Evidence for contamination with C. trachomatis in the household environment of children with active Trachoma: A cross-sectional study in Kongwa, Tanzania

Abstract

BackgroundTrachoma, a conjunctivitis caused by repeated infections with Chlamydia trachomatis, remains a significant cause of blindness worldwide. While mass treatments with azithromycin decreases disease and infection, re-emergence occurs, indicating that elimination may require other sustainable interventions. Environmental changes largely focus on facial hygiene and latrines, but further work to identify other possible transmission targets are needed. We sought to determine, in a cross-sectional survey of households of children with active trachoma, if we could detect the presence of Chlamydia trachomatis on household objects and on family members based on sleeping and caretaking patterns. MethodsIn five villages in Kongwa, Tanzania, children <five years were randomly chosen for examination for trachoma, and households of all children with active trachoma (n = 90) were eligible for this study. We administered structured questionnaires of sleeping and caretaking habits. Based on the responses, environmental swabs of bedding, furniture, clothing, and hands were taken and processed using Amplicor for detecting C. trachomatis DNA. ResultsOf 80 visited households, 13 (16%) had at least one swab from environmental sources positive for C. trachomatis DNA. A positive environmental swab was associated with the presence of ocular infection in the index child (Odds Ratio = 22.0, p = .007), the presence of an PLOS Neglected Tropical Diseases | https://doi.org/10.1371/journal.pntd.

Viability PCR shows that non-ocular surfaces could contribute to transmission of Chlamydia trachomatis infection in trachoma

“…Ct DNA could be recovered from all surfaces except woven mat. These results are in line with previous work demonstrating that Ct DNA could be detected on hands, faces and clothing of individuals and water cans in households where at least one household member had an ocular Ct infection detectable by PCR [6,9,30,31]. The lack of detection from woven mat in the present study may have occurred because Ct culture in 2SP solution seeped through the material and did not leave sufficient DNA on the surface to allow later recovery.…”

Trachoma prevention practice and associated factors among mothers having children aged under nine years in Andabet district, northwest Ethiopia, 2022: A multi-level analysis

“…According to different studies conducted in Ethiopia, the prevalence of poor TPP was high, which ranges between 45.5 and 64.4% [1,17]. Shreds of evidence have shown that individuallevel factors such as the age of the mother, husband's education, basic knowledge about trachoma, mother's attitude towards trachoma, taking health education about trachoma, time taken to the water point and frequency of getting water and also community-level factors such as residence and types of water source were affected TPP [1,7,[16][17][18][19][20][21].…”

Environmental factors and hygiene behaviors associated with facial cleanliness and trachoma in Kongwa, Tanzania

“…Trachoma is the result of repeated infection with Chlamydia trachomatis (C. trachomatis), which causes conjunctivitis in young children [2], who are the main reservoirs of infection. C. trachomatis is transmitted in infected ocular and nasal discharge via direct contact, fomites, or eye-seeking flies [3][4][5].…”

“…In earlier studies in Tanzania, caregivers expressed frustration about the futility of washing children's faces as they would soon become dirty again from interaction with a dirty environment [11,24]. A study found contamination of household environments including clothes, bedding, and furniture with C. trachomatis [5].…”