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Sub-district spatial heterogeneity in trachoma seroprevalence as populations approach elimination

Article scientifique 2026 Autre

Résumé

Abstract Programmatic decisions regarding surveillance and intervention for trachoma are made at the district level, reflecting an implicit assumption that transmission within districts is sufficiently homogeneous. However, as trachoma transmission declines, residual pockets of transmission may become spatially heterogeneous at sub-district scales. Using cluster-level data from 12 districts in Amhara, Ethiopia (2019–2023), we assess the spatial structure of Pgp3 antibody responses, a sensitive measure of infection transmission. Spatial clustering was evident in higher prevalence districts but diminished as populations approach elimination. We show that as districts approach elimination sub-district heterogeneity disappears, and district-level summaries are likely sufficient to guide decision-making.

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Srivathsan, A., Kamau, E., Chernet, A., Ayenew, G., Gonzalez, T., Sata, E., Abebe, A., Tadesse, Z., Callahan, E., Wickens, K., Gwyn, S., Martin, D., Ante-Testard, P., Keenan, J., Lietman, T., Nash, S., Arnold, B. (2026). Sub-district spatial heterogeneity in trachoma seroprevalence as populations approach elimination. https://doi.org/10.64898/2026.02.23.26346913

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Auteur(s)

Ariktha Srivathsan Everlyn Kamau Ambahun Chernet Getahun Ayenew Tania A. Gonzalez Eshetu Sata Adisu Abebe Zerihun Tadesse E. Kelly Callahan Karana Wickens Sarah Gwyn Diana L. Martin Pearl Anne Ante-Testard Jeremy D. Keenan Thomas M. Lietman Scott D. Nash Benjamin F. Arnold

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