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

Ngondi, Jeremiah; Matthews, Fiona E.; Reacher, Mark; King, Jonathan D.; Brayne, Carol; Gouda, Hebe; Emerson, Paul M.

doi:10.1371/journal.pntd.0000396

Cited by 4 publications

(7 citation statements)

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“…Recent surveys have found both extremely high prevalence of active trachoma (trachomatous inflammation-follicular (TF) and/or trachomatous inflammation-intense (TI)) and evidence of TT in children in some of the areas surveyed [25], [26]. These findings indicate that trachoma constitutes a major problem to public health in Southern Sudan [27]. However, not all of Southern Sudan is equally at risk, as indicated by recent surveys that identified areas where trachoma is not endemic [28].…”

Section: Introductionmentioning

confidence: 99%

Targeting Trachoma Control through Risk Mapping: The Example of Southern Sudan

Clements

Kur

Gatpan³

et al. 2010

PLoS Negl Trop Dis

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BackgroundTrachoma is a major cause of blindness in Southern Sudan. Its distribution has only been partially established and many communities in need of intervention have therefore not been identified or targeted. The present study aimed to develop a tool to improve targeting of survey and control activities.Methods/Principal FindingsA national trachoma risk map was developed using Bayesian geostatistics models, incorporating trachoma prevalence data from 112 geo-referenced communities surveyed between 2001 and 2009. Logistic regression models were developed using active trachoma (trachomatous inflammation follicular and/or trachomatous inflammation intense) in 6345 children aged 1–9 years as the outcome, and incorporating fixed effects for age, long-term average rainfall (interpolated from weather station data) and land cover (i.e. vegetation type, derived from satellite remote sensing), as well as geostatistical random effects describing spatial clustering of trachoma. The model predicted the west of the country to be at no or low trachoma risk. Trachoma clusters in the central, northern and eastern areas had a radius of 8 km after accounting for the fixed effects.ConclusionIn Southern Sudan, large-scale spatial variation in the risk of active trachoma infection is associated with aridity. Spatial prediction has identified likely high-risk areas to be prioritized for more data collection, potentially to be followed by intervention.

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Section: Introductionmentioning

confidence: 99%

Targeting Trachoma Control through Risk Mapping: The Example of Southern Sudan

Clements

Kur

Gatpan³

et al. 2010

PLoS Negl Trop Dis

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“…A previous study in Oman also found that females had a higher risk of trichiasis, which was attributed to barriers for trichiasis surgery [13]. In Sudan too women have been reported to live longer and suffer a longer duration of disabling trichiasis and visual disabilities compared with males [14]. Despite the decline in blinding trachoma in a country such as Oman, the gender gap might still be important and approaches need to be modified to bridge the gender gap.…”

Section: Discussionmentioning

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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“…The detailed methods for the population based trachoma prevalence surveys have been described elsewhere [7] . In brief, surveys were conducted in ten districts in South Sudan between September 2001 and May 2005.…”

Section: Methodsmentioning

confidence: 99%

“…An ordinal logistic regression model to the observed VA data was used to explore the age and sex distribution of the three categories of vision status in participants with trichiasis: normal vision; low vision; and blindness. All participants in whom trichiasis and cataract was identified were excluded from analysis; however, it was not possible to adjust for visual impairment due to other causes such as refractive errors [9] , [10] .…”

Section: Methodsmentioning

confidence: 99%

“…Between 2001 and 2005 Ngondi et al [7] collected data on visual acuity in the Mankien district providing the most reliable estimates of the prevalence of trichiasis with normal vision, low vision and blinding available for South Sudan. According to these observations and extrapolating to the whole of South Sudan, it is clear that many of those with trichiasis are not visually impaired and have thus not been included in the attempts to estimate the burden of trachoma.…”

Section: Introductionmentioning

confidence: 99%

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The Burden of Trachoma in South Sudan: Assessing the Health Losses from a Condition of Graded Severity

et al. 2012

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IntroductionTrachoma is a disease that can lead to visual impairment and ultimately blindness. Previous estimates of health losses from trachoma using the Global Burden of Disease methodology have not, however, included the stage prior to visual impairment. We estimated the burden of all stages of trachoma in South Sudan and assessed the uncertainty associated with the severity and duration of stages of trachoma prior to full blindness.MethodsThe prevalence of trachoma with normal vision, low vision and blindness in the Republic of South Sudan has been estimated previously. These estimates were used to model the incidence and duration of the different stages employing DISMOD II. Different assumptions about disability weights and duration were used to estimate the Years Lived with Disability (YLD).ResultsWe have estimated the total burden of trachoma in South Sudan to be between 136,562 and 163,695 YLD and trichiasis with normal vision contributes between 5% and 21% of the total depending on the disability weight applied. Women experience more of this burden than men. The sensitivity of the results to different assumptions about the disability weights is partly dependent upon the assumed duration of the different disease states.InterpretationA better understanding of the natural history of trachoma is critical for a more accurate burden estimate.

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

Cited by 4 publications

References 20 publications

Targeting Trachoma Control through Risk Mapping: The Example of Southern Sudan

Targeting Trachoma Control through Risk Mapping: The Example of Southern Sudan

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

The Burden of Trachoma in South Sudan: Assessing the Health Losses from a Condition of Graded Severity

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