Impact Survey Results after SAFE Strategy Implementation in 15 Local Government Areas of Kebbi, Sokoto and Zamfara States, Nigeria

Abstract

Purpose: To determine prevalence of trachoma after interventions in 15 local government areas (LGAs) of Kebbi, Sokoto and Zamfara States, Nigeria. Methods: A population-based impact survey was conducted in each LGA using Global Trachoma Mapping Project (GTMP) protocols. In each LGA, 25 villages were selected, except in Arewa LGA, where we selected 25 villages from each of four subunits to obtain finer-resolution prevalence information. Villages were selected with probability proportional to size. In each village, 25 households were enrolled and all consenting residents aged ≥1 year were examined by GTMP-certified graders for trachomatous inflammation-follicular (TF) and trachomatous trichiasis (TT). Information on sources of household water and types of sanitation facilities used was collected through questioning and direct observation. Results: The number of households enrolled per LGA ranged from 623 (Kware and Tangaza) to 2488 (Arewa). There have been marked reductions in the prevalence of TF and TT since baseline surveys were conducted in all 15 LGAs. Eight of the 15 LGAs have attained TF prevalences <5% in children, while 10 LGAs have attained TT prevalences <0.2% in persons aged ≥15 years. Between 49% and 96% of households had access to water for hygiene purposes within 1 km of the household, while only 10-59% had access to improved sanitation facilities. Conclusion: Progress towards elimination of trachoma has been made in these 15 LGAs. Collaboration with water and sanitation agencies and community-based trichiasis surgery are still needed in order to eliminate trachoma by the year 2020.

Prevalence of Trachoma in Pakistan: Results of 42 Population-Based Prevalence Surveys from the Global Trachoma Mapping Project

“…Extensive searches around Faisalabad for trachomaendemic localities in which to undertake field-based grader training and testing resulted in very few cases of active trachoma being identified, and it was resolved instead to undertake this process in Sokoto, Nigeria, where a number of local government areas still had TF prevalences of 5.0-9.9%. 30 In August 2015, a total of 23 grader trainees went to Sokoto; 16 passed the intergrader agreement tests and were certified to participate in the surveys. 28 Three recorder trainers were also trained in Sokoto; they later conducted workshops in Pakistan to train 26 recorders.…”

Serological and PCR-based markers of ocular Chlamydia trachomatis transmission in northern Ghana after elimination of trachoma as a public health problem

“…The intervention strategy for trachoma is the World Health Organization (WHO)-endorsed SAFE strategy (S: Surgery for trachomatous trichiasis (TT); A: Antibiotics to clear Ct infection; F: Facial cleanliness and E: Environmental improvement to reduce transmission of Ct ) [2,3]. Successful implementation of this strategy has resulted in a reduction in trachoma prevalence across many endemic countries [4–7]. WHO has set a goal of global elimination of trachoma as a public health problem by 2020 [8].…”

Eliminating Trachoma by 2020: Assessing Progress in Nigeria

“…Research has shown no significant difference in clinical outcomes between nurses and doctors [10]. These surgical efforts have seen the prevalence of trichiasis decrease significantly across several states in Nigeria [7].…”

“…Additionally, they have worked in close collaboration with non-governmental organisations (NGOs) and pharmaceutical companies to provide healthcare to those with, and at risk of, trachoma. However, despite great strides in reducing the incidence and prevalence of trachoma, Nigeria has been unable to achieve eradication by 2020 [7].…”