No abstract

BackgroundDespite historical evidence of blinding trachoma, there have been no widespread contemporary surveys of trachoma prevalence in the northern states of Sudan. We aimed to conduct district-level surveys in this vast region in order to map the extent of the problem and estimate the need for trachoma control interventions to eliminate blinding trachoma.Methods and FindingsSeparate, population based cross-sectional surveys were conducted in 88 localities (districts) in 12 northern states of Sudan between 2006 and 2010. Two-stage cluster random sampling with probability proportional to size was used to select the sample. Trachoma grading was done using the WHO simplified grading system. Key prevalence indicators were trachomatous inflammation-follicular (TF) in children aged 1–9 years and trachomatous trichiasis (TT) in adults aged 15 years and above. The sample comprised 1,260 clusters from which 25,624 households were surveyed. A total of 106,697 participants (81.6% response rate) were examined for trachoma signs. TF prevalence was above 10% in three districts and between 5% and 9% in 11 districts. TT prevalence among adults was above 1% in 20 districts (which included the three districts with TF prevalence >10%). The overall number of people with TT in the population was estimated to be 31,072 (lower and upper bounds = 26,125–36,955).ConclusionTrachoma mapping is complete in the northern states of Sudan except for the Darfur States. The survey findings will facilitate programme planning and inform deployment of resources for elimination of trachoma from the northern states of Sudan by 2015, in accordance with the Sudan Federal Ministry of Health (FMOH) objectives.

BackgroundTrachoma is the leading infectious cause of blindness. Until recently, reliable data on the global extent of the disease, detailed plans for elimination, and government, donor and partner engagement were all inadequate.MethodsThe trachoma community undertook a systematic, three-pronged strategy to map trachoma district by district, develop national-level trachoma elimination plans, and create a framework for governments, donors and partners to convene and coordinate in support of trachoma elimination.ResultThere has been a frame-shift in internal and external perceptions of the global trachoma programme, from being an effort working towards disease control in focussed geographical areas, to one in the process of achieving worldwide disease elimination. Multiple factors contributed to the successful implementation of mapping, planning, and cross-sectional engagement of governments, partners and donors.ConclusionsElimination of trachoma is possible if the right combination of factors is in place. Planning for success is a critical first step. Some remaining challenges must still be addressed if the elimination targets are to be successfully attained.

BackgroundGlobal estimates suggest there are almost 19 million visually impaired children worldwide, most of whom reside in poor countries, with the major cause being treatable.AimTo determine the barriers to accessing childhood eye care services and to develop an eye care plan for children in South Darfur State, Sudan.SettingThe study took place in South Darfur State, Sudan.MethodsThe classical Delphi technique was used to build consensus on a list of statements, which were generated based on the themes established by the experts, as well as on an extensive literature review.ResultsResponse rates ranged from 90% in the first round (n = 18), 100% in the second round (n = 18) to 89% in the third and final round (n = 16). The total number of statements recommended by the Delphi panellists for development of the paediatric eye care plan, was 60 based on a consensus level of 80% agreement or more. The expert’s consensus on the following key elements for promotion and improvement of child eye care: The main barriers to accessing child eye care were high poverty rate, unavailability of child eye services and a lack of community awareness. The challenges facing visually impaired children were an absence of paediatric ophthalmologists, low vision and orthoptic services.ConclusionThe main barriers to accessing child eye care services were financial, clinical access and lack of knowledge. There should be greater collaboration between the Ministries of Health, Education and non-governmental organisations (NGOs), to work together in addressing these barriers.

Purpose To estimate the proportion of children with trachomatous inflammation—follicular (TF) and adults with trachomatous trichiasis (TT) in internally displaced persons (IDP) camps in the Darfur States of Sudan and to evaluate associated risk factors. Methods IDP camps were identified from government census data. We conducted a subanalysis of data collected in these camps during 2014–2015 as part of surveys covering 37 districts of the Darfur States within the Global Trachoma Mapping Project. A random-effects hierarchical model was used to evaluate factors associated with TF in children or TT in adults. Results Thirty-six IDP camps were represented in the survey data, in which 1926 children aged 1–9 y were examined, of whom 38 (8%) had TF. Poor sanitation, younger age and living in a household that purchased water from a vendor were associated with TF in children aged 1–9 y. Of 2139 individuals examined aged ≥15 y, 16 (0.7%) had TT. TT was strongly independently associated with being older and living alone. Conclusion Trachoma is found at low levels in these camps, but still at levels where intervention is needed. Disease elimination in conflict-related settings presents a unique challenge for the trachoma community, and may require an innovative approach. Understanding how best to undertake trachoma elimination interventions in these areas should be prioritized.

No abstract

AIM:This study aimed to compare the central corneal thickness (CCT) measurements using Optical Coherence Tomography (OCT) and TMS-5 topographer with that taken with the gold standard digital Ultrasonic pachymeter (USP).MATERIALS AND METHODS:A total of 61 subjects (122 eyes) were prospectively and consecutively studied in a period from June 2016 to June 2017 at Sudan Eye Centre (SEC), Khartoum, Sudan. Besides the visual and refractive data, measurements of CCT were taken using OCT, TMS-5 and USP. Data analyzed using SPSS software for windows (IBM SPSS 20, IBM Corp., Armonk, NY).RESULTS:A statistically significant differences in mean CCT was detected between the three instruments (P < 0.001). USP was found to measure the CCT 29μm thicker than OCT and 22μm thicker than TMS-5 topographer. A significant difference was also found between OCT and TMS-5. OCT found to give the lower values of CCT compared to both USP and TMS-5 topographer. Further analysis showed that the three procedures were significantly and strongly correlated to each other (USP vs OCT, r = 0.77), (USP vs TMS-5, r = 0.78) and (OCT vs TMS-5, r = 0.80).CONCLUSION:Mean central corneal thicknesses (CCT) were comparable among OCT, TMS-5 topographer and the gold standard USP. However, there is a reproducible systematic difference between CCT measurements taken with the three devices. It is important to note in clinical practice, that measurements acquired by these three modalities are not directly interchangeable.

No abstract