{"doi":"10.1101/2025.09.05.25334960","title":"Design considerations for incorporating serological monitoring into trachoma prevalence surveys","abstract":"Serology is increasingly used to monitor disease transmission and elimination. Embedding dried blood spot collection in trachoma surveys allows transmission intensity inference through population-level seroconversion rates (SCR) estimation, but there is no formal assessment of the required sample size. Using data from 40 prevalence surveys, we estimated intra-cluster correlation coefficient, a key design parameter, and assessed survey design considerations for incorporating serological monitoring. Design scenarios focused on recent proposed operational SCR thresholds (2.2 [no action needed] and 4.5 [action needed] per 100 child years) for interpretation of serological data in low-transmission and post-elimination settings. We evaluated SCR estimation in 42 two-stage designs by calculating precision (confidence interval width around an SCR value) and power (the measure of deviation of suggested thresholds to the SCR value). When the underlying SCR is ≤1.5 and >5.7 per 100 person-years, sample sizes between 300-2000 allowed good precision of SCR estimation. The same sample range would correctly classify areas as above or below the thresholds with >80% power when the underlying SCR is <1.7 or >5 per 100 person-years in lower and higher endemicity settings, respectively. Our results support estimation of serological data via the recommended population-based survey design for trachoma monitoring.","journal":"medRxiv","year":2025,"id":555039,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9565,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":469063,"name":"Katherine Gass","orcid":"0000-0002-2084-8039","position":1,"is_corresponding":false},{"id":1003050,"name":"Emma M. Harding‐Esch","orcid":"0000-0002-1432-8109","position":2,"is_corresponding":false},{"id":1150029,"name":"Martha Idalí Saboyá-Díaz","orcid":"0000-0003-4324-9618","position":3,"is_corresponding":false},{"id":1326904,"name":"Pearl Anne Ante-Testard","orcid":"0000-0002-3416-0817","position":4,"is_corresponding":false},{"id":1042783,"name":"Amir Bedri Kello","orcid":"0000-0003-0150-9186","position":5,"is_corresponding":false},{"id":274628,"name":"Robin L. Bailey","orcid":"0000-0002-8770-1680","position":6,"is_corresponding":false},{"id":906279,"name":"Kimberly Fornace","orcid":"0000-0002-5484-241X","position":7,"is_corresponding":false},{"id":746159,"name":"Anthony W. Solomon","orcid":"0000-0001-7101-6649","position":8,"is_corresponding":false},{"id":392041,"name":"Scott D. Nash","orcid":"0000-0001-5741-8537","position":9,"is_corresponding":false},{"id":328639,"name":"Benjamin F. Arnold","orcid":"0000-0001-6105-7295","position":10,"is_corresponding":false},{"id":1408659,"name":"Global Trachoma Serosurveillance Study Group","orcid":null,"position":11,"is_corresponding":false},{"id":788166,"name":"Everlyn Kamau","orcid":"0000-0003-4285-2255","position":0,"is_corresponding":true}],"reference_count":25,"raw_metadata":null,"created_at":"2026-07-19T02:54:54.542303Z","pmid":"40950426","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}