Defining ocular Chlamydia trachomatis infection prevalence thresholds for the trachoma elimination endgame

An ocular Chlamydia trachomatis PCR prevalence of 0.81% in children aged 1–5 years corresponds to a stopping threshold with at least 90% confidence across 13 countries.

• Why it matters: Programmes need evidence-based criteria for when to stop trachoma control and how to interpret low-prevalence surveillance, where highly sensitive PCR results can be hard to translate into decisions.
• What they did: The team pooled 86 cross-sectional surveys from 13 countries (46,914 children aged 1–5) and analyzed PCR-detected ocular Ct infection to derive prevalence thresholds tied to confidence levels.
• The result: They propose continuing interventions when prevalence is greater than 1.99%, with confidence exceeding 90%, enabling more precise population-level endemicity assessments during the trachoma elimination endgame.

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