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Population-based prevalence survey of follicular trachoma and trachomatous trichiasis in the Casamance region of Senegal.

Harding-Esch, EM; Kadimpeul, J; Sarr, B; Sane, A; Badji, S; Laye, M; Sillah, A; Burr, SE; MacLeod, D; Last, AR; et al. Harding-Esch, EM; Kadimpeul, J; Sarr, B; Sane, A; Badji, S; Laye, M; Sillah, A; Burr, SE; MacLeod, D; Last, AR; Holland, MJ; Mabey, DC; Bailey, RL (2017) Population-based prevalence survey of follicular trachoma and trachomatous trichiasis in the Casamance region of Senegal. BMC Public Health, 18 (1). p. 62. ISSN 1471-2458 https://doi.org/10.1186/s12889-017-4605-0
SGUL Authors: Harding-Esch, Emma Michele

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Abstract

BACKGROUND: Trachoma, caused by ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. We conducted the first population-based trachoma prevalence survey in the Casamance region of Senegal to enable the Senegalese National Eye Care Programme (NECP) to plan its trachoma control activities. The World Health Organization (WHO) guidelines state that any individual with trachomatous trichiasis (TT) should be offered surgery, but that surgery should be prioritised where the prevalence is >0.1%, and that districts and communities with a trachomatous inflammation, follicular (TF) prevalence of ≥10% in 1-9 year-olds should receive mass antibiotic treatment annually for a minimum of three years, along with hygiene promotion and environmental improvement, before re-assessing the prevalence to determine whether treatment can be discontinued (when TF prevalence in 1-9 year-olds falls <5%). METHODS: Local healthcare workers conducted a population-based household survey in four districts of the Bignona Department of Casamance region to estimate the prevalence of TF in 1-9 year-olds, and TT in ≥15 year-olds. Children's facial cleanliness (ocular and/or nasal discharge, dirt on the face, flies on the face) was measured at time of examination. Risk factor questionnaires were completed at the household level. RESULTS: Sixty communities participated with a total censused population of 5580 individuals. The cluster-, age- and sex-adjusted estimated prevalence of TF in 1-9 year-olds was 2.5% (95% Confidence Interval (CI) 1.8-3.6) (38/1425) at the regional level and <5% in all districts, although the upper 95%CI exceeded 5% in all but one district. The prevalence of TT in those aged ≥15 years was estimated to be 1.4% (95%CI 1.0-1.9) (40/2744) at the regional level and >1% in all districts. CONCLUSION: With a prevalence <5%, TF does not appear to be a significant public health problem in this region. However, TF monitoring and surveillance at sub-district level will be required to ensure that elimination targets are sustained and that TF does not re-emerge as a public health problem. TT surgery remains the priority for trachoma elimination efforts in the region, with an estimated 1819 TT surgeries to conduct.

Item Type: Article
Additional Information: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Active trachoma, Chlamydia trachomatis, Control, Senegal, Survey, Trachomatous trichiasis, Public Health, 1117 Public Health And Health Services
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: BMC Public Health
ISSN: 1471-2458
Language: eng
Dates:
DateEvent
26 July 2017Published
18 July 2017Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
48027Bill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
PubMed ID: 28747198
Go to PubMed abstract
URI: http://sgultest.da.ulcc.ac.uk/id/eprint/109025
Publisher's version: https://doi.org/10.1186/s12889-017-4605-0

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