Prevalence of trachoma in Yemen: results of population-based prevalence surveys of 42 evaluation units in nine governorates

Abstract

Purpose: In suspected trachoma-endemic areas of Yemen, we sought to determine the prevalence of the sign trachomatous inflammation-follicular (TF) in children aged 1-9 years, and the potential individual and household risk factors for TF in that age group. We also sought to determine the prevalence of trichiasis in adults aged ≥15 years. Methods: We conducted a cluster-sampled survey in each of 42 evaluation units (EUs) comprising 166 rural districts of nine Governorates (Adh Dhale'a, Al Hodeihah, Al Jawf, Hadramoot, Hajjah, Ibb, Lahj, Ma'rib, Taiz) using the Global Trachoma Mapping Project systems and methodologies. Fieldwork was undertaken from September 2013 to March 2015. Risk factors for TF in children aged 1-9 years were evaluated using multilevel random effects logistic regression. Results: The TF prevalence in children aged 1-9 years was ≥10% in two EUs (7 districts) and 5-9.9% in six EUs (24 districts). In adults aged ≥15 years, trichiasis prevalence was ≥0.2% in five EUs (19 districts). Being older (within the 1-9-year age bracket), being male, living in a household with higher numbers of children, and living in a household that reported the use of open defecation, were each independently associated with higher odds of TF. Conclusions: These surveys provided baseline data to enable planning for trachoma elimination. The World Health Organization Alliance for the Global Elimination of Trachoma by 2020 stands ready to assist Yemen once security considerations permit further surveys and implementation of control activities.

National Comprehensive Trachoma Treatment Campaign: Community Monitoring of Mass Drug Administration (MDA) Coverage and Practices

“…In adults aged ≥15 years, trichiasis prevalence was ≥0.2% in five EUs (19 districts). The surveys revealed that more than 2.7 million people in 30 districts need publichealth interventions to deal with transmission of the trachoma and its associated morbidity [10]. Also, in a study by Al-Shamahi et al [9], the prevalence of active trachoma (TF) was 10.93%, which is slightly higher compared to the previous study conducted in Yemen [10].…”

The National Campaign for the Mass Treatment of Trachoma: Monitoring Coverage and Practices of Mass Drug Administration (Mda) in Yemen- Follow-Up Study

“…In adults aged≥15 years, trichiasis prevalence was ≥0.2% in five EUs (19 districts). The surveys revealed that more than 2.7 million people in 30 districts need public-health interventions to deal with transmission of the trachoma and its associated morbidity 10 . Also, in a study by Al-Shamahi et al, 9 , the prevalence of active trachoma (TF) was 10.93%, which is slightly higher compared to the previous study conducted in Yemen 10 .…”

Ophthalmic services during ongoing conflict: the eye health system in Yemen

“…Trachoma is the leading cause of infectious blindness in the world, and loss of infrastructure in Yemen has allowed trachoma to thrive. While conflict has prevented surveillance over some rural areas, data collected by Ali Thabit et al 24 and the Global Trachoma Mapping Project estimate 2.5 million people are at risk in Yemen 25. This mapping aided a successful large-scale treatment campaign of medicines and equipment following WHO’s recommended SAFE strategy (Surgery, Antibiotics, Facial cleanliness and Environmental improvement), highlighting the importance of accurate health information in disease treatment.…”