Cross-Sectional Surveys of the Prevalence of Follicular Trachoma and Trichiasis in The Gambia: Has Elimination Been Reached?

Burr, Sarah E.; Sillah, Ansumana; Sanou, Adama; Wadagni, Anita Carolle; Hart, John; Harding-Esch, Emma; Kanyi, Sarjo; Bailey, Robin L.

doi:10.1371/journal.pntd.0004906

Cited by 10 publications

(7 citation statements)

References 12 publications

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“…The low TF prevalence in the Casamance region was unexpected since no specific trachoma control efforts have been implemented there, unlike in other regions of Senegal or the neighbouring countries of The Gambia and Mali [ 12 , 13 ]. The natural disappearance of trachoma without trachoma-specific intervention has been described elsewhere in Nepal and in one village in The Gambia [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Guidelines for TT management are provided by the WHO [ 1 , 25 ]. One strategy is active TT case-hunting and surgery camps, as done in The Gambia, with surgeries recorded in a central, electronic TT registry to enable consistent data collection from across the region and ensuring appropriate follow-up care of all cases identified [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…In 2011, results from the Partnership for the Rapid Elimination of Trachoma (PRET) showed that the overall TF prevalence in four districts was 2.8% (compared to 6.5% at baseline in 2008) [ 11 ]. The Gambia’s NEHP has subsequently reported national prevalences of TF ranging between 0.2 and 3.2%, and TT ranging between 0 and 1.7%, suggesting that The Gambia has reached the elimination target for TF but that further efforts are needed to reduce the burden of TT [ 12 ]. Similarly in Mali, the National Blindness Prevention Programme (PNLC)’s trachoma control programme formed in 1998 has helped reduce TF prevalence from a range of 23.1–46.7% in the 1990’s to below 10% in 84% of districts in 2013 [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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BackgroundTrachoma, 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%).MethodsLocal 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.ResultsSixty 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.ConclusionWith 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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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“…Prevalence data from historical studies is presented in Table 6. More recently , six years before the survey reported here, communities in LRR received azithromycin to treat ocular Ct infection, further reducing the prevalence of trachoma in this region 5,29 , while communities in URR did not. Although not measured in our study, previous work has shown that there has been a reduction in the prevalence of ocular Ct infection in two villages in LRR 35,36 with the most recent measurements showing 0.5% infection prevalence in PRET villages, a portion of which are in LRR 5 .…”

Section: Discussionmentioning

confidence: 83%

“…The WHO’s guidelines for validation of elimination of trachoma as a public health problem focus programmatic attention on the prevalence of TF in children aged 1–9 years and TT in people aged 15 years and older. The Gambian government is currently compiling evidence for validation of trachoma elimination, following completion of its three-year TF/TT surveillance plan, which began in 2011 23, 24 . Previous studies have demonstrated declines in the prevalence of active trachoma in The Gambia both prior to 6,25 and in response to the implementation of specific trachoma-control interventions 26–28 .…”

Section: Discussionmentioning

confidence: 99%

Serology reflects a decline in the prevalence of trachoma in two regions of The Gambia

Migchelsen

Sepúlveda

Martin³

et al. 2017

Preprint

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Trachoma is caused by Chlamydia trachomatis (Ct). It is targeted for global elimination as a public health problem. In 2014, a population-based cross-sectional study was performed in two previously trachoma-endemic areas of The Gambia. Participants of all ages from Lower River Region (LRR) (N = 1028) and Upper River Region (URR) (N = 840) underwent examination for trachoma and had blood collected for detection of antibodies against the Ct antigen Pgp3, by ELISA. Overall, 30 (1.6%) individuals had active trachoma; the prevalence in children aged 1–9 years was 3.4% (25/742) with no statistically significant difference in prevalence between the regions. There was a significant difference in overall seroprevalence by region: 26.2% in LRR and 17.1% in URR (p<0.0001). In children 1-9 years old, seroprevalence was 4.4% in LRR and 3.9% in URR. Reversible catalytic models using information on age-specific seroprevalence demonstrated a decrease in the transmission of Ct infection in both regions, possibly reflecting the impact of improved access to water, health and sanitation as well as mass drug administration campaigns. Serological testing for antibodies to Ct antigens is potentially useful for trachoma programmes, but consideration should be given to the coendemicity of sexually transmitted Ct infections.

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Serology reflects a decline in the prevalence of trachoma in two regions of The Gambia

Migchelsen

Sepúlveda

Martin

et al. 2017

Sci Rep

Self Cite

View full text Add to dashboard Cite

Trachoma is caused by Chlamydia trachomatis (Ct). It is targeted for global elimination as a public health problem. In 2014, a population-based cross-sectional study was performed in two previously trachoma-endemic areas of The Gambia. Participants of all ages from Lower River Region (LRR) (N = 1028) and Upper River Region (URR) (N = 840) underwent examination for trachoma and had blood collected for detection of antibodies against the Ct antigen Pgp3, by ELISA. Overall, 30 (1.6%) individuals had active trachoma; the prevalence in children aged 1–9 years was 3.4% (25/742) with no statistically significant difference in prevalence between the regions. There was a significant difference in overall seroprevalence by region: 26.2% in LRR and 17.1% in URR (p < 0.0001). In children 1–9 years old, seroprevalence was 4.4% in LRR and 3.9% in URR. Reversible catalytic models using information on age-specific seroprevalence demonstrated a decrease in the transmission of Ct infection in both regions, possibly reflecting the impact of improved access to water, health and sanitation as well as mass drug administration campaigns. Serological testing for antibodies to Ct antigens is potentially useful for trachoma programmes, but consideration should be given to the co-endemicity of sexually transmitted Ct infections.

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Cross-Sectional Surveys of the Prevalence of Follicular Trachoma and Trichiasis in The Gambia: Has Elimination Been Reached?

Cited by 10 publications

References 12 publications

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

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

Serology reflects a decline in the prevalence of trachoma in two regions of The Gambia

Serology reflects a decline in the prevalence of trachoma in two regions of The Gambia

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