The epidemiology of low vision and blindness associated with trichiasis in southern Sudan

Ngondi, Jeremiah; Reacher, Mark; Matthews, Fiona E.; Ole-Sempele, Francis; Onsarigo, Alice; Matende, Ibrahim; Baba, Samson; Brayne, Carol; Emerson, Paul M.

doi:10.1186/1471-2415-7-12

Cited by 11 publications

(14 citation statements)

References 24 publications

(28 reference statements)

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“…2008). Trachoma was shown to account for 35% of blindness, with 5% of the entire population (including children) suffering from low vision or blindness associated with trachoma (Ngondi et al. 2006b, 2007).…”

Section: Prevalence and Geographical Distributionmentioning

confidence: 99%

Epidemiology and control of trachoma: systematic review

Harding-Esch

Burton

et al. 2010

Tropical Medicine & International Health

148

144

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Trachoma is the commonest infectious cause of blindness. Recurrent episodes of infection with serovars A–C of Chlamydia trachomatis cause conjunctival inflammation in children who go on to develop scarring and blindness as adults. It was estimated that in 2002 at least 1.3 million people were blind from trachoma, and currently 40 million people are thought to have active disease and 8.2 million to have trichiasis. The disease is largely found in poor, rural communities in developing countries, particularly in sub-Saharan Africa. The WHO promotes trachoma control through a multifaceted approach involving surgery, mass antibiotic distribution, encouraging facial cleanliness and environmental improvements. This has been associated with significant reductions in the prevalence of active disease over the past 20 years, but there remain a large number of people with trichiasis who are at risk of blindness.

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Section: Prevalence and Geographical Distributionmentioning

confidence: 99%

Epidemiology and control of trachoma: systematic review

Harding-Esch

Burton

et al. 2010

Tropical Medicine & International Health

148

144

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“…A linear correlation of visual status and TT status was also noted in Ethiopia and southern Sudan [4].…”

Section: Discussionmentioning

confidence: 88%

“…Previous researchers have associated visual acuity and blindness status to TT in countries with high trachoma prevalence [3][4][5][6]. It would be interesting to study this association in a country that is at the threshold of eliminating blinding trachoma [7].…”

Section: Introductionmentioning

confidence: 99%

Lid surgery for trachomatous trichiasis is negatively associated with visual disabilities and visual impairment in Oman

Khandekar¹,

Harby²,

Vora³

2012

Easter Mediterr Health J

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Oman is at the threshold of eliminating blinding trachoma. We conducted a community-based survey in 2009-10 to study the association of trachomatous trichiasis (TT) status with visual acuity and blindness among the Omani population aged 40+ years. A total of 8191 eyes were examined and participants' demographic data were collected. TT was absent in 7890 eyes but 227 of these eyes had had lid surgery for TT in the past. TT was detected in 301 eyes, for the first time in 154 eyes and following lid surgery in 147 eyes. The rate of blindness was significantly lower in eyes that had undergone lid surgery in the past (OR = 0.54). In regression analysis the predictors of blindness were participant's age (adjusted OR = 1.01), sex (aOR = 2.01), history of lid surgery (aOR = 3.09) and residence in a hyperendemic trachoma area (aOR = 10.6). Promotion of TT surgery might be beneficial in reducing blindness. (OR = 0,54). À l'analyse de régression, les facteurs prédictifs de la cécité étaient l'âge du patient (OR ajusté = 1,01), le sexe (ORa = 2,01), les antécédents de chirurgie des paupières (ORa = 3,09) et le lieu de résidence dans une zone où le trachome est hyperendémique (ORa = 10,6). La promotion de la chirurgie du trichiasis trachomateux pourrait contribuer à limiter les cas de cécité.

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“…However, a potential limitation with our VA models is that the effects of co-morbidity of other conditions leading to visual impairment such as refractive error were not controlled for in our model for distribution of VA [19]. Overall, there will be some people for whom this approach is likely to have resulted in an overestimate of trichiasis life expectancy.…”

Section: Discussionmentioning

confidence: 99%

“…In one district (Mankien), visual acuity (VA) testing was conducted in all eligible participants [19] . Experienced Integrated eye care workers (IECW) were re-trained in VA testing, basic eye examination and trachoma grading and their reliability assessed.…”

Section: Methodsmentioning

confidence: 99%

What Will Happen If We Do Nothing To Control Trachoma: Health Expectancies for Blinding Trachoma in Southern Sudan

et al. 2009

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BackgroundUncontrolled trachoma is a leading cause of blindness. Current global trachoma burden summary measures are presented as disability adjusted life years but have limitations due to inconsistent methods and inadequate population-based data on trachomatous low vision and blindness. We aimed to describe more completely the burden of blinding trachoma in Southern Sudan using health expectancies.Methodology/Principal FindingsAge and gender specific trachomatous trichiasis (TT) prevalence was estimated from 11 districts in Southern Sudan. The distribution of visual acuity (VA) in persons with TT was recorded in one district. Sudan life tables, TT prevalence, and VA were used to calculate Trichiasis Free Life Expectancy (TTFLE) and Trichiasis Life Expectancy (TTLE) using the Sullivan method. TTLE was broken down by VA to derive TTLE with normal vision, TTLE with low vision, and TTLE with blindness. Total life expectancy at birth in 2001 was 54.2 years for males and 58.1 for females. From our Sullivan models, trichiasis life expectancy at the age of 5 years was estimated to be 7.0 (95% confidence interval [CI] = 6.2–7.8) years (12% [95% CI = 11–14] of remaining life) for males and 10.9 (95% CI = 9.9–11.9 ) years (18% [95% CI = 16–20] of remaining life) for females. Trichiasis life expectancy with low vision or blindness was 5.1 (95% CI = 3.9–6.4) years (9% [95% CI = 7–11] of remaining life) and 7.6 (95% CI = 6.0–9.1) years (12% [95% CI = 10–15] of remaining life) for males and females, respectively. Women were predicted to live longer and spend a greater proportion of their lives with disabling trichiasis, low vision, and blindness compared to men.ConclusionsThe study shows the future burden associated with doing nothing to control trachoma in Southern Sudan, that is, a substantial proportion of remaining life expectancy spent with trichiasis and low vision or blindness for both men and women, with a disproportionate burden falling on women.

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The epidemiology of low vision and blindness associated with trichiasis in southern Sudan

Abstract: Background: We investigated vision status associated with trachomatous trichiasis (TT) and explored age-sex patterns of low vision and blindness associated with trichiasis in Mankien district of southern Sudan where trachoma prevention and trichiasis surgery were absent.

Cited by 11 publications

References 24 publications

Epidemiology and control of trachoma: systematic review

Epidemiology and control of trachoma: systematic review

Lid surgery for trachomatous trichiasis is negatively associated with visual disabilities and visual impairment in Oman

What Will Happen If We Do Nothing To Control Trachoma: Health Expectancies for Blinding Trachoma in Southern Sudan

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