182 results on '"Martin, Diana L."'
Search Results
2. Effect of biannual azithromycin distribution on antibody responses to malaria, bacterial, and protozoan pathogens in Niger
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Arzika, Ahmed M., Maliki, Ramatou, Goodhew, E. Brook, Rogier, Eric, Priest, Jeffrey W., Lebas, Elodie, O’Brien, Kieran S., Le, Victoria, Oldenburg, Catherine E., Doan, Thuy, Porco, Travis C., Keenan, Jeremy D., Lietman, Thomas M., Martin, Diana L., and Arnold, Benjamin F.
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- 2022
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3. Water, sanitation, and hygiene for control of trachoma in Ethiopia (WUHA): a two-arm, parallel-group, cluster-randomised trial
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Aragie, Solomon, Wittberg, Dionna M, Tadesse, Wondyifraw, Dagnew, Adane, Hailu, Dagnachew, Chernet, Ambahun, Melo, Jason S, Aiemjoy, Kristen, Haile, Mahteme, Zeru, Taye, Tadesse, Zerihun, Gwyn, Sarah, Martin, Diana L, Arnold, Benjamin F, Freeman, Matthew C, Nash, Scott D, Callahan, E Kelly, Porco, Travis C, Lietman, Thomas M, and Keenan, Jeremy D
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- 2022
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4. Lessons learned from the implementation of integrated serosurveillance of communicable diseases in the Americas/Enseñanzas obtenidas en la aplicación de la serovigilancia integrada de las enfermedades transmisibles en la Región de las Américas/Licoes aprendidas com a implementacao da vigilancia sorologica integrada de doencas transmissiveis nas Americas
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Saboya-Diaz, Martha-Idali, Castellanos, Luis Gerardo, Morice, Ana, Ade, Maria Paz, Rey-Benito, Gloria, Cooley, Gretchen M., Scobie, Heather M., Wiegand, Ryan E., Coughlin, Melissa M., and Martin, Diana L.
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- 2023
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5. Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia.
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Sata, Eshetu, Seife, Fikre, Ayele, Zebene, Murray, Sarah A., Wickens, Karana, Le, Phong, Zerihun, Mulat, Melak, Berhanu, Chernet, Ambahun, Jensen, Kimberly A., Gessese, Demelash, Zeru, Taye, Dawed, Adisu Abebe, Debebe, Hiwot, Tadesse, Zerihun, Callahan, E. Kelly, Martin, Diana L., and Nash, Scott D.
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TRACHOMA ,CHLAMYDIA trachomatis ,CHLAMYDIA infections ,DRUG administration ,INFECTIOUS disease transmission - Abstract
Background: Trachoma recrudescence after elimination as a public health problem has been reached is a concern for control programs globally. Programs typically conduct district-level trachoma surveillance surveys (TSS) ≥ 2 years after the elimination threshold is achieved to determine whether the prevalence of trachomatous inflammation-follicular (TF) among children ages 1 to 9 years remains <5%. Many TSS are resulting in a TF prevalence ≥5%. Once a district returns to TF ≥5%, a program typically restarts costly mass drug administration (MDA) campaigns and surveys at least twice, for impact and another TSS. In Amhara, Ethiopia, most TSS which result in a TF ≥5% have a prevalence close to 5%, making it difficult to determine whether the result is due to true recrudescence or to statistical variability. This study's aim was to monitor recrudescence within Amhara by waiting to restart MDA within 2 districts with a TF prevalence ≥5% at TSS, Metema = 5.2% and Woreta Town = 5.1%. The districts were resurveyed 1 year later using traditional and alternative indicators, such as measures of infection and serology, a "wait and watch" approach. Methods/Principal findings: These post-surveillance surveys, conducted in 2021, were multi-stage cluster surveys whereby certified graders assessed trachoma signs. Children ages 1 to 9 years provided a dried blood spot and children ages 1 to 5 years provided a conjunctival swab. TF prevalence in Metema and Woreta Town were 3.6% (95% Confidence Interval [CI]:1.4–6.4) and 2.5% (95% CI:0.8–4.5) respectively. Infection prevalence was 1.2% in Woreta Town and 0% in Metema. Seroconversion rates to Pgp3 in Metema and Woreta Town were 0.4 (95% CI:0.2–0.7) seroconversions per 100 child-years and 0.9 (95% CI:0.6–1.5) respectively. Conclusions/Significance: Both study districts had a TF prevalence <5% with low levels of Chlamydia trachomatis infection and transmission, and thus MDA interventions are no longer warranted. The wait and watch approach represents a surveillance strategy which could lead to fewer MDA campaigns and surveys and thus cost savings with reduced antibiotic usage. Author summary: The return of trachoma transmission after elimination as a public health problem has been reached is a concern for control programs globally. Currently, many district-level trachoma surveillance surveys (conducted ≥2 years since elimination threshold has been reached) are resulting in a prevalence above the established threshold. Once a district returns above threshold, a program typically restarts costly mass drug administration campaigns and conducts more surveys. This study's aim was to monitor recrudescence through a "wait and watch" approach within Amhara, Ethiopia. This entailed waiting to restart mass drug administration within 2 districts with trachoma prevalence above but close to the threshold at surveillance survey, then surveying the districts 1 year later using traditional and alternative indicators. These post-surveillance surveys assessed traditional trachoma signs, and additionally, children provided a dried blood spot for serology outcomes and a conjunctival swab for infection. The results of the study demonstrated that both districts had a prevalence below threshold with low levels of infection and serological evidence of transmission, and thus mass drug administration interventions are no longer warranted. The wait and watch approach represents a surveillance strategy that could lead to fewer surveys and mass drug administration campaigns and thus savings in programmatic costs with reduced usage of antibiotics. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Publisher Correction: Comparison of platforms for testing antibodies to Chlamydia trachomatis antigens in the Democratic Republic of the Congo and Togo
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Gwyn, Sarah, Awoussi, Marcel S., Bakhtiari, Ana, Bronzan, Rachel N., Crowley, Kathryn, Harding-Esch, Emma M., Kassankogno, Yao, Kilangalanga, Janvier N., Makangila, Felix, Mupoyi, Sylvain, Ngondi, Jeremiah, Ngoyi, Bonaventure, Palmer, Stephanie, Randall, Jessica M., Seim, Anders, Solomon, Anthony W., Stewart, Raymond, Togbey, Kwamy, Uvon, Pitchouna A., and Martin, Diana L.
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- 2021
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7. Comparison of platforms for testing antibodies to Chlamydia trachomatis antigens in the Democratic Republic of the Congo and Togo
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Gwyn, Sarah, Awoussi, Marcel S., Bakhtiari, Ana, Bronzan, Rachel N., Crowley, Kathryn, Harding-Esch, Emma M., Kassankogno, Yao, Kilangalanga, Janvier N., Makangila, Felix, Mupoyi, Sylvain, Ngondi, Jeremiah, Ngoyi, Bonaventure, Palmer, Stephanie, Randall, Jessica M., Seim, Anders, Solomon, Anthony W., Stewart, Raymond, Togbey, Kwamy, Uvon, Pitchouna A., and Martin, Diana L.
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- 2021
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8. Optimization of a rapid test for antibodies to the Chlamydia trachomatis antigen Pgp3
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Gwyn, Sarah, Mkocha, Harran, Randall, Jessica Morgan, Kasubi, Mabula, and Martin, Diana L.
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- 2019
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9. Advancing the public health applications of Chlamydia trachomatis serology
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Woodhall, Sarah C, Gorwitz, Rachel J, Migchelsen, Stephanie J, Gottlieb, Sami L, Horner, Patrick J, Geisler, William M, Winstanley, Catherine, Hufnagel, Katrin, Waterboer, Tim, Martin, Diana L, Huston, Wilhelmina M, Gaydos, Charlotte A, Deal, Carolyn, Unemo, Magnus, Dunbar, J Kevin, and Bernstein, Kyle
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- 2018
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10. High prevalence of trachomatous inflammation–follicular with no trachomatous trichiasis: can alternative indicators explain the epidemiology of trachoma in Côte d'Ivoire?
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Atekem, Kareen, Harding-Esch, Emma M, Martin, Diana L, Downs, Philip, Palmer, Stephanie L, Kaboré, Achille, Kelly, Michaela, Bovary, Anoma, Sarr, Astou, Nguessan, Konan, James, Fiona, Gwyn, Sarah, Wickens, Karana, Bakhtiari, Ana, Boyd, Sarah, Aba, Ange, Senyonjo, Laura, Courtright, Paul, and Meite, Aboulaye
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TRACHOMA ,CHLAMYDIA trachomatis ,CHLAMYDIA infections ,EPIDEMIOLOGY ,CLUSTER sampling - Abstract
Baseline trachoma surveys in Côte d'Ivoire (2019) identified seven evaluation units (EUs) with a trachomatous inflammation–follicular (TF) prevalence ≥10%, but a trachomatous trichiasis (TT) prevalence in individuals ≥15 y of age below the elimination threshold (0.2%). Two of these EUs, Bondoukou 1 and Bangolo 2, were selected for a follow-up survey to understand the epidemiology of trachoma using additional indicators of Chlamydia trachomatis infection (DNA from conjunctival swabs) and exposure (anti-Pgp3 and Ct694 antibodies from dried blood spots [DBSs]). A two-stage cluster sampling methodology was used to select villages and households. All individuals 1–9 y of age from each selected household were recruited, graded for trachoma and had a conjunctival swab and DBS collected. Conjunctival swabs and DBSs were tested using Cepheid GeneXpert and a multiplex bead assay, respectively. The age-adjusted TF and infection prevalence in 1- to 9-year-olds was <1% and <0.3% in both EUs. Age-adjusted seroprevalence was 5.3% (95% confidence interval [CI] 1.5 to 15.6) in Bondoukou 1 and 8.2% (95% CI 4.3 to 13.7) in Bangolo 2. The seroconversion rate for Pgp3 was low, at 1.23 seroconversions/100 children/year (95% CI 0.78 to 1.75) in Bondoukou 1 and 1.91 (95% CI 1.58 to 2.24) in Bangolo 2. Similar results were seen for CT694. These infection, antibody and clinical data provide strong evidence that trachoma is not a public health problem in either EU. [ABSTRACT FROM AUTHOR]
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- 2023
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11. Evaluation of a field test for antibodies against Chlamydia trachomatis during trachoma surveillance in Nepal
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Sun, Michelle J., Zambrano, Andrea I., Dize, Laura, Munoz, Beatriz, Gwyn, Sarah, Mishra, Sailesh, Martin, Diana L., Sharma, Shekhar, and West, Sheila K.
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- 2017
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12. Biannual versus annual mass azithromycin distribution and malaria seroepidemiology among preschool children in Niger: a sub-study of a cluster randomized trial
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Oldenburg, Catherine E., Amza, Abdou, Cooley, Gretchen, Kadri, Boubacar, Nassirou, Beido, Arnold, Benjamin F., Rosenthal, Philip J., O’Brien, Kieran S., West, Sheila K., Bailey, Robin L., Porco, Travis C., Keenan, Jeremy D., Lietman, Thomas M., and Martin, Diana L.
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- 2019
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13. Monitoring transmission intensity of trachoma with serology: a multi-country study
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Tedijanto, Christine, Solomon, Anthony W., Martin, Diana L., Nash, Scott D., Keenan, Jeremy D., Lietman, Thomas M., Lammie, Patrick J., Aiemjoy, Kristen, Amza, Abdou, Aragie, Solomon, Arzika, Ahmed M., Callahan, E. Kelly, Carolan, Sydney, Dawed, Adisu Abebe, Goodhew, E. Brook, Gwyn, Sarah, Hammou, Jaouad, Kadri, Boubacar, Kalua, Khumbo, Maliki, Ramatou, Nassirou, Beido, Seife, Fikre, Tadesse, Zerihun, West, Sheila K., Wittberg, Dionna M., Zeru, Taye, and Arnold, Benjamin F.
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Article - Abstract
Trachoma, caused by ocular Chlamydia trachomatis infection, is targeted for global elimination as a public health problem by 2030. To provide evidence for use of antibodies to monitor C. trachomatis transmission, we collated IgG responses to Pgp3 antigen, PCR positivity, and clinical observations from 19,811 children aged 1–9 years in 14 populations. We demonstrate that age-seroprevalence curves consistently shift along a gradient of transmission intensity: rising steeply in populations with high levels of infection and active trachoma and becoming flat in populations near elimination. Seroprevalence (range: 0–54%) and seroconversion rates (range: 0–15 per 100 person-years) correlate with PCR prevalence (r: 0.88, 95% CI: 0.77, 0.93). A seroprevalence threshold of 13.5% (seroconversion rate 2.75 per 100 person-years) identifies clusters with any infection at high sensitivity (>90%) and moderate specificity (69-75%). Antibody responses in young children provide a robust, generalizable approach to monitor population progress toward and beyond trachoma elimination.
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- 2023
14. Changes in trachoma indicators in Kiribati with two rounds of azithromycin mass drug administration, measured in serial population-based surveys.
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Goodhew, E. Brook, Taoaba, Raebwebwe, Harding-Esch, Emma M., Gwyn, Sarah E., Bakhtiari, Ana, Butcher, Robert, Cama, Anasaini, Guagliardo, Sarah Anne J., Jimenez, Cristina, Mpyet, Caleb D., Tun, Kab, Wickens, Karana, Solomon, Anthony W., Martin, Diana L., and Tekeraoi, Rabebe
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TRACHOMA ,DRUG administration ,AZITHROMYCIN ,EYE diseases ,COMMUNITIES - Abstract
Baseline mapping in the two major population centers of Kiribati showed that trachoma was a public health problem in need of programmatic interventions. After conducting two annual rounds of antibiotic mass drug administration (MDA), Kiribati undertook trachoma impact surveys in 2019, using standardized two-stage cluster surveys in the evaluation units of Kiritimati Island and Tarawa. In Kiritimati, 516 households were visited and in Tarawa, 772 households were visited. Nearly all households had a drinking water source and access to an improved latrine. The prevalence of trachomatous trichiasis remained above the elimination threshold (0.2% in ≥15-year-olds) and was virtually unchanged from baseline. The prevalence of trachomatous inflammation—follicular (TF) in 1–9-year-olds decreased by approximately 40% from baseline in both evaluation units but remained above the 5% TF prevalence threshold for stopping MDA. TF prevalence at impact survey was 11.5% in Kiritimati and 17.9% in Tarawa. Infection prevalence in 1–9-year-olds by PCR was 0.96% in Kiritimati and 3.3% in Tarawa. Using a multiplex bead assay to measure antibodies to the C. trachomatis antigen Pgp3, seroprevalence in 1–9-year-olds was 30.2% in Kiritimati and 31.4% in Tarawa. The seroconversion rate, in seroconversion events/100 children/year, was 9.0 in Kiritimati and 9.2 in Tarawa. Seroprevalence and seroconversion rates were both assessed by four different assays, with strong agreement between tests. These results show that, despite decreases in indicators associated with infection at impact survey, trachoma remains a public health problem in Kiribati, and provide additional information about changes in serological indicators after MDA. Author summary: This study compares different indicators for the eye disease trachoma before and after two annual rounds of mass azithromycin treatment of affected communities of Kiribati. We saw decreases in the proportion of children with the sign TF (trachomatous inflammation—follicular) that is used by trachoma programs to make decisions about starting and stopping mass treatment, but these decreases were not sufficient to make the decision to stop. We also saw decreases in infection and antibody levels after treatment. The study provides important public health information to Kiribati trachoma programs, but also adds to the growing body of evidence to guide the use of alternative indicators–infection and antibody–to support these programs. Measuring antibody levels in communities over time helps us understand how antibody levels change as community infection prevalence decreases. Understanding antibody dynamics over time can help us better estimate antibody-based thresholds for surveillance after elimination of trachoma as a public health problem. [ABSTRACT FROM AUTHOR]
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- 2023
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15. Monitoring transmission intensity of trachoma with serology.
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Tedijanto, Christine, Solomon, Anthony W., Martin, Diana L., Nash, Scott D., Keenan, Jeremy D., Lietman, Thomas M., Lammie, Patrick J., Aiemjoy, Kristen, Amza, Abdou, Aragie, Solomon, Arzika, Ahmed M., Callahan, E. Kelly, Carolan, Sydney, Dawed, Adisu Abebe, Goodhew, E. Brook, Gwyn, Sarah, Hammou, Jaouad, Kadri, Boubacar, Kalua, Khumbo, and Maliki, Ramatou
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TRACHOMA ,SEROLOGY ,CHLAMYDIA trachomatis ,CHLAMYDIA infections ,ANTIBODY formation ,IMMUNOGLOBULINS - Abstract
Trachoma, caused by ocular Chlamydia trachomatis infection, is targeted for global elimination as a public health problem by 2030. To provide evidence for use of antibodies to monitor C. trachomatis transmission, we collated IgG responses to Pgp3 antigen, PCR positivity, and clinical observations from 19,811 children aged 1–9 years in 14 populations. We demonstrate that age-seroprevalence curves consistently shift along a gradient of transmission intensity: rising steeply in populations with high levels of infection and active trachoma and becoming flat in populations near elimination. Seroprevalence (range: 0–54%) and seroconversion rates (range: 0–15 per 100 person-years) correlate with PCR prevalence (r: 0.87, 95% CI: 0.57, 0.97). A seroprevalence threshold of 13.5% (seroconversion rate 2.75 per 100 person-years) identifies clusters with any PCR-identified infection at high sensitivity (>90%) and moderate specificity (69–75%). Antibody responses in young children provide a robust, generalizable approach to monitor population progress toward and beyond trachoma elimination. Trachoma is targeted for global elimination as a public health problem by 2030. Here, the authors combine data from 14 African populations to show that IgG in children is a robust approach to monitor transmission as populations approach elimination. [ABSTRACT FROM AUTHOR]
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- 2023
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16. Diagnostics to support the eradication of yaws-Development of two target product profiles
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Fongwen, Noah, Handley, Becca L, Martin, Diana L, Beiras, Camila, Dyson, Louise, Frimpong, Michael, Mitja, Oriol, Asiedu, Kingsley, and Marks, Michael
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BACKGROUND: Yaws is targeted for eradication by 2030, using a strategy based on mass drug administration (MDA) with azithromycin. New diagnostics are needed to aid eradication. Serology is currently the mainstay for yaws diagnosis; however, inaccuracies associated with current serological tests makes it difficult to fully assess the need for and impact of eradication campaigns using these tools. Under the recommendation of the WHO Diagnostic Technical Advisory Group (DTAG) for Neglected Tropical Diseases(NTDs), a working group was assembled and tasked with agreeing on priority use cases for developing target product profiles (TPPs) for new diagnostics tools. METHODOLOGY AND PRINCIPAL FINDINGS: The working group convened three times and established two use cases: identifying a single case of yaws and detecting azithromycin resistance. One subgroup assessed the current diagnostic landscape for yaws and a second subgroup determined the test requirements for both use cases. Draft TPPs were sent out for input from stakeholders and experts. Both TPPs considered the following parameters: product use, design, performance, configuration, cost, access and equity. To identify a single case of yaws, the test should be able to detect an analyte which confirms an active infection with at least 95% sensitivity and 99.9% specificity. The high specificity was deemed important to avoid a high false positive rate which could result in unnecessary continuation or initiation of MDA campaigns. If used in settings where the number of suspected cases is low, further testing could be considered to compensate for imperfect sensitivity and to improve specificity. The test to detect azithromycin resistance should be able to detect known genetic resistance mutations with a minimum sensitivity and specificity of 95%, with the caveat that all patients with suspected treatment failure should be treated as having resistant yaws and offered alternative treatment. CONCLUSIONS: The TPPs developed will provide test developers with guidance to ensure that novel diagnostic tests meet identified public health needs.
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- 2022
17. 'Missing Milestones.'
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Afzal, Nadeem A., Martin, Diana L., and Atkinson, Patricia I.
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Examined the development of seven infants with "missing milestones" in motor development. Found that three children had normal development, three developed global developmental delay, and one was diagnosed with multiple cavernous haemangiomata in the brain. Suggested that missing milestones can be a benign variation of normal motor development or the first sign of neurodevelopmental disorder. (Author/KB)
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- 2001
18. Post mortem of an estate planning malpractice case
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Weiss, Gregory S. and Martin, Diana L.
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Attorneys -- Malpractice ,Limitation of actions -- Laws, regulations and rules ,Estate planning -- Evaluation ,Standing (Law) -- Laws, regulations and rules ,Government regulation ,Law - Abstract
When suing an attorney for legal malpractice over an estate plan, be prepared to face standing and statute of limitations issues. Here are some lessons we learned from one case. [...]
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- 2015
19. The utility of serology for elimination surveillance of trachoma
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Pinsent, Amy, Solomon, Anthony W, Bailey, Robin L, Bid, Rhiannon, Cama, Anaseini, Dean, Deborah, Goodhew, Brook, Gwyn, Sarah E, Jack, Kelvin R, Kandel, Ram Prasad, Kama, Mike, Massae, Patrick, Macleod, Colin, Mabey, David CW, Migchelsen, Stephanie, Müller, Andreas, Sandi, Frank, Sokana, Oliver, Taoaba, Raebwebwe, Tekeraoi, Rabebe, Martin, Diana L, and White, Michael T
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Adult ,Adolescent ,Science ,Chlamydia trachomatis ,Pacific Islands ,Article ,Young Adult ,Nepal ,Models ,Seroepidemiologic Studies ,Humans ,Public Health Surveillance ,Child ,Preschool ,lcsh:Science ,Africa South of the Sahara ,Trachoma ,Models, Statistical ,Age Factors ,Infant ,Statistical ,eye diseases ,Good Health and Well Being ,Child, Preschool ,Female ,lcsh:Q ,Infection - Abstract
Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. Here, we analyse data from nine trachoma-endemic populations and provide operational thresholds for interpretation of serological data in low-transmission and post-elimination settings. Analyses with sero-catalytic and antibody acquisition models provide insights into transmission history within each population. To accurately estimate sero-conversion rates (SCR) for trachoma in populations with high-seroprevalence in adults, the model accounts for secondary exposure to Chlamydia trachomatis due to urogenital infection. We estimate the population half-life of sero-reversion for anti-Pgp3 antibodies to be 26 (95% credible interval (CrI): 21–34) years. We show SCRs below 0.015 (95% confidence interval (CI): 0.0–0.049) per year correspond to a prevalence of trachomatous inflammation—follicular below 5%, the current threshold for elimination of active trachoma as a public health problem. As global trachoma prevalence declines, we may need cross-sectional serological survey data to inform programmatic decisions., Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. Here, Pinsent et al. analyse data from nine trachoma-endemic populations and provide operational thresholds for interpretation of serological data in low transmission and post-elimination settings.
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- 2018
20. Evaluation of a Single Dose of Azithromycin for Trachoma in Low-Prevalence Communities
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Wilson, Nana, Goodhew, Brook, Mkocha, Harran, Joseph, Kahaliah, Bandea, Claudiu, Black, Carolyn, Igietseme, Joseph, Munoz, Beatriz, West, Sheila K., Lammie, Patrick, Kasubi, Mabula, and Martin, Diana L.
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DNA, Bacterial ,Male ,Trachoma ,mass drug administration ,Time Factors ,Dose-Response Relationship, Drug ,Infant ,chlamydia ,Chlamydia trachomatis ,Original Articles ,Azithromycin ,Tanzania ,Eye Infections, Bacterial ,Anti-Bacterial Agents ,Treatment Outcome ,Child, Preschool ,trachomatis ,Prevalence ,Humans ,Female ,Child ,Antibody ,Follow-Up Studies - Abstract
Purpose: Trachoma, caused by repeated ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide and is targeted for elimination as a public health problem. We sought to determine whether a one-time azithromycin mass treatment would reduce trachomatous inflammation–follicular (TF) levels below the elimination threshold of 5% in communities with disease prevalence between 5 and 9.9%. Methods: The study was conducted in 96 sub-village units (balozis) in the Kongwa district of Tanzania which were predicted from prior prevalence surveys to have TF between 5 and 9.9%. Balozis were randomly assigned to the intervention and control arms. The intervention arm received a single mass drug administration of azithromycin. At baseline and 12-month follow-up, ocular exams for trachoma, ocular swabs for detection of chlamydial DNA, and finger prick blood for analysis of anti-chlamydial antibody were taken. Results: Comparison of baseline and 12-month follow-up showed no significant difference in the overall TF1-9 prevalence by balozi between control and treatment arms. In the treatment arm there was a significant reduction of ocular infection 12 months after treatment (p = 0.004) but no change in the control arm. No change in Pgp3-specific antibody responses were observed after treatment in the control or treatment arms. Anti-CT694 responses increased in both study arms (p = 0.009 for control arm and p = 0.04 for treatment arm). Conclusion: These data suggest that a single round of MDA may not be sufficient to decrease TF levels below 5% when TF1-9 is between 5 and 9.9% at baseline.
- Published
- 2018
21. Post-Validation Survey in Two Districts of Morocco after the Elimination of Trachoma as a Public Health Problem.
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Hammou, Jaouad, Guagliardo, Sarah Anne J., Obtel, Majdouline, Razine, Rachid, Haroun, Abbas Ermilo, Youbi, Mohamed, Bellefquih, Abdelkrim Meziane, White, Michael, Gwyn, Sarah, and Martin, Diana L.
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- 2022
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22. Predicting future community-level ocular Chlamydia trachomatis infection prevalence using serological, clinical, molecular, and geospatial data.
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Tedijanto, Christine, Aragie, Solomon, Tadesse, Zerihun, Haile, Mahteme, Zeru, Taye, Nash, Scott D., Wittberg, Dionna M., Gwyn, Sarah, Martin, Diana L., Sturrock, Hugh J. W., Lietman, Thomas M., Keenan, Jeremy D., and Arnold, Benjamin F.
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TRACHOMA ,CHLAMYDIA trachomatis ,CHLAMYDIA infections ,GEOSPATIAL data ,SYMPTOMS ,COMMUNICABLE diseases - Abstract
Trachoma is an infectious disease characterized by repeated exposures to Chlamydia trachomatis (Ct) that may ultimately lead to blindness. Efficient identification of communities with high infection burden could help target more intensive control efforts. We hypothesized that IgG seroprevalence in combination with geospatial layers, machine learning, and model-based geostatistics would be able to accurately predict future community-level ocular Ct infections detected by PCR. We used measurements from 40 communities in the hyperendemic Amhara region of Ethiopia to assess this hypothesis. Median Ct infection prevalence among children 0–5 years old increased from 6% at enrollment, in the context of recent mass drug administration (MDA), to 29% by month 36, following three years without MDA. At baseline, correlation between seroprevalence and Ct infection was stronger among children 0–5 years old (ρ = 0.77) than children 6–9 years old (ρ = 0.48), and stronger than the correlation between active trachoma and Ct infection (0-5y ρ = 0.56; 6-9y ρ = 0.40). Seroprevalence was the strongest concurrent predictor of infection prevalence at month 36 among children 0–5 years old (cross-validated R
2 = 0.75, 95% CI: 0.58–0.85), though predictive performance declined substantially with increasing temporal lag between predictor and outcome measurements. Geospatial variables, a spatial Gaussian process, and stacked ensemble machine learning did not meaningfully improve predictions. Serological markers among children 0–5 years old may be an objective tool for identifying communities with high levels of ocular Ct infections, but accurate, future prediction in the context of changing transmission remains an open challenge. Author summary: Trachoma, one of the leading infectious causes of blindness globally, is targeted for elimination as a public health problem by 2030. District-level estimates of active trachoma among children 1–9 years old are currently used to guide control programs and assess elimination. However, active trachoma, based on diagnosis of clinical signs, is a subjective indicator. Serological markers present an objective, scalable alternative that could be measured in integrated platforms. In a hyperendemic region, community-level seroprevalence aligned more closely with concurrent infection prevalence than active trachoma. The correlation between seroprevalence and infection prevalence was stronger among 0–5-year-olds compared to 6–9-year-olds and was consistent over a three-year period of increasing transmission. Serosurveillance among children 0–5 years old may be a promising monitoring strategy to identify communities with the highest burdens of ocular chlamydial infection. [ABSTRACT FROM AUTHOR]- Published
- 2022
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23. Characterising spatial patterns of neglected tropical disease transmission using integrated sero-surveillance in Northern Ghana.
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Fornace, Kimberly M., Senyonjo, Laura, Martin, Diana L., Gwyn, Sarah, Schmidt, Elena, Agyemang, David, Marfo, Benjamin, Addy, James, Mensah, Ernest, Solomon, Anthony W., Bailey, Robin, Drakeley, Chris J., and Pullan, Rachel L.
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NEGLECTED diseases ,INFECTIOUS disease transmission ,TRACHOMA ,DISEASE prevalence ,JUVENILE diseases ,ANTIBODY formation - Abstract
Background: As prevalence decreases in pre-elimination settings, identifying the spatial distribution of remaining infections to target control measures becomes increasingly challenging. By measuring multiple antibody responses indicative of past exposure to different pathogens, integrated serological surveys enable simultaneous characterisation of residual transmission of multiple pathogens. Methodology/Principal findings: Here, we combine integrated serological surveys with geostatistical modelling and remote sensing-derived environmental data to estimate the spatial distribution of exposure to multiple diseases in children in Northern Ghana. The study utilised the trachoma surveillance survey platform (cross-sectional two-stage cluster-sampled surveys) to collect information on additional identified diseases at different stages of elimination with minimal additional cost. Geostatistical modelling of serological data allowed identification of areas with high probabilities of recent exposure to diseases of interest, including areas previously unknown to control programmes. We additionally demonstrate how serological surveys can be used to identify areas with exposure to multiple diseases and to prioritise areas with high uncertainty for future surveys. Modelled estimates of cluster-level prevalence were strongly correlated with more operationally feasible metrics of antibody responses. Conclusions/Significance: This study demonstrates the potential of integrated serological surveillance to characterise spatial distributions of exposure to multiple pathogens in low transmission and elimination settings when the probability of detecting infections is low. Author summary: Following implementation of successful interventions, one of the primary challenges for neglected tropical disease programmes is identifying areas with remaining disease transmission. As disease prevalence decreases, these infections become increasingly rare and hard to detect. Serological assays measure long-lived disease-specific antibody responses indicating past exposure to pathogens and increase the probability of detecting disease transmission. Here, we integrate serological assays with environmental and spatial data to map priority areas for surveillance for multiple neglected tropical diseases in Northern Ghana using the two-stage cluster-based survey platform established for trachoma surveillance. The use of multiplex bead assays measuring exposure to multiple pathogens allows integrated surveillance of diseases of interest to the national control programme. We identify areas with high risks of transmission to selected diseases as well as areas with high uncertainty which are priorities for future control and surveillance efforts. Together, this highlights the utility of multiplex serological platforms as a tool for integrated surveillance and mapping of neglected tropical diseases. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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24. The importance of D'Amario v. Ford and how it protects Florida's consumers
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Leopold, Theodore J., Kroeger, Leslie M., and Martin, Diana L.
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Transportation equipment industry -- Laws, regulations and rules ,Automobiles -- Laws, regulations and rules ,Government regulation ,Law - Abstract
Due to an aggressive campaign seeking to legislatively overrule the Florida Supreme Court's decision in D'Amario v. Ford, 806 So. 2d 424 (Fla. 2001), the decision may no longer be [...]
- Published
- 2011
25. High Plasmid Gene Protein 3 (Pgp3) Chlamydia trachomatis Seropositivity, Pelvic Inflammatory Disease, and Infertility Among Women, National Health and Nutrition Examination Survey, United States, 2013–2016.
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Anyalechi, Gloria E, Hong, Jaeyoung, Danavall, Damien C, Martin, Diana L, Gwyn, Sarah E, Horner, Patrick J, Raphael, Brian H, Kirkcaldy, Robert D, Kersh, Ellen N, and Bernstein, Kyle T
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NUCLEIC acid analysis ,DIAGNOSIS of bacterial diseases ,PELVIC inflammatory disease diagnosis ,BIOMARKERS ,RESEARCH ,SEROPREVALENCE ,CONFIDENCE intervals ,PLASMIDS ,CHLAMYDIACEAE ,INFERTILITY ,SURVEYS ,COMPARATIVE studies ,SEXUALLY transmitted diseases ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,CHLAMYDIA trachomatis ,GENE amplification ,WOMEN'S health ,BLOOD - Abstract
Background Chlamydia trachomatis causes pelvic inflammatory disease (PID) and tubal infertility. Plasmid gene protein 3 antibody (Pgp3Ab) detects prior chlamydial infections. We evaluated for an association of high chlamydial seropositivity with sequelae using a Pgp3Ab multiplex bead array (Pgp3AbMBA). Methods We performed chlamydia Pgp3AbMBA on sera from women 18-39 years old participating in the 2013–2016 National Health and Nutrition Examination Survey (NHANES) with urine chlamydia nucleic acid amplification test results. High chlamydial seropositivity was defined as a median fluorescence intensity (MFI ≥ 50 000; low-positive was MFI > 551–<50 000. Weighted US population high-positive, low-positive, and negative Pgp3Ab chlamydia seroprevalence and 95% confidence intervals (CI) were compared for women with chlamydial infection, self-reported PID, and infertility. Results Of 2339 women aged 18–39 years, 1725 (73.7%) had sera, and 1425 were sexually experienced. Overall, 104 women had high positive Pgp3Ab (5.4% [95% CI 4.0–7.0] of US women); 407 had lowpositive Pgp3Ab (25.1% [95% CI 21.5–29.0]), and 914 had negative Pgp3Ab (69.5% [95% CI 65.5–73.4]). Among women with high Pgp3Ab, infertility prevalence was 2.0 (95% CI 1.1–3.7) times higher than among Pgp3Ab-negative women (19.6% [95% CI 10.5–31.7] versus 9.9% [95% CI 7.7–12.4]). For women with low Pgp3Ab, PID prevalence was 7.9% (95% CI 4.6–12.6) compared to 2.3% (95% CI 1.4–3.6) in negative Pgp3Ab. Conclusions High chlamydial Pgp3Ab seropositivity was associated with infertility although small sample size limited evaluation of an association of high seropositivity with PID. In infertile women, Pgp3Ab may be a marker of prior chlamydial infection. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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26. Surveillance for peri-elimination trachoma recrudescence: Exploratory studies in Ghana.
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Senyonjo, Laura, Addy, James, Martin, Diana L., Agyemang, David, Yeboah-Manu, Dorothy, Gwyn, Sarah, Marfo, Benjamin, Asante-Poku, Adwoa, Aboe, Agatha, Solomon, Anthony W., and Bailey, Robin L.
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TRACHOMA ,CHLAMYDIA trachomatis ,GOAL programming ,SEROPREVALENCE ,DRIED blood spot testing - Abstract
Introduction: To date, eleven countries have been validated as having eliminated trachoma as a public health problem, including Ghana in 2018. Surveillance for recrudescence is needed both pre- and post-validation but evidence-based guidance on appropriate strategies is lacking. We explored two potential surveillance strategies in Ghana. Methodology/principal findings: Amongst randomly-selected communities enrolled in pre-validation on-going surveillance between 2011 and 2015, eight were identified as having had trachomatous-inflammation follicular (TF) prevalence ≥5% in children aged 1–9 years between 2012 and 2014. These eight were re-visited in 2015 and 2016 and neighbouring communities were also added ("TF trigger" investigations). Resident children aged 1–9 years were then examined for trachoma and had a conjunctival swab to test for Chlamydia trachomatis (Ct) and a dried blood spot (DBS) taken to test for anti-Pgp3 antibodies. These investigations identified at least one community with evidence of probable recent Ct ocular transmission. However, the approach likely lacks sufficient spatio-temporal power to be reliable. A post-validation surveillance strategy was also evaluated, this reviewed the ocular Ct infection and anti-Pgp3 seroprevalence data from the TF trigger investigations and from the pre-validation surveillance surveys in 2015 and 2016. Three communities identified as having ocular Ct infection >0% and anti-Pgp3 seroprevalence ≥15.0% were identified, and along with three linked communities, were followed-up as part of the surveillance strategy. An additional three communities with a seroprevalence ≥25.0% but no Ct infection were also followed up ("antibody and infection trigger" investigations). DBS were taken from all residents aged ≥1 year and ocular swabs from all children aged 1–9 years. There was evidence of transmission in the group of communities visited in one district (Zabzugu-Tatale). There was no or little evidence of continued transmission in other districts, suggesting previous infection identified was transient or potentially not true ocular Ct infection. Conclusions/significance: There is evidence of heterogeneity in Ct transmission dynamics in northern Ghana, even 10 years after wide-scale MDA has stopped. There is added value in monitoring Ct infection and anti-Ct antibodies, using these indicators to interrogate past or present surveillance strategies. This can result in a deeper understanding of transmission dynamics and inform new post-validation surveillance strategies. Opportunities should be explored for integrating PCR and serological-based markers into surveys conducted in trachoma elimination settings. Author summary: The goal for trachoma programmes is elimination of trachoma as a public health problem. This means that ongoing low-level eye-to-eye transmission of the causative bacterium, Chlamydia trachomatis (Ct), is acceptable. Countries need to implement a suitable surveillance system to identify any return to higher transmission levels. The best methodology for doing this is not known. We first explored the approach used by Ghana in its standard programme, which involved monitoring a limited number of randomly selected communities for evidence of active (inflammatory) trachoma visible in children's eyes on examination by trained observers. Although this strategy led to identification of at least one community that had probably had recent Ct transmission, the approach is unlikely to consistently identify places where return to higher levels of transmission is a risk. We also explored using information on infection (detected in eye swabs) and antibodies to Ct (detected in the blood) to identify communities at risk. We found evidence of both persistent eye-to-eye Ct transmission and areas where infection was transient and has now gone away. We conclude that the use of infection and antibody data for surveillance of trachoma appears promising. [ABSTRACT FROM AUTHOR]
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- 2021
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27. Precision of Serologic Testing from Dried Blood Spots Using a Multiplex Bead Assay.
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Gwyn, Sarah, Aragie, Solomon, Wittberg, Dionna M., Melo, Jason S., Dagnew, Adane, Hailu, Dagnachew, Tadesse, Zerihun, Haile, Mahteme, Zeru, Taye, Nash, Scott D., Arnold, Benjamin F., Martin, Diana L., and Keenan, Jeremy D.
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- 2021
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28. Taking the pathway of discretionary review toward Florida's highest court
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Martin, Diana L. and Bresky, Robin I.
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Florida. Supreme Court -- Powers and duties ,Judicial discretion -- Laws, regulations and rules ,Judicial review -- Laws, regulations and rules ,Law ,Government regulation ,Powers and duties ,Laws, regulations and rules - Abstract
Your client is on the losing end of an opinion issued by one of Florida's five district courts of appeal and wants to know whether there is hope of having [...]
- Published
- 2009
29. Community-level chlamydial serology for assessing trachoma elimination in trachoma-endemic Niger
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Kim, Jessica S, Oldenburg, Catherine E, Cooley, Gretchen, Amza, Abdou, Kadri, Boubacar, Nassirou, Baido, Cotter, Sun Yu, Stoller, Nicole E, West, Sheila K, Bailey, Robin L, Keenan, Jeremy D, Gaynor, Bruce D, Porco, Travis C, Lietman, Thomas M, Martin, Diana L, and Senok, Abiola
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Pediatric Research Initiative ,lcsh:Arctic medicine. Tropical medicine ,Endemic Diseases ,lcsh:RC955-962 ,Clinical Trials and Supportive Activities ,Chlamydia trachomatis ,Azithromycin ,Medical and Health Sciences ,Antibodies ,Bacterial Proteins ,Clinical Research ,Tropical Medicine ,Humans ,Niger ,Antigens ,Disease Eradication ,Child ,Preschool ,Eye Disease and Disorders of Vision ,Trachoma ,Pediatric ,lcsh:Public aspects of medicine ,Bacterial ,Infant ,lcsh:RA1-1270 ,DNA ,Biological Sciences ,Newborn ,Anti-Bacterial Agents ,Infectious Diseases ,Good Health and Well Being ,Mass Drug Administration ,Sexually Transmitted Infections ,Infection - Abstract
BACKGROUND: Program decision-making for trachoma elimination currently relies on conjunctival clinical signs. Antibody tests may provide additional information on the epidemiology of trachoma, particularly in regions where it is disappearing or elimination targets have been met. METHODS: A cluster-randomized trial of mass azithromycin distribution strategies for trachoma elimination was conducted over three years in a mesoendemic region of Niger. Dried blood spots were collected from a random sample of children aged 1-5 years in each of 24 study communities at 36 months after initiation of the intervention. A multiplex bead assay was used to test for antibodies to two Chlamydia trachomatis antigens, Pgp3 and CT694. We compared seropositivity to either antigen to clinical signs of active trachoma (trachomatous inflammation-follicular [TF] and trachomatous inflammation-intense [TI]) at the individual and cluster level, and to ocular chlamydia prevalence at the community level. RESULTS: Of 988 children with antibody data, TF prevalence was 7.8% (95% CI 6.1 to 9.5) and TI prevalence was 1.6% (95% CI 0.9 to 2.6). The overall prevalence of antibody positivity to Pgp3 was 27.2% (95% CI 24.5 to 30), and to CT694 was 23.7% (95% CI 21 to 26.2). Ocular chlamydia infection prevalence was 5.2% (95% CI 2.8 to 7.6). Seropositivity to Pgp3 and/or CT694 was significantly associated with TF at the individual and community level and with ocular chlamydia infection and TI at the community level. Older children were more likely to be seropositive than younger children. CONCLUSION: Seropositivity to Pgp3 and CT694 correlates with clinical signs and ocular chlamydia infection in a mesoendemic region of Niger. TRIAL REGISTRATION: ClinicalTrials.gov NCT00792922.
- Published
- 2019
30. Determining seropositivity—A review of approaches to define population seroprevalence when using multiplex bead assays to assess burden of tropical diseases.
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Chan, YuYen, Fornace, Kimberly, Wu, Lindsey, Arnold, Ben F., Priest, Jeffrey W., Martin, Diana L., Chang, Michelle A., Cook, Jackie, Stresman, Gillian, and Drakeley, Chris
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TROPICAL medicine ,SEROPREVALENCE ,BIOLOGICAL assay ,ANTIBODY formation - Abstract
Background: Serological surveys with multiplex bead assays can be used to assess seroprevalence to multiple pathogens simultaneously. However, multiple methods have been used to generate cut-off values for seropositivity and these may lead to inconsistent interpretation of results. A literature review was conducted to describe the methods used to determine cut-off values for data generated by multiplex bead assays. Methodology/Principal findings: A search was conducted in PubMed that that included articles published from January 2010 to January 2020, and 291 relevant articles were identified that included the terms "serology", "cut-offs", and "multiplex bead assays". After application of exclusion of articles not relevant to neglected tropical diseases (NTD), vaccine preventable diseases (VPD), or malaria, 55 articles were examined based on their relevance to NTD or VPD. The most frequently applied approaches to determine seropositivity included the use of presumed unexposed populations, mixture models, receiver operating curves (ROC), and international standards. Other methods included the use of quantiles, pre-exposed endemic cohorts, and visual inflection points. Conclusions/Significance: For disease control programmes, seropositivity is a practical and easily interpretable health metric but determining appropriate cut-offs for positivity can be challenging. Considerations for optimal cut-off approaches should include factors such as methods recommended by previous research, transmission dynamics, and the immunological backgrounds of the population. In the absence of international standards for estimating seropositivity in a population, the use of consistent methods that align with individual disease epidemiological data will improve comparability between settings and enable the assessment of changes over time. Author summary: Serological surveys can provide information regarding population-level disease exposure by assessing immune responses created during infection. Multiplex bead assays (MBAs) allow for an integrated serological platform to monitor antibody responses to multiple pathogens concurrently. As programs adopt integrated disease control strategies, MBAs are especially advantageous since many of these diseases may be present in the same population and antibodies against all pathogens of interest can be detected simultaneously from a single blood sample. Interpreting serological data in a programmatic context typically involves classifying individuals as seronegative or seropositive using a 'cut-off', whereby anyone with a response above the defined threshold is considered to be seropositive. Although studies increasingly test blood samples with MBAs, published studies have applied different methods of determining seropositivity cut-offs, making results difficult to compare across settings and over time. The lack of harmonized methods for defining seropositivity is due to the absence of international standards, pathogen biology, or assay-specific methods that may impact resulting data. This review highlights the need for a standardized approach for which cut-off methods to use per pathogen when applied to integrated disease surveillance using platforms such as MBAs. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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31. No Serological Evidence of Trachoma or Yaws Among Residents of Registered Camps and Makeshift Settlements in Cox’s Bazar, Bangladesh.
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Cooley, Gretchen M., Feldstein, Leora R., Bennett, Sarah D., Estivariz, Concepcion F., Weil, Lauren, Bohara, Rajendra, Vandenent, Maya, Hasan, A. S. M. Mainul, Akhtar, Mohammad Saifuddin, Uzzaman, M. Salim, Billah, Mallick Masum, Conklin, Laura, Ehlman, Daniel C., Asiedu, Kingsley, Solomon, Anthony W., Alamgir, A. S. M., Flora, Meerjady Sabrina, and Martin, Diana L.
- Published
- 2021
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32. Trachoma, Anti-Pgp3 Serology, and Ocular Chlamydia trachomatis Infection in Papua New Guinea.
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Macleod, Colin K, Butcher, Robert, Javati, Sarah, Gwyn, Sarah, Jonduo, Marinjho, Abdad, Mohammad Yazid, Roberts, Chrissy H, Keys, Drew, Koim, Samuel Peter, Ko, Robert, Garap, Jambi, Pahau, David, Houinei, Wendy, Martin, Diana L, Pomat, William S, and Solomon, Anthony W
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AGE distribution ,ANTIBIOTICS ,BACTERIAL diseases ,CHLAMYDIA infections ,CONJUNCTIVA ,DRUG administration ,EYE infections ,IMMUNOGLOBULINS ,POLYMERASE chain reaction ,PUBLIC health ,RESEARCH ,SEROLOGY ,TRACHOMA ,DISEASE prevalence ,SEROPREVALENCE ,BACTERIAL antibodies ,DESCRIPTIVE statistics - Abstract
Background In Melanesia, the prevalence of trachomatous inflammation–follicular (TF) suggests that public health–level interventions against active trachoma are needed. However, the prevalence of trachomatous trichiasis is below the threshold for elimination as a public health problem and evidence of conjunctival infection with trachoma's causative organism (Chlamydia trachomatis [CT]) is rare. Here, we examine the prevalence of ocular infection with CT and previous exposure to CT in three evaluation units (EUs) of Papua New Guinea. Methods All individuals aged 1–9 years who were examined for clinical signs of trachoma in 3 Global Trachoma Mapping Project EUs were eligible to take part in this study (N = 3181). Conjunctival swabs were collected from 349 children with TF and tested by polymerase chain reaction to assess for ocular CT infection. Dried blood spots were collected from 2572 children and tested for anti-Pgp3 antibodies using a multiplex assay. Results The proportion of children with TF who had CT infection was low across all 3 EUs (overall 2%). Anti-Pgp3 seroprevalence was 5.2% overall and there was no association between anti-Pgp3 antibody level and presence of TF. In 2 EUs, age-specific seroprevalence did not increase significantly with increasing age in the 1- to 9-year-old population. In the third EU, there was a statistically significant change with age but the overall seroprevalence and peak age-specific seroprevalence was very low. Conclusions Based on these results, together with similar findings from the Solomon Islands and Vanuatu, the use of TF to guide antibiotic mass drug administration decisions in Melanesia should be reviewed. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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33. Population-Based Prevalence of Chlamydia trachomatis Infection and Antibodies in Four Districts with Varying Levels of Trachoma Endemicity in Amhara, Ethiopia.
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Nash, Scott D., Astale, Tigist, Nute, Andrew W., Bethea, Danaya, Chernet, Ambahun, Sata, Eshetu, Zerihun, Mulat, Gessese, Demelash, Ayenew, Gedefaw, Ayele, Zebene, Melak, Berhanu, Haile, Mahteme, Zeru, Taye, Tadesse, Zerihun, Arnold, Benjamin F., Callahan, Elizabeth Kelly, and Martin, Diana L.
- Published
- 2021
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34. The use of serology for trachoma surveillance: Current status and priorities for future investigation.
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Martin, Diana L., Saboyà-Díaz, Martha Idalí, Abashawl, Aida, Alemayeh, Wondu, Gwyn, Sarah, Hooper, Pamela J., Keenan, Jeremy, Kalua, Khumbo, Szwarcwald, Celia Landmann, Nash, Scott, Oldenburg, Catherine, West, Sheila K., White, Michael, and Solomon, Anthony W.
- Subjects
- *
TRACHOMA , *SEROLOGY , *INSECTICIDE-treated mosquito nets , *DRIED blood spot testing - Published
- 2020
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35. Lessons from the Field: Integrated survey methodologies for neglected tropical diseases.
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Harding-Esch, Emma M, Brady, Molly A, Angeles, Cristiam A Carey, Fleming, Fiona M, Martin, Diana L, McPherson, Scott, Hurtado, Hollman Miller, Nesemann, John M, Nwobi, Benjamin C, Scholte, Ronaldo G C, Taleo, Fasihah, Talero, Sandra Liliana, Solomon, Anthony W, and Saboyá-Díaz, Martha Idalí
- Subjects
TROPICAL medicine ,ROAD maps ,DISEASE mapping - Abstract
The 2021–2030 Neglected Tropical Diseases road map calls for intensified cross-cutting approaches. By moving away from vertical programming, the integration of platforms and intervention delivery aims to improve efficiency, cost-effectiveness and programme coverage. Drawing on the direct experiences of the authors, this article outlines key elements for successful integrated surveys, the challenges encountered, as well as future opportunities and threats to such surveys. There are multiple advantages. Careful planning should ensure that integration does not result in a process that is less efficient, more expensive or that generates data driving less reliable decisions than conducting multiple disease-specific surveys. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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36. Evaluation of a Single Dose of Azithromycin for Trachoma in Low-Prevalence Communities.
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Wilson, Nana, Goodhew, Brook, Mkocha, Harran, Joseph, Kahaliah, Bandea, Claudiu, Black, Carolyn, Igietseme, Joseph, Munoz, Beatriz, West, Sheila K., Lammie, Patrick, Kasubi, Mabula, and Martin, Diana L.
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EVALUATION ,AZITHROMYCIN ,TRACHOMA ,CHLAMYDIA trachomatis ,IMMUNOGLOBULINS ,DISEASE prevalence - Abstract
Purpose: Trachoma, caused by repeated ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide and is targeted for elimination as a public health problem. We sought to determine whether a one-time azithromycin mass treatment would reduce trachomatous inflammation-follicular (TF) levels below the elimination threshold of 5% in communities with disease prevalence between 5 and 9.9%. Methods: The study was conducted in 96 sub-village units (balozis) in the Kongwa district of Tanzania which were predicted from prior prevalence surveys to have TF between 5 and 9.9%. Balozis were randomly assigned to the intervention and control arms. The intervention arm received a single mass drug administration of azithromycin. At baseline and 12-month follow-up, ocular exams for trachoma, ocular swabs for detection of chlamydial DNA, and finger prick blood for analysis of anti-chlamydial antibody were taken. Results: Comparison of baseline and 12-month follow-up showed no significant difference in the overall TF
1-9 prevalence by balozi between control and treatment arms. In the treatment arm there was a significant reduction of ocular infection 12 months after treatment (p = 0.004) but no change in the control arm. No change in Pgp3-specific antibody responses were observed after treatment in the control or treatment arms. Anti-CT694 responses increased in both study arms (p = 0.009 for control arm and p = 0.04 for treatment arm). Conclusion: These data suggest that a single round of MDA may not be sufficient to decrease TF levels below 5% when TF1-9 is between 5 and 9.9% at baseline. [ABSTRACT FROM AUTHOR]- Published
- 2019
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37. Serological and PCR-based markers of ocular Chlamydia trachomatis transmission in northern Ghana after elimination of trachoma as a public health problem.
- Author
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Senyonjo, Laura G., Debrah, Oscar, Martin, Diana L., Asante-Poku, Adwoa, Migchelsen, Stephanie J., Gwyn, Sarah, deSouza, Dzeidzom K., Solomon, Anthony W., Agyemang, David, Biritwum-Kwadwo, Nana, Marfo, Benjamin, Bakajika, Didier, Mensah, Ernest O., Aboe, Agatha, Koroma, Joseph, Addy, James, and Bailey, Robin
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TRACHOMA prevention ,CHLAMYDIA infections ,POLYMERASE chain reaction ,SEROLOGY ,PUBLIC health - Abstract
Background: Validation of elimination of trachoma as a public health problem is based on clinical indicators, using the WHO simplified grading system. Chlamydia trachomatis (Ct) infection and anti-Ct antibody responses (anti-Pgp3) have both been evaluated as alternative indicators in settings with varying levels of trachoma. There is a need to evaluate the feasibility of using tests for Ct infection and anti-Pgp3 antibodies at scale in a trachoma-endemic country and to establish the added value of the data generated for understanding transmission dynamics in the peri-elimination setting. Methodology/Principal findings: Dried blood spots for serological testing and ocular swabs for Ct infection testing (taken from children aged 1–9 years) were integrated into the pre-validation trachoma surveys conducted in the Northern and Upper West regions of Ghana in 2015 and 2016. Ct infection was detected using the GeneXpert PCR platform and the presence of anti-Pgp3 antibodies was detected using both the ELISA assay and multiplex bead array (MBA). The overall mean cluster-summarised TF prevalence (the clinical indicator) was 0.8% (95% CI: 0.6–1.0) and Ct infection prevalence was 0.04% (95%CI: 0.00–0.12). Anti-Pgp3 seroprevalence using the ELISA was 5.5% (95% CI: 4.8–6.3) compared to 4.3% (95%CI: 3.7–4.9) using the MBA. There was strong evidence from both assays that seropositivity increased with age (p<0.001), although the seroconversion rate was estimated to be very low (between 1.2 to 1.3 yearly events per 100 children). Conclusions/Significance: Infection and serological data provide useful information to aid in understanding Ct transmission dynamics. Elimination of trachoma as a public health problem does not equate to the absence of ocular Ct infection nor cessation in acquisition of anti-Ct antibodies. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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38. Prevalence of Chlamydia trachomatis-Specific Antibodies before and after Mass Drug Administration for Trachoma in Community-Wide Surveys of Four Communities in Nepal.
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Gwyn, Sarah E., Lingwei Xiang, Kandel, Ram Prasad, Dean, Deborah, Gambhir, Manoj, and Martin, Diana L.
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- 2018
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39. Comparison of Platforms for Testing Antibody Responses against the Chlamydia trachomatis Antigen Pgp3.
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Gwyn, Sarah, Cooley, Gretchen, Goodhew, Brook, Kohlhoff, Stephan, Banniettis, Natalie, Wiegand, Ryan, and Martin, Diana L.
- Published
- 2017
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40. Prevalence of signs of trachoma, ocular Chlamydia trachomatis infection and antibodies to Pgp3 in residents of Kiritimati Island, Kiribati.
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Cama, Anaseini, Müller, Andreas, Taoaba, Raebwebwe, Butcher, Robert M. R., Itibita, Iakoba, Migchelsen, Stephanie J., Kiauea, Tokoriri, Pickering, Harry, Willis, Rebecca, Roberts, Chrissy H., Bakhtiari, Ana, Le Mesurier, Richard T., Alexander, Neal D. E., Martin, Diana L., Tekeraoi, Rabebe, Solomon, Anthony W., and null, null
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INFECTION ,TRACHOMA ,CHLAMYDIA trachomatis ,IMMUNOGLOBULINS ,BLINDNESS - Abstract
Objective: In some Pacific Island countries, such as Solomon Islands and Fiji, active trachoma is common, but ocular Chlamydia trachomatis (Ct) infection and trachomatous trichiasis (TT) are rare. On Tarawa, the most populous Kiribati island, both the active trachoma sign “trachomatous inflammation—follicular” (TF) and TT are present at prevalences warranting intervention. We sought to estimate prevalences of TF, TT, ocular Ct infection, and anti-Ct antibodies on Kiritimati Island, Kiribati, to assess local relationships between these parameters, and to help determine the need for interventions against trachoma on Kiribati islands other than Tarawa. Methods: As part of the Global Trachoma Mapping Project (GTMP), on Kiritimati, we examined 406 children aged 1–9 years for active trachoma. We collected conjunctival swabs (for droplet digital PCR against Ct plasmid targets) from 1–9-year-olds with active trachoma, and a systematic selection of 1–9-year-olds without active trachoma. We collected dried blood spots (for anti-Pgp3 ELISA) from all 1–9-year-old children. We also examined 416 adults aged ≥15 years for TT. Prevalence of TF and TT was adjusted for age (TF) or age and gender (TT) in five-year age bands. Results: The age-adjusted prevalence of TF in 1–9-year-olds was 28% (95% confidence interval [CI]: 24–35). The age- and gender-adjusted prevalence of TT in those aged ≥15 years was 0.2% (95% CI: 0.1–0.3%). Twenty-six (13.5%) of 193 swabs from children without active trachoma, and 58 (49.2%) of 118 swabs from children with active trachoma were positive for Ct DNA. Two hundred and ten (53%) of 397 children had anti-Pgp3 antibodies. Both infection (p<0.0001) and seropositivity (p<0.0001) were strongly associated with active trachoma. In 1–9-year-olds, the prevalence of anti-Pgp3 antibodies rose steeply with age. Conclusion: Trachoma presents a public health problem on Kiritimati, where the high prevalence of ocular Ct infection and rapid increase in seropositivity with age suggest intense Ct transmission amongst young children. Interventions are required here to prevent future blindness. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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41. Defining Seropositivity Thresholds for Use in Trachoma Elimination Studies.
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Migchelsen, Stephanie J., Martin, Diana L., Southisombath, Khamphoua, Turyaguma, Patrick, Heggen, Anne, Rubangakene, Peter Paul, Joof, Hassan, Makalo, Pateh, Cooley, Gretchen, Gwyn, Sarah, Solomon, Anthony W., Holland, Martin J., Courtright, Paul, Willis, Rebecca, Alexander, Neal D. E., Mabey, David C. W., and Roberts, Chrissy h.
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TRACHOMA , *CHLAMYDIA trachomatis , *SEROPREVALENCE , *DRIED blood spot testing , *RECEIVER operating characteristic curves - Abstract
Background: Efforts are underway to eliminate trachoma as a public health problem by 2020. Programmatic guidelines are based on clinical signs that correlate poorly with Chlamydia trachomatis (Ct) infection in post-treatment and low-endemicity settings. Age-specific seroprevalence of anti Ct Pgp3 antibodies has been proposed as an alternative indicator of the need for intervention. To standardise the use of these tools, it is necessary to develop an analytical approach that performs reproducibly both within and between studies. Methodology: Dried blood spots were collected in 2014 from children aged 1–9 years in Laos (n = 952) and Uganda (n = 2700) and from people aged 1–90 years in The Gambia (n = 1868). Anti-Pgp3 antibodies were detected by ELISA. A number of visual and statistical analytical approaches for defining serological status were compared. Principal Findings: Seroprevalence was estimated at 11.3% (Laos), 13.4% (Uganda) and 29.3% (The Gambia) by visual inspection of the inflection point. The expectation-maximisation algorithm estimated seroprevalence at 10.4% (Laos), 24.3% (Uganda) and 29.3% (The Gambia). Finite mixture model estimates were 15.6% (Laos), 17.1% (Uganda) and 26.2% (The Gambia). Receiver operating characteristic (ROC) curve analysis using a threshold calibrated against external reference specimens estimated the seroprevalence at 6.7% (Laos), 6.8% (Uganda) and 20.9% (The Gambia) when the threshold was set to optimise Youden’s J index. The ROC curve analysis was found to estimate seroprevalence at lower levels than estimates based on thresholds established using internal reference data. Thresholds defined using internal reference threshold methods did not vary substantially between population samples. Conclusions: Internally calibrated approaches to threshold specification are reproducible and consistent and thus have advantages over methods that require external calibrators. We propose that future serological analyses in trachoma use a finite mixture model or expectation-maximisation algorithm as a means of setting the threshold for ELISA data. This will facilitate standardisation and harmonisation between studies and eliminate the need to establish and maintain a global calibration standard. [ABSTRACT FROM AUTHOR]
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- 2017
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42. Effect of Biannual Mass Azithromycin Distributions to Preschool-Aged Children on Trachoma Prevalence in Niger: A Cluster Randomized Clinical Trial.
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Arzika, Ahmed M., Mindo-Panusis, Dallas, Abdou, Amza, Kadri, Boubacar, Nassirou, Beido, Maliki, Ramatou, Alsoudi, Amer F., Zhang, Tianyi, Cotter, Sun Y., Lebas, Elodie, O'Brien, Kieran S., Callahan, E. Kelly, Bailey, Robin L., West, Sheila K., Goodhew, E. Brook, Martin, Diana L., Arnold, Benjamin F., Porco, Travis C., Lietman, Thomas M., and Keenan, Jeremy D.
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- 2022
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43. Control of Trachoma from Achham District, Nepal: A Cross-Sectional Study from the Nepal National Trachoma Program.
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Pant, Bidya Prasad, Bhatta, Ramesh C., Chaudhary, J. S. P., Awasthi, Suresh, Mishra, Sailesh, Sharma, Shekhar, Cuddapah, Puja A., Gwyn, Sarah E., Stoller, Nicole E., Martin, Diana L., Keenan, Jeremy D., Lietman, Thomas M., and Gaynor, Bruce D.
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TRACHOMA prevention ,PUBLIC health ,DRUG administration ,SEROLOGY - Abstract
Background: The WHO seeks to control trachoma as a public health problem in endemic areas. Achham District in western Nepal was found to have TF (trachoma follicular) above 20% in a 2006 government survey, triggering 3 annual mass drug administrations finishing in 2010. Here we assess the level of control that has been achieved using surveillance for clinical disease, ocular chlamydia trachomatis infection, and serology for antibodies against chlamydia trachomatis protein antigens. Methods: We conducted a cross-sectional survey of children aged 1–9 years in communities in Achham District in early 2014 including clinical examination validated with photographs, conjunctival samples for Chlamydia trachomatis (Amplicor PCR), and serological testing for antibodies against chlamydia trachomatis protein antigens pgp3 and CT694 using the Luminex platform. Findings: In 24 randomly selected communities, the prevalence of trachoma (TF and/or TI) in 1–9 year olds was 3/1124 (0.3%, 95% CI 0.1 to 0.8%), and the prevalence of ocular chlamydia trachomatis infection was 0/1124 (0%, 95% CI 0 to 0.3%). In 18 communities selected because they had the highest prevalence of trachoma in a previous survey, the prevalence of TF and/or TI was 7/716 (1.0%, 95% CI 0.4 to 2.0%) and the prevalence of ocular chlamydia trachomatis infection was 0/716 (0%, 95% CI 0 to 0.5%). In 3 communities selected for serological testing, the prevalence of trachoma was 0/68 (0%, 95% CI 0 to 5.3%), the prevalence of ocular chlamydia trachomatis infection was 0/68 (0%, 95% CI 0 to 0.5%), the prevalence of antibodies against chlamydia trachomatis protein antigen pgp3 was 1/68 (1.5%, 95% CI 0.04% to 7.9%), and the prevalence of antibodies against chlamydia trachomatis protein antigen CT694 was 0/68 (0%, 95% CI 0 to 5.3%). Conclusion/Significance: This previously highly endemic district in Nepal has little evidence of recent clinical disease, chlamydia trachomatis infection, or serological evidence of trachoma, suggesting that epidemiological control has been achieved. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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44. Can We Use Antibodies to Chlamydia trachomatis as a Surveillance Tool for National Trachoma Control Programs? Results from a District Survey.
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West, Sheila K., Munoz, Beatriz, Weaver, Jerusha, Mrango, Zakayo, Dize, Laura, Gaydos, Charlotte, Quinn, Thomas C., and Martin, Diana L.
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CHLAMYDIA trachomatis ,IMMUNOGLOBULINS ,TRACHOMA prevention ,PUBLIC health surveillance - Abstract
Background: Trachoma is targeted for elimination by 2020. World Health Organization advises districts to undertake surveillance when follicular trachoma (TF) <5% in children 1–9 years and mass antibiotic administration has ceased. There is a question if other tools could be used for surveillance as well. We report data from a test for antibodies to C. trachomatis antigen pgp3 as a possible tool. Methodology: We randomly sampled 30 hamlets in Kilosa district, Tanzania, and randomly selected 50 children ages 1–9 per hamlet. The tarsal conjunctivae were graded for trachoma (TF), tested for C. trachomatis infection (Aptima Combo2 assay: Hologic, San Diego, CA), and a dried blood spot processed for antibodies to C. trachomatis pgp3 using a multiplex bead assay on a Luminex 100 platform. Principal findings: The prevalence of trachoma (TF) was 0.4%, well below the <5% indicator for re-starting a program. Infection was also low, 1.1%. Of the 30 hamlets, 22 had neither infection nor TF. Antibody positivity overall was low, 7.5% and increased with age from 5.2% in 1–3 year olds, to 9.3% in 7–9 year olds (p = 0.015). In 16 of the 30 hamlets, no children ages 1–3 years had antibodies to pgp3. Conclusions: The antibody status of the 1–3 year olds indicates low cumulative exposure to infection during the surveillance period. Four years post MDA, there is no evidence for re-emergence of follicular trachoma. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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45. Trachoma and Yaws: Common Ground?
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Solomon, Anthony W., Marks, Michael, Martin, Diana L., Mikhailov, Alexei, Flueckiger, Rebecca M., Mitjà, Oriol, Asiedu, Kingsley, Jannin, Jean, Engels, Dirk, and Mabey, David C. W.
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YAWS ,TRACHOMA ,EPIDEMIOLOGY ,PENICILLIN ,INTERVENTION (Social services) - Abstract
The article offers information on the overlapping of management strategies and epidemiologies for yaws and trachoma diseases. Topics discussed include the control program for yaws employed through penicillin injection, how to determine the need for disease intervention, and the occurrence of yaws and trachoma.
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- 2015
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46. Potential sexual transmission of Trypanosoma cruzi in mice.
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Martin, Diana L., Lowe, Kory R., McNeill, Tyana, Thiele, Elizabeth A., Roellig, Dawn M., Zajdowicz, Jan, Hunter, Shawn A., and Brubaker, Scott A.
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TRYPANOSOMA cruzi , *SEXUALLY transmitted diseases , *PARASITIC diseases , *ETIOLOGY of diseases , *IMMUNOSUPPRESSION , *LABORATORY mice - Abstract
Infection with the protozoan parasite Trypanosoma cruzi , the etiologic agent of human Chagas disease, results in life-long infection. Infective trypomastigotes circulate in the bloodstream and have the capacity to infect any cell type, including reproductive tissue. This study sought to assess the potential for sexual transmission of T. cruzi in an experimental mouse model. The conditions used in this study, in which acutely infected males and immunosuppressing the females, created a worst-case scenario allowing for the greatest chance of measuring transmission through intercourse. Male BALB/c mice were infected and mated with uninfected females, and the females were subsequently examined for T. cruzi tissue parasitism. A single transmission event of 61 total matings was observed, indicating a low but non-zero risk potential for male-to-female sexual transmission of T. cruzi . [ABSTRACT FROM AUTHOR]
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- 2015
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47. Serology for Trachoma Surveillance after Cessation of Mass Drug Administration.
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Martin, Diana L., Bid, Rhiannon, Sandi, Frank, Goodhew, E. Brook, Massae, Patrick A., Lasway, Augustin, Philippin, Heiko, Makupa, William, Molina, Sandra, Holland, Martin J., Mabey, David C. W., Drakeley, Chris, Lammie, Patrick J., and Solomon, Anthony W.
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TRACHOMA , *NUCLEIC acid amplification techniques , *DRUG administration , *CHLAMYDIA infections , *SEROLOGY - Abstract
Background: Trachoma, caused by Chlamydia trachomatis (Ct), is the leading infectious cause of blindness worldwide. Yearly azithromycin mass drug administration (MDA) plays a central role in efforts to eliminate blinding trachoma as a public health problem. Programmatic decision-making is currently based on the prevalence of the clinical sign "trachomatous inflammation-follicular" (TF) in children. We sought to test alternative tools for trachoma surveillance based on serology in the 12-year cohort of Kahe Mpya, Rombo District, Tanzania, where ocular chlamydial infection was eliminated with azithromycin MDA by 2005. Methodology and Principal Findings: The present study was a community-based cross-sectional survey in Kahe Mpya. Of 989 residents, 571 people aged 6 months to 87 years were enrolled: 58% of the total population and 73% of 1–9 year olds, the key WHO indicator age group. Participants were examined for TF, had conjunctival swabs collected for nucleic acid amplification test (NAAT)-based detection of Ct, and blood collected for analysis of antibodies to the Ct antigens pgp3 and CT694 by multiplex bead-based immunoassay. Seroconversion rate was used to estimate changes in the force of infection in a reversible catalytic model. No conjunctival swabs tested positive for Ct infection by NAAT. Among 1–9 year olds, TF prevalence was 6.5%, whereas only 3.5% were seropositive. Force of infection modelling indicated a 10-fold decrease in seroconversion rate at a time corresponding to MDA commencement. Without baseline serological data, the inferences we can make about antibody status before MDA and the longevity of the antibody response are limited, though our use of catalytic modelling overcomes some of these limitations. Conclusions/Significance: Serologic tests support NAAT findings of very low to zero prevalence of ocular Ct in this community and have potential to provide objective measures of transmission and useful surveillance tools for trachoma elimination programs. Author Summary: Trachoma is the leading infectious cause of blindness. The infectious agent, Chlamydia trachomatis, can be treated with a single oral dose of azithromycin. Donated drug is a cornerstone of programs dedicated to the elimination of trachoma as a public health problem. Azithromycin is given to the entire district for 3–5 years when 10% or more of 1–9 year-olds in the district have signs of a defined follicular conjunctivitis in one or both eyes. However, follicles can be difficult to reliably diagnose and can be caused by other pathogens, especially in settings with low trachoma prevalence. More sensitive and specific ways to assess communities for trachoma transmission at program endpoints are needed. Herein we examined antibody responses in children living in a community in Tanzania born after stopping drug treatment 10 years previously. Low antibody levels (3.5% in 1–9 year-olds) reflected the lack of ocular chlamydial infection in these children. We also modelled the data to show that changes in age-specific antibody prevalence occurred when the mass drug treatment stopped. These data suggest that the age-specific prevalence of antibody responses may be of use to programs seeking to demonstrate the impact of interventions against trachoma. [ABSTRACT FROM AUTHOR]
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- 2015
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48. Circulating Serum Markers and QRS Scar Score in Chagas Cardiomyopathy.
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Clark, Eva H., Marks, Morgan A., Gilman, Robert H., Fernandez, Antonio B., Crawford, Thomas C., Samuels, Aaron M., Hidron, Alicia I., Galdos-Cardenas, Gerson, Menacho-Mendez, Gilberto Silvio, Bozo-Gutierrez, Ricardo W., Martin, Diana L., and Bern, Caryn
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- 2015
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49. Regional Variation in the Correlation of Antibody and T-Cell Responses to Trypanosoma cruzi.
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Martin, Diana L., Marks, Morgan, Galdos-Cardenas, Gerson, Gilman, Robert H., Goodhew, Brook, Ferrufino, Lisbeth, Halperin, Anthony, Sanchez, Gerardo, Verastegui, Manuela, Escalante, Patricia, Naquira, Cesar, Levy, Michael Z., and Bern, Caryn
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- 2014
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50. Longitudinal analysis of antibody responses to trachoma antigens before and after mass drug administration.
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Goodhew, Erica Brook, Morgan, Sheri Maria, Switzer, Andrew J., Munoz, Beatriz, Dize, Laura, Gaydos, Charlotte, Mkocha, Harran, West, Sheila K., Wiegand, Ryan E., Lammie, Patrick J., and Martin, Diana L.
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TRACHOMA ,CHLAMYDIA trachomatis ,AZITHROMYCIN ,DRUG administration ,SEROLOGY - Abstract
Background Blinding trachoma, caused by the bacteria Chlamydia trachomatis, is a neglected tropical disease targeted for elimination by 2020. A major component of the elimination strategy is mass drug administration (MDA) with azithromycin. Currently, program decisions are made based on clinical signs of ocular infection, but we have been investigating the use of antibody responses for post-MDA surveillance. In a previous study, IgG responses were detected in children lacking clinical evidence of trachoma, suggesting that IgG responses represented historical infection. To explore the utility of serology for program evaluation, we compared IgG and IgA responses to trachoma antigens and examined changes in IgG and IgA post-drug treatment. Methods Dried blood spots and ocular swabs were collected with parental consent from 264 1-6 year olds in a single village of Kongwa District, central Tanzania. Each child also received an ocular exam for detection of clinical signs of trachoma. MDA was given, and six months later an additional blood spot was taken from these same children. Ocular swabs were analyzed for C. trachomatis DNA and antibody responses for IgA and total IgG were measured in dried bloods spots. Results Baseline antibody responses showed an increase in antibody levels with age. By age 6, the percentage positive for IgG (96.0%) was much higher than for IgA (74.2%). Antibody responses to trachoma antigens declined significantly six months after drug treatment for most age groups. The percentage decrease in IgA response was much greater than for IgG. However, no instances of seroreversion were observed. Conclusions Data presented here suggest that focusing on concordant antibody responses in children will provide the best serological surveillance strategy for evaluation of trachoma control programs. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
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