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      No Serological Evidence of Trachoma or Yaws Among Residents of Registered Camps and Makeshift Settlements in Cox’s Bazar, Bangladesh

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          Abstract.

          Successful achievement of global targets for elimination of trachoma as a public health problem and eradication of yaws will require control efforts to reach marginalized populations, including refugees. Testing for serologic evidence of transmission of trachoma and yaws in residents of registered camps and a Makeshift Settlement in Cox’s Bazar District, Bangladesh, was added to a serosurvey for vaccine-preventable diseases (VPDs) conducted April–May 2018. The survey was primarily designed to estimate remaining immunity gaps for VPDs, including diphtheria, measles, rubella, and polio. Blood specimens from 1- to 14-year-olds from selected households were collected and tested for antibody responses against antigens from Treponema pallidum and Chlamydia trachomatis using a multiplex bead assay to evaluate for serologic evidence of the neglected tropical diseases (NTDs) yaws and trachoma, respectively. The prevalence of antibodies against two C. trachomatis antigens in children ranged from 1.4% to 1.5% for Pgp3 and 2.8% to 7.0% for CT694. The prevalence of antibody responses against both of two treponemal antigens (recombinant protein17 and treponemal membrane protein A) tested was 0% to 0.15% in two camps. The data are suggestive of very low or no transmission of trachoma and yaws, currently or previously, in children resident in these communities. This study illustrates how integrated serologic testing can provide needed data to help NTD programs prioritize limited resources.

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          Control of neglected tropical diseases.

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            The Global Trachoma Mapping Project: Methodology of a 34-Country Population-Based Study

            ABSTRACT Purpose: To complete the baseline trachoma map worldwide by conducting population-based surveys in an estimated 1238 suspected endemic districts of 34 countries. Methods: A series of national and sub-national projects owned, managed and staffed by ministries of health, conduct house-to-house cluster random sample surveys in evaluation units, which generally correspond to “health district” size: populations of 100,000–250,000 people. In each evaluation unit, we invite all residents aged 1 year and older from h households in each of c clusters to be examined for clinical signs of trachoma, where h is the number of households that can be seen by 1 team in 1 day, and the product h × c is calculated to facilitate recruitment of 1019 children aged 1–9 years. In addition to individual-level demographic and clinical data, household-level water, sanitation and hygiene data are entered into the purpose-built LINKS application on Android smartphones, transmitted to the Cloud, and cleaned, analyzed and ministry-of-health-approved via a secure web-based portal. The main outcome measures are the evaluation unit-level prevalence of follicular trachoma in children aged 1–9 years, prevalence of trachomatous trichiasis in adults aged 15 + years, percentage of households using safe methods for disposal of human feces, and percentage of households with proximate access to water for personal hygiene purposes. Results: In the first year of fieldwork, 347 field teams commenced work in 21 projects in 7 countries. Conclusion: With an approach that is innovative in design and scale, we aim to complete baseline mapping of trachoma throughout the world in 2015.
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              Estimating medium- and long-term trends in malaria transmission by using serological markers of malaria exposure.

              The implementation and evaluation of malaria control programs would be greatly facilitated by new tools for the rapid assessment of malaria transmission intensity. Because acquisition and maintenance of antimalarial antibodies depend on exposure to malaria infection, such antibodies might be used as proxy measures of transmission intensity. We have compared the prevalence of IgG antibodies with three Plasmodium falciparum asexual stage antigens in individuals of all ages living at varying altitudes encompassing a range of transmission intensities from hyper- to hypoendemic in northeastern Tanzania, with alternative measures of transmission intensity. The prevalence of antibodies to merozoite surface protein-1(19) was significantly more closely correlated with altitude than either point-prevalence malaria parasitemia or single measures of hemoglobin concentration. Analysis of age-specific seroprevalence rates enabled differentiation of recent (seasonal) changes in transmission intensity from longer-term transmission trends and, using a mathematical model of the annual rate of seroconversion, estimation of the longevity of the antibody response. Thus, serological tools allow us to detect variations in malaria transmission over time. Such tools will be invaluable for monitoring trends in malaria endemicity and the effectiveness of malaria control programs.
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                Author and article information

                Journal
                Am J Trop Med Hyg
                Am J Trop Med Hyg
                tpmd
                tropmed
                The American Journal of Tropical Medicine and Hygiene
                The American Society of Tropical Medicine and Hygiene
                0002-9637
                1476-1645
                June 2021
                03 May 2021
                03 May 2021
                : 104
                : 6
                : 2031-2037
                Affiliations
                [1 ]Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;
                [2 ]Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia;
                [3 ]Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia;
                [4 ]National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
                [5 ]World Health Organization, Dhaka, Bangladesh;
                [6 ]United Nations Children’s Fund, Dhaka, Bangladesh;
                [7 ]World Health Organization, Geneva, Switzerland;
                [8 ]Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh
                Author notes
                [* ]Address correspondence to Diana Martin, 1600 Clifton Road NE, Atlanta, GA 30329. E-mail: hzx3@ 123456cdc.gov

                Disclaimer: The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated.

                Authors’ addresses: Gretchen M. Cooley and Diana L. Martin, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: xxd1@ 123456cdc.gov and hzx3@ 123456cdc.gov . Leora R. Feldstein, Epidemic Intelligence Service and Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: nqw5@ 123456cdc.gov . Sarah D. Bennett, Concepcion F. Estivariz, Laura Conklin, and Daniel C. Ehlman, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: iyk3@ 123456cdc.gov , cge3@ 123456cdc.gov , dvj3@ 123456cdc.gov , and euh3@ 123456cdc.gov . Lauren Weil, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: nsi4@ 123456cdc.gov . Rajendra Bohara, World Health Organization, Dhaka, Bangladesh, E-mail: boharar@ 123456who.int . Maya Vandenent, ASM Mainul Hasan, and Mohammad Saifuddin Akhtar, United Nations Children’s Fund, Dhaka, Bangladesh, E-mails: mvandenent@ 123456unicef.org , ashasan@ 123456unicef.org , and msakhtar@ 123456unicef.org . M. Salim Uzzaman, Mallick Masum Billah, ASM Alamgir, and Meerjady Sabrina Flora, Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh, E-mails msalimuzzaman@ 123456hotmail.com , drmasumbillah@ 123456yahoo.com , aalamgir@ 123456gmail.com , and meerflora@ 123456yahoo.com . Kingsley Asiedu and Anthony W. Solomon, World Health Organization, Geneva, Switzerland, E-mails: asieduk@ 123456who.int and solomona@ 123456who.int .

                Article
                tpmd210124
                10.4269/ajtmh.21-0124
                8176462
                33939630
                bedffb87-56be-4718-9535-d7b5f8748e2c
                Copyright @ 2021

                This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 01 February 2021
                : 16 March 2021
                Page count
                Pages: 7
                Categories
                Articles

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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