Milestones in the fight to eliminate trachoma

West, Sheila K.

doi:10.1111/opo.12666

Cited by 12 publications

(7 citation statements)

References 31 publications

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“…However, the highburden areas, including most Western Sub-Saharan Africa countries and Afghanistan, presented a minor increased trend. Our results may indicate that the various risk factors responsible for other vision loss, such as the lack of access to water and crowded living conditions that cause trachoma [39], need to be improved, and the available treatment, such as the use of azithromycin for trachoma [40], need to be strengthened, especially in high-burden areas.…”

Section: Agingmentioning

confidence: 98%

Global, regional, and national burden of blindness and vision loss due to common eye diseases along with its attributable risk factors from 1990 to 2019: a systematic analysis from the global burden of disease study 2019

Yang

Chen

Zhang

et al. 2021

Aging

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To map the magnitudes and temporal trends of blindness and vision loss (BVL) due to common eye diseases along with its attributable risk factors at the national, regional, and global levels. The annual burden of BVL in 204 countries and territories was extracted from the Global Burden of Disease Study 2019. The estimated annual percentage change (EAPC) and causes composition change were calculated to quantify the temporal trends of BVL-related disease burden by sex, region, and eye disease. The global disability-adjusted life years (DALYs) of BVL increased from 12.44 million in 1990 to 22.56 million in 2019, with a slightly decreased rate from 3.03 to 2.78 per 1000 population (EAPC = -0.30). About 29.6% of BVL-related DALYs worldwide were caused by cataract, followed by refraction disorders (29.1%), near vision loss (21.7%), other vision loss (13.7%), glaucoma (3.3%), and age-related macular degeneration (2.5%) in 2019. The age-standardized DALYs rates due to each eye disease type in most regions were decreased, especially in countries with high burden and high-middle socio-demographic index. Moreover, the contribution of smoking and air pollution from solid fuels to BVL burden decreased, however, the age-standardized burden of BVL attributed to high body-mass index and high fasting plasma glucose elevated gradually across almost all regions. The temporal trend of BVL burden due to specific eye diseases varies remarkably by region, sex and age. Understanding the real-time patterns of BVL burden is crucial for formulating more effective and targeted prevention and healthcare strategies to decrease the BVL burden.

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Section: Agingmentioning

confidence: 98%

Global, regional, and national burden of blindness and vision loss due to common eye diseases along with its attributable risk factors from 1990 to 2019: a systematic analysis from the global burden of disease study 2019

Yang

Chen

Zhang

et al. 2021

Aging

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“…In a multivariate model, only Ct infection prevalence was associated with increasing ompA diversity. Almost 900 million doses of azithromycin have been distributed by trachoma control programmes since 1999 42 and in Amhara alone 15 million doses are administered every year. 3 Mass distribution of azithromycin is likely to become more common as more evidence emerges of off-target effects such as reducing infectious diseases, 23,[43][44][45] diarrheal diseases 46 and childhood mortality.…”

Section: Resultsmentioning

confidence: 99%

Genomics of OcularChlamydia trachomatisafter 5 years of SAFE interventions for trachoma in Amhara, Ethiopia

Pickering

Chernet

Sata

et al. 2020

Preprint

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BackgroundTo eliminate trachoma as a public health problem, the WHO recommends the SAFE strategy. As part of the SAFE strategy in the Amhara Region, Ethiopia, the Trachoma Control Program distributed over 124 million doses of antibiotic between 2007 and 2015. Despite these interventions, trachoma remained hyperendemic in many districts and a considerable level of Chlamydia trachomatis (Ct) infection was evident. Methods

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“…Despite intensive worldwide control efforts, trachoma remains the most important infectious cause of vision loss [1][2][3] and one of the overall leading causes of global blindness [4,5], with nearly 136 million people at risk of losing vision [6]. While the goal set by the World Health Organization (WHO) for the global elimination of trachoma as a public health problem by 2020 [7] was not met, this work contributed to dramatic reductions in the prevalence of the disease [8]. However, as with other diseases with the potential for elimination, the "last mile" may prove to be the most difficult [9,10].…”

Section: Trachomamentioning

confidence: 99%

A Virtual Reading Center Model Using Crowdsourcing to Grade Photographs for Trachoma: Validation Study

Brady¹,

Cockrell²,

Aldrich³

et al. 2023

J Med Internet Res

Self Cite

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Background As trachoma is eliminated, skilled field graders become less adept at correctly identifying active disease (trachomatous inflammation—follicular [TF]). Deciding if trachoma has been eliminated from a district or if treatment strategies need to be continued or reinstated is of critical public health importance. Telemedicine solutions require both connectivity, which can be poor in the resource-limited regions of the world in which trachoma occurs, and accurate grading of the images. Objective Our purpose was to develop and validate a cloud-based “virtual reading center” (VRC) model using crowdsourcing for image interpretation. Methods The Amazon Mechanical Turk (AMT) platform was used to recruit lay graders to interpret 2299 gradable images from a prior field trial of a smartphone-based camera system. Each image received 7 grades for US $0.05 per grade in this VRC. The resultant data set was divided into training and test sets to internally validate the VRC. In the training set, crowdsourcing scores were summed, and the optimal raw score cutoff was chosen to optimize kappa agreement and the resulting prevalence of TF. The best method was then applied to the test set, and the sensitivity, specificity, kappa, and TF prevalence were calculated. Results In this trial, over 16,000 grades were rendered in just over 60 minutes for US $1098 including AMT fees. After choosing an AMT raw score cut point to optimize kappa near the World Health Organization (WHO)–endorsed level of 0.7 (with a simulated 40% prevalence TF), crowdsourcing was 95% sensitive and 87% specific for TF in the training set with a kappa of 0.797. All 196 crowdsourced-positive images received a skilled overread to mimic a tiered reading center and specificity improved to 99%, while sensitivity remained above 78%. Kappa for the entire sample improved from 0.162 to 0.685 with overreads, and the skilled grader burden was reduced by over 80%. This tiered VRC model was then applied to the test set and produced a sensitivity of 99% and a specificity of 76% with a kappa of 0.775 in the entire set. The prevalence estimated by the VRC was 2.70% (95% CI 1.84%-3.80%) compared to the ground truth prevalence of 2.87% (95% CI 1.98%-4.01%). Conclusions A VRC model using crowdsourcing as a first pass with skilled grading of positive images was able to identify TF rapidly and accurately in a low prevalence setting. The findings from this study support further validation of a VRC and crowdsourcing for image grading and estimation of trachoma prevalence from field-acquired images, although further prospective field testing is required to determine if diagnostic characteristics are acceptable in real-world surveys with a low prevalence of the disease.

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Milestones in the fight to eliminate trachoma

Cited by 12 publications

References 31 publications

Global, regional, and national burden of blindness and vision loss due to common eye diseases along with its attributable risk factors from 1990 to 2019: a systematic analysis from the global burden of disease study 2019

Global, regional, and national burden of blindness and vision loss due to common eye diseases along with its attributable risk factors from 1990 to 2019: a systematic analysis from the global burden of disease study 2019

Genomics of OcularChlamydia trachomatisafter 5 years of SAFE interventions for trachoma in Amhara, Ethiopia

A Virtual Reading Center Model Using Crowdsourcing to Grade Photographs for Trachoma: Validation Study

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