Molecular Epidemiology of Trachoma in Three Endemic States of North West Nigeria: Towards Elimination by 2030

Trachoma elimination targets set for 2030 by the World Health Organization require a granular understanding of the molecular epidemiology of Chlamydia trachomatis (Ct) ocular infection, including circulating genotypes, antibiotic resistance patterns, and transmission dynamics in endemic communities. This study investigates the molecular epidemiology of ocular trachoma in Jigawa, Katsina, and Kebbi States in North West Nigeria, three states with active trachoma endemicity. A longitudinal multi-round survey design will be employed, recruiting 2,000 children aged 1 to 9 years from 40 communities over two survey rounds spaced 18 months apart. Ocular swabs will be collected for Ct detection using polymerase chain reaction and genotyping using multi-locus variable number tandem repeat analysis. Antibiotic susceptibility testing will examine resistance patterns to azithromycin. Spatial analysis will map transmission clusters and examine associations with water, sanitation, and hygiene (WASH) indicators. The study will generate the first molecular surveillance dataset for trachoma from North West Nigeria, informing WHO-GTMP recommendations for the SAFE strategy implementation. Findings will be submitted to the Federal Ministry of Health's Neglected Tropical Diseases division, relevant state governments, and international trachoma elimination programs. This research represents an original scientific contribution to trachoma elimination science in sub-Saharan Africa. Keywords: trachoma, molecular epidemiology, Chlamydia trachomatis, North West Nigeria, elimination