02996nas a2200457   4500000000100000008004100001653001300042653001300055653002900068653002900097653001500126653002600141653003100167653000900198653002000207653001100227653002700238653002700265653001100292653002100303653001900324653002600343653002100369653001000390100001300400700000900413700001300422700001100435700001700446700001500463700001700478700001300495700001200508700001300520245011200533856007300645300001100718490000700729520178800736022001402524       2011                            d10aTrachoma10aTanzania10aStreptococcus pneumoniae10aStreptococcal Infections10aPrevalence10aMultivariate Analysis10aMicrobiological Techniques10aMale10aLogistic Models10aHumans10aHaemophilus influenzae10aHaemophilus Infections10aFemale10aEndemic Diseases10aConjunctivitis10aChlamydia trachomatis10aChild, Preschool10aChild1 aBurton M1 aHu V1 aMassae P1 aBurr S1 aChevallier C1 aAfwamba IA1 aCourtright P1 aWeiss HA1 aMabey D1 aBailey R00aWhat is causing active trachoma? The role of nonchlamydial bacterial pathogens in a low prevalence setting.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3176035/pdf/z7g6012.pdf  a6012-70 v523 a<p><strong>PURPOSE: </strong>In low prevalence settings, clinically active follicular trachoma (TF) is often found in the absence of detectable Chlamydia trachomatis. The reasons for this persistent follicular phenotype are not well understood; one possible explanation is that other bacterial species are provoking the inflammatory response. This study investigated the relationship between TF, C. trachomatis, and nonchlamydial bacterial infection.</p>

<p><strong>METHODS: </strong>A cross-sectional survey was conducted in a trachoma endemic village in Tanzania. All available children were examined for trachoma and swabs were collected for microbiologic culture (blood and chocolate agar) and C. trachomatis PCR (Amplicor).</p>

<p><strong>RESULTS: </strong>Four hundred seventy-three children under 10 years of age were recruited for this study. The prevalences of TF and C. trachomatis were 13.7% and 5.3%, respectively, and were not associated. Bacteria were cultured from 305 (64.5%) swab samples; 162 (34.3%) grew a pathogen (with or without a commensal organism) and 143 (30.2%) grew commensal bacteria only. The most common pathogens were Streptococcus pneumoniae and Haemophilus influenzae (type B and non-type B). The presence of bacterial pathogens was associated with TF (odds ratio, 4.68; 95% confidence interval, 2.31-9.50; P &lt; 0.001).</p>

<p><strong>CONCLUSIONS: </strong>In regions with low levels of endemic trachoma, it is possible that much of the TF that is observed is attributable to nonchlamydial bacterial pathogens. It is plausible that individuals who have previously developed a follicular conjunctivitis in response to C. trachomatis may more readily reform conjunctival follicles when challenged with certain other bacterial species.</p>
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