachoma in The Gambia. In: Oriel, JD. Ridgway, G. Schachter, J, Taylor-Robinson, D, Ward, ME, eds. Chlamydial infections. Cambridge: Cambridge University Press, 1986: 145–8.Google Scholar
21.Mabey, DCW, Thomas, K. Genital infection with Chlamydia trachomatis and other pathogens among women in a rural Gambian village. Afr J Sex Transm Dis 1986; 2: 19–20.Google Scholar
22.Sowa, S, Sowa, J, Collier, LH, Blyth, W. Trachoma and allied infections in a Gambian village. Medical Research Council Special Report series, 1965, 308: 42.Google Scholar
23.Taylor, HR, Siler, JA, Mkocha, H et al. , The microbiology of endemic trachoma. A longitudinal study. Abstract, seventh international symposium on human chlamydial infections, Vancouver. 1990.Google Scholar
24.Hanna, L, Dawson, CR, Briones, O, Thygeson, P, Jawetz, E. Latency in human infections with TRIC agents. J Immunol 1968; 101: 43–50.CrossRefGoogle ScholarPubMed
25.Schachter, J, Moncada, J.Dawson, CR et al. , Non-culture methods for diagnosing chlamydial infection in patients with trachoma: a clue to the pathogenesis of the disease? J Infect Dis 1988; 158: 1347–52.CrossRefGoogle Scholar
26.Detels, R, Alexander, ER, Dhir, SP. Trachoma in Punjabi Indians in British Columbia. Am J Epidemiol 1966; 84: 81–91.CrossRefGoogle ScholarPubMed