biostudies-literatureUnknown217(10)Lynch KD<h4>Objectives</h4>To compare the findings of standard clinical assessments and of complementary clinical and laboratory methods for determining whether community-wide treatment for trachoma is warranted in a remote Queensland community.<h4>Design</h4>Three cross-sectional screening surveys, 2019-2021, complemented by laboratory pathology testing.<h4>Setting</h4>Small community in northwest Queensland with geographic and cultural ties to Northern Territory communities where trachoma persists.<h4>Participants</h4>Children aged 1-14 years; opportunistic screening of people aged 15 years or more.<h4>Main outcome measures</h4>Prevalence of clinical signs of trachoma, Chlamydia trachomatis infection, ocular non-chlamydial infections, and seropositivity for antibodies to the C. trachomatis Pgp3 protein.<h4>Results</h4>During the three surveys, 73 examinations of 58 children aged 1-4 years, 309 of 171 aged 5-9 years, and 142 of 105 aged 10-14 years for trachoma were undertaken, as were 171 examinations of 164 people aged 15 years or more; 691 of 695 examinations were of Aboriginal or Torres Strait Islander people (99%), 337 were of girls or young women (48%). Clinical signs consistent with trachomatous inflammation-follicular were identified in 5-9-year-old children 23 times (7%), including in eleven with non-chlamydial infections and one with a C. trachomatis infection. One child (10-14 years) met the criteria for trachomatous scarring. Two of 272 conjunctival swab samples (all ages) were polymerase chain reaction-positive for C. trachomatis (0.7%). Two of 147 people aged 15 years or more examined in 2019 had trichiasis, both aged 40 years or more. Seven of 53 children aged 1-9 years in 2019 and seven of 103 in 2021 were seropositive for anti-Pgp3 antibodies.<h4>Conclusions</h4>Despite the prevalence of clinical signs consistent with trachomatous inflammation-follicular among 5-9-year-old children exceeding the 5% threshold for community-wide treatment, laboratory testing indicated that childhood exposure to ocular C. trachomatis is rare in this community. Laboratory testing should be integrated into Australian trachoma guidelines.The Medical journal of Australia538-543https://www.ebi.ac.uk/biostudies/studies/S-EPMC9827872biostudies-literatureClinical signs of trachoma and laboratory evidence of ocular Chlamydia trachomatis infection in a remote Queensland community: a serial cross-sectional study.PMC9827872Morotti WLambert SBKaldor JMWhop LJO'Keefe AKingston KStarr MLynch KDKetchup LBrian GEverill BWare RSAsgar NfalseClinical signs of trachoma and laboratory evidence of ocular Chlamydia trachomatis infection in a remote Queensland community: a serial cross-sectional study.<h4>Objectives</h4>To compare the findings of standard clinical assessments and of complementary clinical and laboratory methods for determining whether community-wide treatment for trachoma is warranted in a remote Queensland community.<h4>Design</h4>Three cross-sectional screening surveys, 2019-2021, complemented by laboratory pathology testing.<h4>Setting</h4>Small community in northwest Queensland with geographic and cultural ties to Northern Territory communities where trachoma persists.<h4>Participants</h4>Children aged 1-14 years; opportunistic screening of people aged 15 years or more.<h4>Main outcome measures</h4>Prevalence of clinical signs of trachoma, Chlamydia trachomatis infection, ocular non-chlamydial infections, and seropositivity for antibodies to the C. trachomatis Pgp3 protein.<h4>Results</h4>During the three surveys, 73 examinations of 58 children aged 1-4 years, 309 of 171 aged 5-9 years, and 142 of 105 aged 10-14 years for trachoma were undertaken, as were 171 examinations of 164 people aged 15 years or more; 691 of 695 examinations were of Aboriginal or Torres Strait Islander people (99%), 337 were of girls or young women (48%). Clinical signs consistent with trachomatous inflammation-follicular were identified in 5-9-year-old children 23 times (7%), including in eleven with non-chlamydial infections and one with a C. trachomatis infection. One child (10-14 years) met the criteria for trachomatous scarring. Two of 272 conjunctival swab samples (all ages) were polymerase chain reaction-positive for C. trachomatis (0.7%). Two of 147 people aged 15 years or more examined in 2019 had trichiasis, both aged 40 years or more. Seven of 53 children aged 1-9 years in 2019 and seven of 103 in 2021 were seropositive for anti-Pgp3 antibodies.<h4>Conclusions</h4>Despite the prevalence of clinical signs consistent with trachomatous inflammation-follicular among 5-9-year-old children exceeding the 5% threshold for community-wide treatment, laboratory testing indicated that childhood exposure to ocular C. trachomatis is rare in this community. Laboratory testing should be integrated into Australian trachoma guidelines.2022-01-01T00:00:00Z2022 Nov2025-04-21T17:54:42.422Z2025-04-05T17:03:28.963ZS-EPMC98278723618009710.5694/mja2.51735