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Trachoma in Western Equatoria State, Southern Sudan: implications for national control.

Kur LW, Picon D, Adibo O, Robinson E, Sabasio A, Edwards T, Ndyaba A, Rumunu J, Lewis K, Lado M, Kolaczinski J - PLoS Negl Trop Dis (2009)

Bottom Line: No trachomatous trichiasis (TT) was found in those aged under 15, and prevalence was 0.1% (95% CI, 0.0%-0.4%) in those aged 15 years and above.Again, no TT was found in those aged under 15, and prevalence in those aged 15 years and above was 0.3% (95% CI, 0.0%-0.8%).Studies should thus be targeted to areas where collection of new data would be most informative.

View Article: PubMed Central - PubMed

Affiliation: Ministry of Health, Government of Southern Sudan, Juba, Southern Sudan.

ABSTRACT

Background: Trachoma is thought to be common over large parts of Southern Sudan. However, many areas of the country, particularly west of the Nile, have not yet been surveyed. The aim of this study was to confirm whether trachoma extends into Western Equatoria State from neighboring Central Equatoria, where trachoma is highly prevalent, and whether intervention with the SAFE strategy is required.

Methods and findings: Population-based cross-sectional surveys were conducted using a two-stage cluster random sampling method to select the study population. Subjects were examined for trachoma by experienced graders using the World Health Organization (WHO) simplified grading scheme. Two counties thought to be most likely to have trachoma were surveyed, Maridi and Mundri. In Maridi, prevalence of one of the signs of active trachoma (trachomatous inflammation-follicular (TF)) in children aged 1-9 years was 0.4% (95% confidence interval (CI), 0.0%-0.8%), while no children showing the other possible sign, trachomatous inflammation-intense (TI), were identified. No trachomatous trichiasis (TT) was found in those aged under 15, and prevalence was 0.1% (95% CI, 0.0%-0.4%) in those aged 15 years and above. In Mundri, active trachoma was also limited to signs of TF, with a prevalence of 4.1% (95% CI, 1.4%-6.9%) in children aged 1-9 years. Again, no TT was found in those aged under 15, and prevalence in those aged 15 years and above was 0.3% (95% CI, 0.0%-0.8%).

Conclusion: Trachoma prevalence in the east of Western Equatoria State is below the WHO recommended intervention threshold for mass drug administration of antibiotic treatment in all villages. However, the prevalence of TF and TT in some villages, particularly in Mundri County, is sufficiently high to warrant targeted interventions at the community level. These results demonstrate that trachoma is not a major public health problem throughout Southern Sudan. Further studies will be required to determine trachoma prevalence in other areas, particularly west of the Nile, but there are presently no resources to survey each county. Studies should thus be targeted to areas where collection of new data would be most informative.

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Related in: MedlinePlus

Maps showing surveyed counties in Western Equatoria State (hatched), and the prevalence of active trachoma (TF) and of trichiasis at each study site.
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pntd-0000492-g001: Maps showing surveyed counties in Western Equatoria State (hatched), and the prevalence of active trachoma (TF) and of trichiasis at each study site.

Mentions: During November 2008, two population-based prevalence surveys were conducted in Western Equatoria State, which lies in the South-West of Southern Sudan (Figure 1). The majority of people are agriculturalist, growing maize, cassava, groundnut, and fruit. The state capital is Yambio, and the other major towns are Tambura, Nzara, Maridi and Mundri. The total population of Western Equatoria State was estimated to be 845,989 in 2008, using data collected during National Immunization Day. This is approximately 8% of the total population of Southern Sudan, which is estimated to be around 10 million. One trachoma survey was conducted in Mundri county and the other in Maridi county (Figure 1). At the time of the surveys, 186,668 people were estimated to live in Mundri and 186,830 in Maridi; both counties consisted of six payams.


Trachoma in Western Equatoria State, Southern Sudan: implications for national control.

Kur LW, Picon D, Adibo O, Robinson E, Sabasio A, Edwards T, Ndyaba A, Rumunu J, Lewis K, Lado M, Kolaczinski J - PLoS Negl Trop Dis (2009)

Maps showing surveyed counties in Western Equatoria State (hatched), and the prevalence of active trachoma (TF) and of trichiasis at each study site.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2710503&req=5

pntd-0000492-g001: Maps showing surveyed counties in Western Equatoria State (hatched), and the prevalence of active trachoma (TF) and of trichiasis at each study site.
Mentions: During November 2008, two population-based prevalence surveys were conducted in Western Equatoria State, which lies in the South-West of Southern Sudan (Figure 1). The majority of people are agriculturalist, growing maize, cassava, groundnut, and fruit. The state capital is Yambio, and the other major towns are Tambura, Nzara, Maridi and Mundri. The total population of Western Equatoria State was estimated to be 845,989 in 2008, using data collected during National Immunization Day. This is approximately 8% of the total population of Southern Sudan, which is estimated to be around 10 million. One trachoma survey was conducted in Mundri county and the other in Maridi county (Figure 1). At the time of the surveys, 186,668 people were estimated to live in Mundri and 186,830 in Maridi; both counties consisted of six payams.

Bottom Line: No trachomatous trichiasis (TT) was found in those aged under 15, and prevalence was 0.1% (95% CI, 0.0%-0.4%) in those aged 15 years and above.Again, no TT was found in those aged under 15, and prevalence in those aged 15 years and above was 0.3% (95% CI, 0.0%-0.8%).Studies should thus be targeted to areas where collection of new data would be most informative.

View Article: PubMed Central - PubMed

Affiliation: Ministry of Health, Government of Southern Sudan, Juba, Southern Sudan.

ABSTRACT

Background: Trachoma is thought to be common over large parts of Southern Sudan. However, many areas of the country, particularly west of the Nile, have not yet been surveyed. The aim of this study was to confirm whether trachoma extends into Western Equatoria State from neighboring Central Equatoria, where trachoma is highly prevalent, and whether intervention with the SAFE strategy is required.

Methods and findings: Population-based cross-sectional surveys were conducted using a two-stage cluster random sampling method to select the study population. Subjects were examined for trachoma by experienced graders using the World Health Organization (WHO) simplified grading scheme. Two counties thought to be most likely to have trachoma were surveyed, Maridi and Mundri. In Maridi, prevalence of one of the signs of active trachoma (trachomatous inflammation-follicular (TF)) in children aged 1-9 years was 0.4% (95% confidence interval (CI), 0.0%-0.8%), while no children showing the other possible sign, trachomatous inflammation-intense (TI), were identified. No trachomatous trichiasis (TT) was found in those aged under 15, and prevalence was 0.1% (95% CI, 0.0%-0.4%) in those aged 15 years and above. In Mundri, active trachoma was also limited to signs of TF, with a prevalence of 4.1% (95% CI, 1.4%-6.9%) in children aged 1-9 years. Again, no TT was found in those aged under 15, and prevalence in those aged 15 years and above was 0.3% (95% CI, 0.0%-0.8%).

Conclusion: Trachoma prevalence in the east of Western Equatoria State is below the WHO recommended intervention threshold for mass drug administration of antibiotic treatment in all villages. However, the prevalence of TF and TT in some villages, particularly in Mundri County, is sufficiently high to warrant targeted interventions at the community level. These results demonstrate that trachoma is not a major public health problem throughout Southern Sudan. Further studies will be required to determine trachoma prevalence in other areas, particularly west of the Nile, but there are presently no resources to survey each county. Studies should thus be targeted to areas where collection of new data would be most informative.

Show MeSH
Related in: MedlinePlus