Limits...
The burden of trachoma in Ayod County of Southern Sudan.

King JD, Ngondi J, Gatpan G, Lopidia B, Becknell S, Emerson PM - PLoS Negl Trop Dis (2008)

Bottom Line: Prevalence of trachomatous trichiasis (TT) was 14.6% (95% CI, 10.9-18.3) in adults over 14 years of age; 2.9% (95% CI, 0.4-5.3) in children 1-14 years of age; and 8.4% (95% CI, 5.5-11.3) overall.The prevalence of corneal opacity in persons over 14 years of age with TT was 6.4% (95% CI, 4.5-8.3).The high prevalence of active trachoma and trichiasis confirms the severe burden of blinding trachoma found in other post-conflict areas of Southern Sudan.

View Article: PubMed Central - PubMed

Affiliation: The Carter Center, Atlanta, Georgia, USA. jonathan.king@emory.edu

ABSTRACT

Background: Blindness due to trachoma is avoidable through Surgery, Antibiotics, Facial hygiene and Environmental improvements (SAFE). Recent surveys have shown trachoma to be a serious cause of blindness in Southern Sudan. We conducted this survey in Ayod County of Jonglei State to estimate the need for intervention activities to eliminate blinding trachoma.

Methodology and findings: A cross-sectional two-stage cluster random survey was conducted in November 2006. All residents of selected households were clinically assessed for trachoma using the World Health Organization (WHO) simplified grading scheme. A total of 2,335 people from 392 households were examined, of whom 1,107 were over 14 years of age. Prevalence of signs of active trachoma in children 1-9 years of age was: trachomatous inflammation follicular (TF) = 80.1% (95% confidence interval [CI], 73.9-86.3); trachomatous inflammation intense (TI) = 60.7% (95% CI, 54.6-66.8); and TF and/or TI (active trachoma) = 88.3% (95% CI, 83.7-92.9). Prevalence of trachomatous trichiasis (TT) was 14.6% (95% CI, 10.9-18.3) in adults over 14 years of age; 2.9% (95% CI, 0.4-5.3) in children 1-14 years of age; and 8.4% (95% CI, 5.5-11.3) overall. The prevalence of corneal opacity in persons over 14 years of age with TT was 6.4% (95% CI, 4.5-8.3). No statistically significant difference was observed in the prevalence of trachoma signs between genders. Trachoma affected almost all households surveyed: 384/392 (98.0%) had at least one person with active trachoma and 130 (33.2%) had at least one person with trichiasis.

Conclusions: Trachoma is an unnecessary public health problem in Ayod. The high prevalence of active trachoma and trichiasis confirms the severe burden of blinding trachoma found in other post-conflict areas of Southern Sudan. Based on WHO recommended thresholds, all aspects of the SAFE strategy are indicated to eliminate blinding trachoma in Ayod.

Show MeSH

Related in: MedlinePlus

The WHO simplified grading scheme for assessment of Trachoma.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2553487&req=5

pntd-0000299-g002: The WHO simplified grading scheme for assessment of Trachoma.

Mentions: All survey team members received training in the WHO simplified grading system (Figure 2) through explanations, review of slides and field exercises.[12] Each member was required to grade a standardized set of slides to identify clinical signs of trachoma. Only team members achieving more than 80% overall agreement with the trainer's gold standard diagnosis were selected to participate in the field examinations on the fifth day of training. The presence or absence of each sign was assessed separately for each eye of 25 children. After reviewing the individual results of the team members, the trainer spent additional time with examiners on day 6 and day 7 during practical household survey training to confirm diagnoses. In order for a survey worker to be considered an examiner, she/he must have achieved a overall agreement of at least 80% compared to the trainer during the field examinations. Only the best 10 members of the survey team were used as examiners. Examiner's agreement with the gold standard and Cohen's Kappa statistic for each trachoma grade TF,TI and TS, and all three grades combined for the WHO standardized slide set are shown in Table 1.


The burden of trachoma in Ayod County of Southern Sudan.

King JD, Ngondi J, Gatpan G, Lopidia B, Becknell S, Emerson PM - PLoS Negl Trop Dis (2008)

The WHO simplified grading scheme for assessment of Trachoma.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2553487&req=5

pntd-0000299-g002: The WHO simplified grading scheme for assessment of Trachoma.
Mentions: All survey team members received training in the WHO simplified grading system (Figure 2) through explanations, review of slides and field exercises.[12] Each member was required to grade a standardized set of slides to identify clinical signs of trachoma. Only team members achieving more than 80% overall agreement with the trainer's gold standard diagnosis were selected to participate in the field examinations on the fifth day of training. The presence or absence of each sign was assessed separately for each eye of 25 children. After reviewing the individual results of the team members, the trainer spent additional time with examiners on day 6 and day 7 during practical household survey training to confirm diagnoses. In order for a survey worker to be considered an examiner, she/he must have achieved a overall agreement of at least 80% compared to the trainer during the field examinations. Only the best 10 members of the survey team were used as examiners. Examiner's agreement with the gold standard and Cohen's Kappa statistic for each trachoma grade TF,TI and TS, and all three grades combined for the WHO standardized slide set are shown in Table 1.

Bottom Line: Prevalence of trachomatous trichiasis (TT) was 14.6% (95% CI, 10.9-18.3) in adults over 14 years of age; 2.9% (95% CI, 0.4-5.3) in children 1-14 years of age; and 8.4% (95% CI, 5.5-11.3) overall.The prevalence of corneal opacity in persons over 14 years of age with TT was 6.4% (95% CI, 4.5-8.3).The high prevalence of active trachoma and trichiasis confirms the severe burden of blinding trachoma found in other post-conflict areas of Southern Sudan.

View Article: PubMed Central - PubMed

Affiliation: The Carter Center, Atlanta, Georgia, USA. jonathan.king@emory.edu

ABSTRACT

Background: Blindness due to trachoma is avoidable through Surgery, Antibiotics, Facial hygiene and Environmental improvements (SAFE). Recent surveys have shown trachoma to be a serious cause of blindness in Southern Sudan. We conducted this survey in Ayod County of Jonglei State to estimate the need for intervention activities to eliminate blinding trachoma.

Methodology and findings: A cross-sectional two-stage cluster random survey was conducted in November 2006. All residents of selected households were clinically assessed for trachoma using the World Health Organization (WHO) simplified grading scheme. A total of 2,335 people from 392 households were examined, of whom 1,107 were over 14 years of age. Prevalence of signs of active trachoma in children 1-9 years of age was: trachomatous inflammation follicular (TF) = 80.1% (95% confidence interval [CI], 73.9-86.3); trachomatous inflammation intense (TI) = 60.7% (95% CI, 54.6-66.8); and TF and/or TI (active trachoma) = 88.3% (95% CI, 83.7-92.9). Prevalence of trachomatous trichiasis (TT) was 14.6% (95% CI, 10.9-18.3) in adults over 14 years of age; 2.9% (95% CI, 0.4-5.3) in children 1-14 years of age; and 8.4% (95% CI, 5.5-11.3) overall. The prevalence of corneal opacity in persons over 14 years of age with TT was 6.4% (95% CI, 4.5-8.3). No statistically significant difference was observed in the prevalence of trachoma signs between genders. Trachoma affected almost all households surveyed: 384/392 (98.0%) had at least one person with active trachoma and 130 (33.2%) had at least one person with trichiasis.

Conclusions: Trachoma is an unnecessary public health problem in Ayod. The high prevalence of active trachoma and trichiasis confirms the severe burden of blinding trachoma found in other post-conflict areas of Southern Sudan. Based on WHO recommended thresholds, all aspects of the SAFE strategy are indicated to eliminate blinding trachoma in Ayod.

Show MeSH
Related in: MedlinePlus