%0 Journal Article
%T Detecting extra-ocular Chlamydia trachomatis in a trachoma-endemic community in Ethiopia: Identifying potential routes of transmission
%A Ailie Robinson
%A Alexandra Czerniewska
%A Anna Last
%A Anthony W. Solomon
%A Bart Versteeg
%A David Macleod
%A Gebeyehu Dumessa
%A Gemechu Shumi Bejiga
%A James Logan
%A Katie Greenland
%A Matthew J. Burton
%A Muluadam Abraham Aga
%A Nebiyu Negussu
%A Nicholas Thomson
%A Oumer Shafi Abdurahman
%A Sandy Cairncross
%A Virginia Sarah
%J -
%D 2020
%R 10.1371/journal.pntd.0008120
%X Background Trachoma elimination efforts are hampered by limited understanding of Chlamydia trachomatis (Ct) transmission routes. Here we aimed to detect Ct DNA at non-ocular sites and on eye-seeking flies.   Methods A population-based household survey was conducted in Oromia Region, Ethiopia. Ocular and non-ocular (faces, hands, clothing, water containers and sleeping surfaces) swabs were collected from all individuals. Flies were caught from faces of children. Flies, ocular swabs and non-ocular swabs were tested for Ct by quantitative PCR.   Results In total, 1220 individuals in 247 households were assessed. Active trachoma (trachomatous inflammation¡ªfollicular) and ocular Ct were detected in 10% and 2% of all-ages, and 21% and 3% of 1¨C9-year-olds, respectively. Ct was detected in 12% (95% CI:8¨C15%) of tested non-ocular swabs from ocular-positive households, but in none of the non-ocular swabs from ocular-negative households. Ct was detected on 24% (95% CI:18¨C32%) of flies from ocular-positive households and 3% (95% CI:1¨C6%) of flies from ocular-negative households.   Conclusion Ct DNA was detected on hands, faces and clothing of individuals living in ocular-positive households suggesting that this might be a route of transmission within Ct infected households. In addition, we detected Ct on flies from ocular-positive households and occasionally in ocular-negative households suggesting that flies might be a vector for transmission within and between Ct infected and uninfected households. These potential transmission routes may need to be simultaneously addressed to suppress transmission
%K Trachoma
%K Chlamydia trachomatis
%K Face
%K Inflammation
%K Eye infections
%K Geographic distribution
%K Pilot studies
%K Ethiopia
%U https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0008120