Diversity of chlamydia trachomatis in trachoma-hyperendemic communities treated with azithromycin

Stephanie A. Chin, Daniel P. Morberg, Wondu Alemayehu, Muluken Melese, Takele Lakew, Michael C. Chen, Zhaoxia Zhou, Thuy Doan, Vicky Cevallos, Thomas M. Lietman, Jeremy D. Keenan

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6 Scopus citations


Prior studies have theorized that low chlamydial genetic diversity following mass azithromycin treatments for trachoma may create a population bottleneck that prevents the return of infection, but little empirical evidence exists to support this hypothesis. In this study, a singlemass azithromycin distribution was administered to 21 communities in theGurage Zone of Ethiopia in 2003. All children aged 1-5 years had conjunctival swabs performed before treatment and 2 and 6 months after treatment. All swabs positive for Chlamydia trachomatis at 2 months underwent typing of the gene encoding the major outer membrane protein (ompA) of C. trachomatis, as did the same number of swabs per community from the pretreatment and 6-month visits. Diversity of ompA types, expressed as the reciprocal of Simpson's index,was calculated for each community. In total, 15 ompA types belonging to the A and B genovars were identified. The mean diversity was 2.11 (95% confidence interval: 1.79, 2.43) before treatment and 2.16 (95% confidence interval: 1.76, 2.55) 2months after treatment (P = 0.78, paired t test). Diversity of ompA was not associated with the prevalence of ocular chlamydia (P = 0.76) and did not predict subsequent changes in the prevalence of ocular chlamydia (P = 0.32). This study found no evidence to support the theory that ompA diversity is associated with transmission of ocular chlamydia.

Original languageEnglish (US)
Pages (from-to)1840-1845
Number of pages6
JournalAmerican journal of epidemiology
Issue number9
StatePublished - Sep 1 2018

All Science Journal Classification (ASJC) codes

  • General Medicine


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