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

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Title
Population-based prevalence survey of follicular trachoma and trachomatous trichiasis in the Casamance region of Senegal
Published in
BMC Public Health, July 2017
DOI 10.1186/s12889-017-4605-0
Pubmed ID
Authors

Emma M. Harding-Esch, Julbert Kadimpeul, Boubacar Sarr, Awa Sane, Souleymane Badji, Mass Laye, Ansumana Sillah, Sarah E. Burr, David MacLeod, Anna R. Last, Martin J. Holland, David C. Mabey, Robin L. Bailey

Abstract

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%). 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. 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. 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.

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The data shown below were compiled from readership statistics for 86 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 86 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 13 15%
Researcher 8 9%
Student > Bachelor 7 8%
Lecturer 5 6%
Student > Postgraduate 5 6%
Other 16 19%
Unknown 32 37%
Readers by discipline Count As %
Medicine and Dentistry 15 17%
Nursing and Health Professions 14 16%
Social Sciences 6 7%
Economics, Econometrics and Finance 4 5%
Agricultural and Biological Sciences 2 2%
Other 12 14%
Unknown 33 38%