Chlamydia trachomatis is a bacterium of which infection of the eye (trachoma) is the most common infectious cause of blindness worldwide and infection of the urogenital tract (chlamydia) is one of the most sexually transmitted infections (STIs) in women. We are collaborating with the Ministry of Health of the Republic of Nauru and the Solomon Islands to conduct national surveys that aim to investigate whether trachoma is still endemic in these settings. These surveys are the first to combine clinical, bacterial, serological and WASH variables to test for evidence of current or past C. trachomatis infection with particular interest in children aged 1-9 years. Data was collected by local health workers from the participating communities. The results of the 2019 survey in Nauru prompted the Ministry of Health to implement a mass drug administration with azithromycin the following year. Both ocular and STI strains of infection are known public health problems in Nauru. Previous studies have shown a high proportion of children have early stages of trachoma but there is little evidence of the disease in adults. This concept is known as the ‘pacific enigma’. Our researchers hypothesise that the STI strain has a potential impact on trachoma like eye disease in Nauru. To investigate this, an STI survey collected samples for urogenital C. trachomatis testing in adults. Strains found in ocular samples collected will be compared with urogenital samples by genotyping. The findings will be highly relevant for trachoma control and could inform the delivery of integrated community-based interventions for trachoma and STI control.