Trachoma, a chronic conjunctivitis caused by repeated infections with C. trachomatis, is a leading cause of blindness for poverty-stricken communities in Africa, Asia, and the Middle East. Trachoma was once widespread globally, but has vanished from the developed world. The World Health Organization has created a growing alliance, including over 23 countries now, with the hope of eliminating blinding trachoma from the rest of the world by the year 2020. Research within trachoma endemic communities has documented the short- term profound effect of a single dose of azithromycin on the community load of infection when administered on a mass treatment basis. While infection may fall by 90% or more, and in some villages to less than 1% at one year following mass treatment, clinical disease may only decline by 30% to 50% in the same time frame. Sustaining mass treatment for many years is both expensive and wasteful of resources if in fact infection in children in these communities after multiple rounds of mass treatment is absent or very low. There is an urgent need to determine the actual prevalence of infection after mass treatment on a timely basis in order to guide decisions about altering the approach to antibiotic treatment from mass coverage to targeted treatment or even cessation. Such an approach would conserve scarce resources in these resource poor environments. Thus, we propose to develop a comprehensive assay for trachoma based on nucleic acid amplification technology, using a new platform technique called Loop-mediated AMPlification (LAMP). LAMP is an isothermal technique, precluding the need for thermocyclers and can often result in an answer in under 30 minutes. Once a test is developed, it is very simple to perform and does not require DNA isolation for sample preparation (as compared to PCR). Such simplified detection facilitates interpretation by less skilled operators. The goal of this project is to fully integrate simple instrumentation with low cost, versatile chemistry to provide rapid, reliable tests for Chlamydia that are easily performed and interpreted in a point of care setting in resource poor settings. The development of a reliable, sensitive and specific "point of care" test for C. trachomatis in ocular swabs would be a major breakthrough for National Trachoma Control programs. The project is proposed by the PI in collaboration with several eminent scientists including across a broad field of research interests. The proposed research will address a fundamental, program-relevant need for a point of care test useful in developing country settings to guide monitoring. Such a test is urgently needed by program planners to be certain that resources are being allocated optimally and the public health goal of elimination of blinding trachoma can be attained. Trachoma, a chronic conjunctivitis caused by repeated infections with C. trachomatis, is a leading cause of blindness for poverty-stricken communities in Africa, Asia, and the Middle East. The development of a reliable, sensitive and specific "point of care" test for trachoma would be a major breakthrough for National Trachoma Control programs. The proposed research proposes to develop such a test and will address a fundamental, program-relevant need for a point of care test useful in developing country settings to guide monitoring of trachoma. This will ultimately help in the public health goal of elimination of blinding trachoma.

Public Health Relevance

Trachoma, a chronic conjunctivitis caused by repeated infections with C. trachomatis, is a leading cause of blindness for poverty-stricken communities in Africa, Asia, and the Middle East. The development of a reliable, sensitive and specific point of care test for trachoma would be a major breakthrough for National Trachoma Control programs. The proposed research proposes to develop such a test and will address a fundamental, program-relevant need for a point of care test useful in developing country settings to guide monitoring of trachoma. This will ultimately help in the public health goal of elimination of blinding trachoma.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI082614-04
Application #
8246308
Study Section
Special Emphasis Panel (ZAI1-GSM-M (J2))
Program Officer
Rogers, Elizabeth
Project Start
2009-04-15
Project End
2014-03-31
Budget Start
2012-04-01
Budget End
2013-03-31
Support Year
4
Fiscal Year
2012
Total Cost
$370,192
Indirect Cost
$82,876
Name
University of Pittsburgh
Department
Pediatrics
Type
Schools of Medicine
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213