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Harding-Esch EM, Burgert-Brucker CR, Jimenez C, Bakhtiari A, Willis R, Dejene Bejiga M, Mpyet C, Ngondi J, Boyd S, Abdala M, Abdou A, Adamu Y, Alemayehu A, Alemayehu W, Al-Khatib T, Apadinuwe SC, Awaca N, Awoussi MS, Baayendag G, Badiane Mouctar D, Bailey RL, Batcho W, Bay Z, Bella A, Beido N, Bol YY, Bougouma C, Brady CJ, Bucumi V, Butcher R, Cakacaka R, Cama A, Camara M, Cassama E, Chaora SG, Chebbi AC, Chisambi AB, Chu B, Conteh A, Coulibaly SM, Courtright P, Dalmar A, Dat TM, Davids T, DJAKER MEA, de Fátima Costa Lopes M, Dézoumbé D, Dodson S, Downs P, Eckman S, Elshafie BE, Elmezoghi M, Elvis AA, Emerson P, Epée EEE, Faktaufon D, Fall M, Fassinou A, Fleming F, Flueckiger R, Gamael KK, Garae M, Garap J, Gass K, Gebru G, Gichangi MM, Giorgi E, Goépogui A, Gómez DVF, Gómez Forero DP, Gower EW, Harte A, Henry R, Honorio-Morales HA, Ilako DR, Issifou AAB, Jones E, Kabona G, Kabore M, Kadri B, Kalua K, Kanyi SK, Kebede S, Kebede F, Keenan JD, Kello AB, Khan AA, KHELIFI H, Kilangalanga J, KIM SH, Ko R, Lewallen S, Lietman T, Logora MSY, Lopez YA, MacArthur C, Macleod C, Makangila F, Mariko B, Martin DL, Masika M, Massae P, Massangaie M, Matendechero HS, Mathewos T, McCullagh S, Meite A, Mendes EP, Abdi HM, Miller H, Minnih A, Mishra SK, Molefi T, Mosher A, M’Po N, Mugume F, Mukwiza R, Mwale C, Mwatha S, Mwingira U, Nash SD, NASSA C, Negussu N, Nieba C, Noah Noah JC, Nwosu CO, Olobio N, Opon R, Pavluck A, Phiri I, Rainima-Qaniuci M, Renneker KK, Saboyá-Díaz MI, Sakho F, Sanha S, Sarah V, Sarr B, Szwarcwald CL, Shah Salam A, Sharma S, Seife F, Serrano Chavez GM, Sissoko M, Sitoe HM, Sokana O, Tadesse F, Taleo F, Talero SL, Tarfani Y, Tefera A, Tekeraoi R, Tesfazion A, Traina A, Traoré L, Trujillo-Trujillo J, Tukahebwa EM, Vashist P, Wanyama EB, WARUSAVITHANA SD, Watitu TK, West S, Win Y, Woods G, YAJIMA A, Yaya G, Zecarias A, Zewengiel S, Zoumanigui A, Hooper PJ, Millar T, Rotondo L, Solomon AW. Tropical Data: Approach and Methodology as Applied to Trachoma Prevalence Surveys. Ophthalmic Epidemiol 2023; 30:544-560. [PMID: 38085791 PMCID: PMC10751062 DOI: 10.1080/09286586.2023.2249546] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/11/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys. METHODS Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations. Founding principles are health ministry ownership, partnership and collaboration, and quality assurance and quality control at every step of the survey process. Support covers survey planning, survey design, training, electronic data collection and fieldwork, and data management, analysis and dissemination. Methods are adapted to meet local context and needs. Customisations, operational research and integration of other diseases into routine trachoma surveys have also been supported. RESULTS Between 29th February 2016 and 24th April 2023, 3373 trachoma surveys across 50 countries have been supported, resulting in 10,818,502 people being examined for trachoma. CONCLUSION This health ministry-led, standardised approach, with support from the start to the end of the survey process, has helped all trachoma elimination stakeholders to know where interventions are needed, where interventions can be stopped, and when elimination as a public health problem has been achieved. Flexibility to meet specific country contexts, adaptation to changes in global guidance and adjustments in response to user feedback have facilitated innovation in evidence-based methodologies, and supported health ministries to strive for global disease control targets.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Amza Abdou
- Programme National de Santé Oculaire, Niger
| | | | | | | | | | | | - Naomie Awaca
- Ministère de la Santé Publique, Democratic Republic of Congo
| | | | | | | | | | | | | | | | | | | | - Clarisse Bougouma
- Programme national de lutte contre les maladies tropicales négligées (PNMTN), Burkina Faso
| | | | - Victor Bucumi
- National Integrated Programme for the Control of Neglected Tropical Diseases and Blindness (PNIMTNC), Burundi
| | | | | | | | | | | | | | | | | | - Brian Chu
- International Trachoma Initiative, USA
| | | | | | - Paul Courtright
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa, South Africa
| | - Abdi Dalmar
- Ministry of Human Development and Public Services, Somalia
| | | | | | | | | | | | | | | | | | | | | | - Ange Aba Elvis
- Programme National de la Santé Oculaire et de la lutte contre l’Onchocercose, Côte d’Ivoire
| | | | | | | | | | | | | | | | | | | | - Jambi Garap
- Port Moresby General Hospital, Papua New Guinea
| | | | | | | | | | | | | | | | | | - Anna Harte
- London School of Hygiene & Tropical Medicine, UK
| | - Rob Henry
- U.S. Agency for International Development, USA
| | | | | | | | | | | | - Martin Kabore
- Programme national de lutte contre les maladies tropicales négligées (PNMTN), Burkina Faso
| | | | - Khumbo Kalua
- Blantyre Institute for Community Outreach, Malawi
| | | | | | | | | | | | | | | | | | | | - Robert Ko
- Port Moresby General Hospital, Papua New Guinea
| | - Susan Lewallen
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa, South Africa
| | | | | | - Yuri A Lopez
- SACAICET / MINISTERIO DEL PODER POPULAR PARA LA SALUD, Venezuela
| | | | | | | | | | | | | | | | | | | | | | | | - Aboulaye Meite
- Ministère de la Santé et de l’Hygiène Publique, Cote d’Ivoire
| | | | | | | | | | | | | | - Aryc Mosher
- U.S. Agency for International Development, USA
| | | | | | | | | | | | | | | | | | | | - Cece Nieba
- Ministère de la Santé et de l’Hygiene Publique, Guinea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Oliver Sokana
- Solomon Islands Ministry of Health and Medical Services, Solomon Islands
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Jamal M, Kebede F. Exploring multi-level risk factors and post-war burdens of trachomatous trichiasis among displaced population in Raya Kobo districts, implication for urgent action. Int J Ophthalmol 2023; 16:1299-1308. [PMID: 37602352 PMCID: PMC10398518 DOI: 10.18240/ijo.2023.08.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/26/2023] [Indexed: 08/22/2023] Open
Abstract
AIM To estimate post-war burdens of trachomatous trichiasis (TT) and multi-level risk factors among displaced population in Raya Kobo districts, implication for urgent action. METHODS A community-based cross-sectional study was conducted among 603 participants from randomly selected 14 displaced slums in the Raya Kobo district. The data was collected from February 16th to March 30th, 2023. Study participants were selected using the multistage sampling technique. A structured questionnaire and ophthalmic loupe with ×2.5 magnificence were used to collect from participants. Multi-level binary logistic regression was used to determine associated factors with TT infection. Adjusted odds ratio (AOR) with 95% confidence interval (CI) were claimed for the strength of association at P<0.05. RESULTS We recruited 602 (99.9%) participants for the final analysis. From the total, 126 (20.9%) and 98 (16.3%, 95%CI: 13.5%-19.4%) participants were diagnosed with active trachoma & TT infection, respectively. Being age ≥45y (AOR=7.9, 95%CI: 2.4-25.3), having multiple eye infections (AOR=2.73, 95%CI: 1.47-5.29), poor wealth index (AOR=9.2; 95%CI: 2.7-23.7) and twice face washing per day (AOR=0.082, 95%CI: 0.03-0.21) has identified as individual as factors for TT infection. Whereas, distance between clean water source ≥10 km (AOR=6.5, 95%CI: 3.9-31.3), and latrine availability (AOR=0.35, 95%CI: 0.21-0.58) were the two community-level factors associated with TT infections. CONCLUSION The high prevalence of TT infection post-war throughout the study districts indicates a need for urgent clinical intervention in addition to rapid scaling up surgery, antibiotics, facial cleanliness, and environmental improvement (SAFE) strategies, strategy for high-risk population. Age≥45y, distance from the clean water source, poor wealth indexes, and eye infection are identified to be risk factors for TT infection. Furthermore, community-level preventative factors for TT infection are found as latrine availability and face washing practice.
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Affiliation(s)
- Muhammad Jamal
- Mersa Health Center, Habru Woreda North Wollo, Woldia, Amhara 400, Ethiopia
| | - Fassikaw Kebede
- School of Public Health, College of Health Science, Woldia University, Woldia, Amhara 400, Ethiopia
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Kebede F, Jamal M. Prevalence of active trachoma infection and associated factors post-war resettled population in raya kobo districts, North East Ethiopia: A community-based cross-sectional study in 2022. Health Sci Rep 2023; 6:e1486. [PMID: 37554953 PMCID: PMC10404653 DOI: 10.1002/hsr2.1486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/10/2023] Open
Abstract
Background Active trachoma infection poses a serious threat to public health, particularly for those who live in an unprivileged area and has practiced open-field defecation. This study aimed to estimate the prevalence of active trachoma infection and associated factors in the post-war resettled population in Raya Kobo district, North East Ethiopia: a community-based cross-sectional study in 2022. Methods A community-based cross-sectional study was conducted among 602 participants randomly selected in 14 slum villages in Raya Kobo from February 16th to March 30th, 2023. After the data was collected using a semi-structured questionnaire and entered into Epi-data version 3.2. The study participants were chosen using a two-stage sampling process. Binary logistic regression was used to identify factors for active trachoma infection. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were claimed for the strength of association at p < 0.05. Results Overall, 602 (99.9%) study participants were included in the final analysis. At the end of the study period, 126 (20.9) participants developed active trachoma infection. On multivariable analysis, were aged ≥45 years (AOR = 7.9, 95% CI = 2.4-25.3), history of eye infection (AOR = 3.7, 95% CI = 2.4-10.4, p = 0.001), were poor wealth index (AOR = 9.2, 95% CI = 2.7-23.7), having separated kitchen (AOR = 4.05, 95% CI = 1.86-8.86), living with animals (AOR = 5.92, 95% CI = 2.31-14.7) and having got administration of mass-drug (AOR = 8.9, 95% CI = 2.36-33.6) were significant risk factors for active trachoma infection. Whereas, face washing practice regularly (AOR = 0.23, 95% CI = 0.127-0.43), and toilet availability (AOR = 0.35, 95% CI = 0.20-0.97) were preventive factors for active trachoma infection. Conclusion A significant prevalence of active trachoma infection was reported in the area as compared with previous findings and urgent clinical intervention, and the WHO critical SAFE strategies (surgery, antibiotics, facial cleanliness, and environmental improvement) implementation is highly needed in the area. In addition, healthcare providers should focus on information dissemination on proper latrine utilization, and washing the face regularly to prevent active trachoma infection is highly recommended.
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Affiliation(s)
- Fassikaw Kebede
- Department of Epidemiology and BiostaticsCollege of Health ScienceWoldia UniversityWoldiaEthiopia
| | - Muhammad Jamal
- Mersa Health CentreHabru Woreda North WolloNorth WolloEthiopia
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Vengesai A, Naicker T, Midzi H, Kasambala M, Mduluza-Jokonya TL, Rusakaniko S, Mutapi F, Mduluza T. Multiplex peptide microarray profiling of antibody reactivity against neglected tropical diseases derived B-cell epitopes for serodiagnosis in Zimbabwe. PLoS One 2022; 17:e0271916. [PMID: 35867689 PMCID: PMC9307155 DOI: 10.1371/journal.pone.0271916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 07/08/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Peptides (B-cell epitopes) have broad applications in disease diagnosis and surveillance of pathogen exposure. In this framework, we present a pilot study to design and produce a peptide microarray for the integrated surveillance of neglected tropical diseases. The peptide microarray was evaluated against peptides derived from Ascaris lumbricoides, Necator americanus, Schistosoma haematobium, Schistosoma mansoni, Trichuris trichiura, Bacillus anthracis, Mycobacterium leprae, Wuchereria bancrofti, Rabies lyssavirus, Chlamydia trachomatis and Trypanosoma brucei. Methods S. haematobium was diagnosed using the urine filtration technique. S. mansoni, A. lumbricoides, N. americanus and T. trichiura were diagnosed using the Kato Katz and formal ether concentration techniques. Immunogenic peptides were retrieved from the Tackling Infection to Benefit Africa infectious diseases epitope microarray. Further peptides were predicted using ABCpred. IgG and IgM reactivity against the derived peptides were evaluated using peptide microarray multiplex immunoassays. Positive response was defined as fluorescence intensity ≥ 500 fluorescence units. Immunodominant peptides were identified using color-coded heat maps and bar graphs reflecting the obtained fluorescence signal intensities. Receiver Operating Characteristic analysis and Mann-Whitney-U test were performed to determine the diagnostic validity of the peptides. Results Species-specific responses with at least one peptide derived from each NTD pathogen were observed. The reactive peptides included; for S. haematobium, XP_035588858.1-206-220 and XP_035588858.1-206-220 immunodominant for IgG and IgM respectively, for S. mansoni, P20287.1-58-72 immunodominant for both antibodies and for T. trichiura, CDW52482.1-326-340 immunodominant for IgG and CDW57769.1-2017-2031 and CDW57769.1-1518-1532 immunodominant for IgM. According to ROC analysis most of the peptides selected were inaccurate; with AUC < 0.5. Some peptides had AUC values ranging from 0.5 to 0.5875 for both IgM and IgG suggesting no discrimination. Conclusion Multiplex peptide microarrays are a valuable tool for integrated NTDs surveillance and for screening parasites exposure in endemic areas. Species sero-reactivity observed in the study maybe indicative of exposure to the different NTDs parasites. However, although peptides with the least cross reactivity were selected there is need to validate the sero-reactivity with recombinant antigens and immune-blotting techniques such as western blotting.
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Affiliation(s)
- Arthur Vengesai
- Department of Biochemistry, Faculty of Medicine, Midlands State University, Gweru, Zimbabwe
- * E-mail:
| | - Thajasvarie Naicker
- Department of Optics and Imaging, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Herald Midzi
- Department of Optics and Imaging, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Biotechnology and Biochemistry, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
| | - Maritha Kasambala
- Department of Biological Sciences and Ecology, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
| | - Tariro L. Mduluza-Jokonya
- Department of Optics and Imaging, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Simbarashe Rusakaniko
- Family Medicine, Global and Public Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Francisca Mutapi
- Institute for Immunology and Infection Research and Centre for Immunity, Infection and Evolution, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
| | - Takafira Mduluza
- Department of Biotechnology and Biochemistry, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
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Tedijanto C, Aragie S, Tadesse Z, Haile M, Zeru T, Nash SD, Wittberg DM, Gwyn S, Martin DL, Sturrock HJW, Lietman TM, Keenan JD, Arnold BF. Predicting future community-level ocular Chlamydia trachomatis infection prevalence using serological, clinical, molecular, and geospatial data. PLoS Negl Trop Dis 2022; 16:e0010273. [PMID: 35275911 PMCID: PMC8942265 DOI: 10.1371/journal.pntd.0010273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 03/23/2022] [Accepted: 02/23/2022] [Indexed: 11/18/2022] Open
Abstract
Trachoma is an infectious disease characterized by repeated exposures to Chlamydia trachomatis (Ct) that may ultimately lead to blindness. Efficient identification of communities with high infection burden could help target more intensive control efforts. We hypothesized that IgG seroprevalence in combination with geospatial layers, machine learning, and model-based geostatistics would be able to accurately predict future community-level ocular Ct infections detected by PCR. We used measurements from 40 communities in the hyperendemic Amhara region of Ethiopia to assess this hypothesis. Median Ct infection prevalence among children 0–5 years old increased from 6% at enrollment, in the context of recent mass drug administration (MDA), to 29% by month 36, following three years without MDA. At baseline, correlation between seroprevalence and Ct infection was stronger among children 0–5 years old (ρ = 0.77) than children 6–9 years old (ρ = 0.48), and stronger than the correlation between active trachoma and Ct infection (0-5y ρ = 0.56; 6-9y ρ = 0.40). Seroprevalence was the strongest concurrent predictor of infection prevalence at month 36 among children 0–5 years old (cross-validated R2 = 0.75, 95% CI: 0.58–0.85), though predictive performance declined substantially with increasing temporal lag between predictor and outcome measurements. Geospatial variables, a spatial Gaussian process, and stacked ensemble machine learning did not meaningfully improve predictions. Serological markers among children 0–5 years old may be an objective tool for identifying communities with high levels of ocular Ct infections, but accurate, future prediction in the context of changing transmission remains an open challenge.
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Affiliation(s)
- Christine Tedijanto
- Francis I. Proctor Foundation, University of California, San Francisco, California, United States of America
- * E-mail:
| | | | | | | | - Taye Zeru
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Scott D. Nash
- The Carter Center, Atlanta, Georgia, United States of America
| | - Dionna M. Wittberg
- Francis I. Proctor Foundation, University of California, San Francisco, California, United States of America
| | - Sarah Gwyn
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Diana L. Martin
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Thomas M. Lietman
- Francis I. Proctor Foundation, University of California, San Francisco, California, United States of America
- Department of Ophthalmology, University of California, San Francisco, California, United States of America
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
| | - Jeremy D. Keenan
- Francis I. Proctor Foundation, University of California, San Francisco, California, United States of America
- Department of Ophthalmology, University of California, San Francisco, California, United States of America
| | - Benjamin F. Arnold
- Francis I. Proctor Foundation, University of California, San Francisco, California, United States of America
- Department of Ophthalmology, University of California, San Francisco, California, United States of America
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Vengesai A, Naicker T, Kasambala M, Midzi H, Mduluza-Jokonya T, Rusakaniko S, Mduluza T. Clinical utility of peptide microarrays in the serodiagnosis of neglected tropical diseases in sub-Saharan Africa: protocol for a diagnostic test accuracy systematic review. BMJ Open 2021; 11:e042279. [PMID: 34330850 PMCID: PMC8327806 DOI: 10.1136/bmjopen-2020-042279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Neglected tropical diseases tend to cluster in the same poor populations and, to make progress with their control, they will have to be dealt with in an integrated manner. Peptide microarrays may be a solution to these problems, where diagnosis for co-infection can be detected simultaneously using the one tool. A meta-analysis using hierarchical models will be performed to assess the diagnostic accuracy of peptide microarrays for detecting schistosomiasis (Schistosoma mansoni and S. haematobium), soil-transmitted helminths (Trichuris trichiura, Ascaris lumbricoides and Necator americanus), trachoma (Chlamydia trachomatis), lymphatic filariasis (Wuchereria bancrofti) and onchocerciasis (Onchocerca volvulus) in people residing in sub-Saharan Africa. METHODS AND ANALYSIS A comprehensive search of the following databases will be performed: Cochrane Infectious Diseases Group Specialised Register, PubMed, EMBASE and The Web of Science. Studies comparing peptide microarrays with a reference standard from a random or consecutive series of patients will be included in the study. Two review authors will independently screen titles and abstracts for relevance, assess full-text articles for inclusion and carry out data extraction using a tailored data extraction form. The quality Assessment of Diagnostic Accuracy Studies-2 tool will be used to assess the quality of the selected studies. The bivariate model and the hierarchical summary receiver operating characteristic curve model will be performed to evaluate the diagnostic accuracy of the peptide microarrays. Meta-regression analyses will be performed to investigate heterogeneity across studies. ETHICS AND DISSEMINATION There is no requirement for ethical approval because the work will be carried out using previously published data, without human beings involvement. Findings will be disseminated through peer-reviewed publication and in conference presentations. PROSPERO REGISTRATION NUMBER CRD42020175145.
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Affiliation(s)
- Arthur Vengesai
- Biotechnology and Biochemistry, University of Zimbabwe Faculty of Science, Harare, Zimbabwe
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Thajasvarie Naicker
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Maritha Kasambala
- Faculty of Science and Agriculture, University of KwaZulu-Natal, Durban, South Africa
| | - Herald Midzi
- Biotechnology and Biochemistry, University of Zimbabwe Faculty of Science, Harare, Zimbabwe
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | | | | | - Takafira Mduluza
- Biotechnology and Biochemistry, University of Zimbabwe Faculty of Science, Harare, Zimbabwe
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Solomon AW, Willis R, Pavluck AL, Alemayehu W, Bakhtiari A, Bovill S, Chu BK, Courtright P, Dejene M, Downs P, Flueckiger RM, Haddad D, Hooper PJ, Kalua K, Kebede B, Kello AB, Macleod CK, McCullagh S, Millar T, Mpyet C, Ngondi J, Nwobi B, Olobio N, Onyebuchi U, Rotondo LA, Sarr B, Shafi O, Sokana O, West SK, Foster A, For The Global Trachoma Mapping Project. Quality Assurance and Quality Control in the Global Trachoma Mapping Project. Am J Trop Med Hyg 2019; 99:858-863. [PMID: 30039782 PMCID: PMC6159583 DOI: 10.4269/ajtmh.18-0082] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In collaboration with the health ministries that we serve and other partners, we set out to complete the multiple-country Global Trachoma Mapping Project. To maximize the accuracy and reliability of its outputs, we needed in-built, practical mechanisms for quality assurance and quality control. This article describes how those mechanisms were created and deployed. Using expert opinion, computer simulation, working groups, field trials, progressively accumulated in-project experience, and external evaluations, we developed 1) criteria for where and where not to undertake population-based prevalence surveys for trachoma; 2) three iterations of a standardized training and certification system for field teams; 3) a customized Android phone–based data collection app; 4) comprehensive support systems; and 5) a secure end-to-end pipeline for data upload, storage, cleaning by objective data managers, analysis, health ministry review and approval, and online display. We are now supporting peer-reviewed publication. Our experience shows that it is possible to quality control and quality assure prevalence surveys in such a way as to maximize comparability of prevalence estimates between countries and permit high-speed, high-fidelity data processing and storage, while protecting the interests of health ministries.
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Affiliation(s)
- Anthony W Solomon
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom.,London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | | | | | - Wondu Alemayehu
- Berhan Public Health and Eye Care Consultancy, Addis Adaba, Ethiopia.,The Fred Hollows Foundation Ethiopia, Addis Ababa, Ethiopia
| | | | - Sarah Bovill
- Sightsavers, Haywards Heath, West Sussex, United Kingdom
| | - Brian K Chu
- Task Force for Global Health, Decatur, Georgia
| | - Paul Courtright
- ilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Michael Dejene
- Michael Dejene Public Health Consultancy Services, Addis Ababa, Ethiopia
| | - Philip Downs
- Sightsavers, Haywards Heath, West Sussex, United Kingdom
| | | | - Danny Haddad
- Orbis International, New York, New York.,Emory Eye Center, Atlanta, Georgia
| | - P J Hooper
- Task Force for Global Health, Decatur, Georgia
| | - Khumbo Kalua
- Blantyre Institute for Community Outreach, Blantyre, Malawi
| | | | - Amir Bedri Kello
- Light for the World, Addis Ababa, Ethiopia.,ilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | | | | | - Tom Millar
- Sightsavers, Haywards Heath, West Sussex, United Kingdom
| | - Caleb Mpyet
- Department of Ophthalmology, Jos University, Jos, Nigeria.,Sightsavers Nigeria, Kaduna, Nigeria.,ilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Jeremiah Ngondi
- RTI International, Washington, District of Columbia.,The Carter Center, Atlanta, Georgia
| | - Benjamin Nwobi
- National Trachoma Control Program, Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | - Nicholas Olobio
- National Trachoma Control Program, Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | - Uwazoeke Onyebuchi
- National Trachoma Control Program, Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | | | - Boubacar Sarr
- Ministère de la Santé et de la Prévention Médicale, Dakar, Senegal
| | - Oumer Shafi
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Oliver Sokana
- Eyecare Department, Ministry of Health, Honiara, Solomon Islands
| | - Sheila K West
- Dana Center for Preventive Ophthalmology, The Wilmer Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Allen Foster
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Missamou F, Marlhand H, Dzabatou-Babeaux ASP, Sendzi S, Bernasconi J, D'Souza S, Bakhtiari A, Millar T, Willis R, Bengraïne K, Resnikoff S, Solomon AW. A Population-Based Trachoma Prevalence Survey Covering Seven Districts of Sangha and Likouala Departments, Republic of the Congo. Ophthalmic Epidemiol 2019; 25:155-161. [PMID: 30806542 PMCID: PMC6444200 DOI: 10.1080/09286586.2018.1546878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE We set out to estimate the prevalence of trachoma and access to water and sanitation in seven suspected-trachoma-endemic districts of northern Congo, surveyed as a single evaluation unit. METHODS From a complete list of rural villages in the seven districts, we systematically selected 22 with probability proportional to village size. In selected villages, we included all households where there were fewer than 25 in total, or used compact segment sampling to select a group of approximately 20 households by random draw. In each selected household, all consenting residents aged ≥1 year were examined by Global Trachoma Mapping Project-certified trachoma graders, and data collected on household-level access to water and sanitation. RESULTS In November and December 2015, 466 households were visited in 22 villages, and 2081 (88%) of 2377 residents of those households were examined. No examined individual had trichiasis. The age-adjusted prevalence of the active trachoma sign trachomatous inflammation-follicular (TF) in 1-9-year-olds was 2.5% (95%CI 0.9-4.5%). Only 39% (95%CI 35-44%) of households had access to an improved source of drinking water. Only 10% (95%CI 7-13%) of households had access to an improved sanitation facility. CONCLUSION Trachoma is not a public health problem in this part of Congo. Access to water and sanitation is inadequate.
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Affiliation(s)
- François Missamou
- a Directorate-General for the Fight against Communicable Diseases and HIV/AIDS , Ministère de la Santé et de la Population , Brazzaville , Congo
| | - Hemilembolo Marlhand
- a Directorate-General for the Fight against Communicable Diseases and HIV/AIDS , Ministère de la Santé et de la Population , Brazzaville , Congo
| | - Angelie S Patrick Dzabatou-Babeaux
- a Directorate-General for the Fight against Communicable Diseases and HIV/AIDS , Ministère de la Santé et de la Population , Brazzaville , Congo
| | - Samuel Sendzi
- a Directorate-General for the Fight against Communicable Diseases and HIV/AIDS , Ministère de la Santé et de la Population , Brazzaville , Congo
| | | | | | | | | | | | - Karim Bengraïne
- b Organisation pour la prevention de la cécité , Paris , France
| | - Serge Resnikoff
- b Organisation pour la prevention de la cécité , Paris , France
| | - Anthony W Solomon
- e Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.,f Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
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Mpyet C, Muhammad N, Adamu MD, Ladan M, Willis R, Umar MM, Alada J, Aliero AA, Bakhtiari A, Flueckiger RM, Olobio N, Nwosu C, Damina M, Gwom A, Labbo AA, Boisson S, Isiyaku S, William A, Rabiu MM, Pavluck AL, Gordon BA, Solomon AW. Impact Survey Results after SAFE Strategy Implementation in 15 Local Government Areas of Kebbi, Sokoto and Zamfara States, Nigeria. Ophthalmic Epidemiol 2019; 25:103-114. [PMID: 30806537 PMCID: PMC6444276 DOI: 10.1080/09286586.2018.1481984] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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.
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Affiliation(s)
- Caleb Mpyet
- a Department of Ophthalmology , Jos University Teaching Hospital , Jos , Nigeria.,b Sightsavers , Kaduna , Nigeria.,c Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Nasiru Muhammad
- d Ophthalmology Unit, Surgery Department , Usmanu Dan Fodiyo University , Sokoto , Nigeria
| | - Mohammed Dantani Adamu
- d Ophthalmology Unit, Surgery Department , Usmanu Dan Fodiyo University , Sokoto , Nigeria
| | | | | | | | - Joel Alada
- a Department of Ophthalmology , Jos University Teaching Hospital , Jos , Nigeria.,h Department of Ophthalmology , Jos University Teaching Hospital , Jos , Nigeria
| | | | | | | | - Nicholas Olobio
- j National Trachoma Control Program, Department of Public Health , Federal Ministry of Health , Abuja , Nigeria
| | | | | | | | | | - Sophie Boisson
- l Department of Public Health, the Environment and Social Determinants of Health , World Health Organization , Geneva , Switzerland
| | | | | | | | | | - Bruce A Gordon
- l Department of Public Health, the Environment and Social Determinants of Health , World Health Organization , Geneva , Switzerland
| | - Anthony W Solomon
- n Clinical Research Department , London School of Hygiene & Tropical Medicine , London , United Kingdom.,o London Centre for Neglected Tropical Disease Research , London , United Kingdom.,p Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
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Amer K, Müller A, Abdelhafiz HM, Al-Khatib T, Bakhtiari A, Boisson S, El Arab GE, Gad H, Gordon BA, Madian A, Mahanna AT, Mokhtar S, Safa OH, Samy M, Shalaby M, Taha ZA, Willis R, Yacoub A, Mamdouh AR, Younis AK, Zoheir MBE, Courtright P, Solomon AW. Prevalence of trachoma in four marakez of Elmenia and Bani Suef Governorates, Egypt. Ophthalmic Epidemiol 2019; 25:70-78. [PMID: 30806536 PMCID: PMC6444193 DOI: 10.1080/09286586.2018.1446536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE In 2015, to determine where interventions are needed to eliminate trachoma as a public health problem from Egypt, we initiated population-based prevalence surveys using the Global Trachoma Mapping Project platform in four suspected-endemic marakez (districts; singular: markaz) of the governorates of Elmenia and Bani Suef. METHODS In each markaz, 30 households were selected in each of 25 villages. Certified graders examined a total of 3682 children aged 1-9 years in 2993 households, noting the presence or absence of trachomatous inflammation-follicular (TF) and trachomatous inflammation-intense (TI) in each eye. A total of 5582 adults aged ≥15 years living in the same households were examined for trachomatous trichiasis (TT). Household-level access to water and sanitation was recorded. RESULTS Three of four marakez had age-adjusted TF prevalence estimates in 1-9-year olds of >10%; the other markaz had a TF prevalence estimate of 5-9.9%. Estimates of the age- and gender-adjusted prevalence of unmanaged TT in adults ranged from 0.7% to 2.3%. Household-level access to water and sanitation was high. (We did not, however, measure use of water or sanitation facilities.) Conclusions: Each of the four marakez surveyed has trachoma as a public health problem, with a need for implementation of the SAFE (surgery, antibiotics, facial cleanliness, environmental improvement) strategy. Further mapping is also required to determine the need for interventions in other areas of Egypt.
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Affiliation(s)
- Khaled Amer
- a Ministry of Health and Population , Cairo , Egypt
| | - Andreas Müller
- b Centre for Eye Research , University of Melbourne , Melbourne , Australia
| | | | | | | | - Sophie Boisson
- f Department of Public Health, the Environment and Social Determinants of Health , World Health Organization , Geneva , Switzerland
| | | | - Hema Gad
- h Health Office , Deir Mawass , Egypt
| | - Bruce A Gordon
- f Department of Public Health, the Environment and Social Determinants of Health , World Health Organization , Geneva , Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | - Paul Courtright
- n Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Anthony W Solomon
- o Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.,p Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
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Dézoumbé D, Djada DA, Harba TT, Biao JE, Kali B, Bernasconi J, Hiron D, Bengraïne K, D’Souza S, Willis R, Bakhtiari A, Resnikoff S, Courtright P, Solomon AW. Prevalence of trachoma in the Republic of Chad: results of 41 population-based surveys. Ophthalmic Epidemiol 2018; 25:143-154. [PMID: 30806544 PMCID: PMC6444194 DOI: 10.1080/09286586.2018.1546877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 10/12/2018] [Accepted: 11/06/2018] [Indexed: 11/04/2022]
Abstract
PURPOSE To estimate the prevalence of trachoma in suspected-endemic areas of Chad, and thereby determine whether trachoma is a public health problem requiring intervention. METHODS We divided the suspected-endemic population living in secure districts into 46 evaluation units (EUs), and used the standardized methodologies of the Global Trachoma Mapping Project. A two-stage cluster-sampling procedure was adopted. In each EU, the goal was to examine at least 1019 children aged 1-9 years by recruiting 649 households; all consenting residents aged ≥ 1 year living in those households were examined. Each participant was examined for trachomatous inflammation-follicular (TF), trachomatous inflammation-intense (TI), and trichiasis. RESULTS Two EUs had data that could not be validated, and were excluded from the analysis. GPS data for three other pairs of EUs suggested that EU divisions were inaccurate; data for each pair were combined within the pair. In the 41 resulting EUs, 29,924 households in 967 clusters were visited, and 104,584 people were examined. The age-adjusted EU-level prevalence of TF in 1-9-year-olds ranged from 0.0% to 23.3%, and the age- and gender-adjusted EU-level prevalence of trichiasis in ≥ 15-year-olds ranged from 0.02% to 1.3%. TF was above the WHO elimination threshold in 16 EUs (39%) and trichiasis was above the WHO elimination threshold in 29 EUs (71%). Women had a higher prevalence of trichiasis than did men in 31 EUs (76%). A higher ratio of trichiasis prevalence in women to trichiasis prevalence in men was associated (p = 0.03) with a higher prevalence of trichiasis at EU level. CONCLUSION Public health-level interventions against trachoma are needed in Chad. Over 10,000 people need management of their trichiasis; women account for about two-thirds of this total. The association between a higher ratio of trichiasis prevalence in women to that in men with higher overall trichiasis prevalence needs further investigation.
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Affiliation(s)
- Djoré Dézoumbé
- Programme national de lutte contre la cécité, Ministère de la Santé Publique, N’Djamena, Tchad
| | | | | | - Jean-Eudes Biao
- Organisation pour la Prévention de la Cécité, N’Djamena, Tchad
| | - Barka Kali
- Organisation pour la Prévention de la Cécité, N’Djamena, Tchad
| | | | - Doniphan Hiron
- Organisation pour la Prévention de la Cécité, Paris, France
| | | | | | | | | | | | - Paul Courtright
- Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Anthony W. Solomon
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Trotignon G, Jones E, Engels T, Schmidt E, McFarland DA, Macleod CK, Amer K, Bio AA, Bakhtiari A, Bovill S, Doherty AH, Khan AA, Mbofana M, McCullagh S, Millar T, Mwale C, Rotondo LA, Weaver A, Willis R, Solomon AW. The cost of mapping trachoma: Data from the Global Trachoma Mapping Project. PLoS Negl Trop Dis 2017; 11:e0006023. [PMID: 29045419 PMCID: PMC5675456 DOI: 10.1371/journal.pntd.0006023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 11/07/2017] [Accepted: 10/09/2017] [Indexed: 11/18/2022] Open
Abstract
Background The Global Trachoma Mapping Project (GTMP) was implemented with the aim of completing the baseline map of trachoma globally. Over 2.6 million people were examined in 1,546 districts across 29 countries between December 2012 and January 2016. The aim of the analysis was to estimate the unit cost and to identify the key cost drivers of trachoma prevalence surveys conducted as part of GTMP. Methodology and principal findings In-country and global support costs were obtained using GTMP financial records. In-country expenditure was analysed for 1,164 districts across 17 countries. The mean survey cost was $13,113 per district [median: $11,675; IQR = $8,365-$14,618], $17,566 per evaluation unit [median: $15,839; IQR = $10,773-$19,915], $692 per cluster [median: $625; IQR = $452-$847] and $6.0 per person screened [median: $4.9; IQR = $3.7-$7.9]. Survey unit costs varied substantially across settings, and were driven by parameters such as geographic location, demographic characteristics, seasonal effects, and local operational constraints. Analysis by activities showed that fieldwork constituted the largest share of in-country survey costs (74%), followed by training of survey teams (11%). The main drivers of in-country survey costs were personnel (49%) and transportation (44%). Global support expenditure for all surveyed districts amounted to $5.1m, which included grant management, epidemiological support, and data stewardship. Conclusion This study provides the most extensive analysis of the cost of conducting trachoma prevalence surveys to date. The findings can aid planning and budgeting for future trachoma surveys required to measure the impact of trachoma elimination activities. Furthermore, the results of this study can also be used as a cost basis for other disease mapping programmes, where disease or context-specific survey cost data are not available. There are currently few data sets available to aid programmes in planning and budgeting for population-based surveys in low- and middle- income countries. With the objective of identifying cost drivers and key variables influencing prevalence survey costs, the authors collected expenses incurred during the Global Trachoma Mapping Project (GTMP) which surveyed 2.6 million people across 29 countries. Expenditure from surveying 1,164 districts in 17 countries was analysed. Our results showed that the majority of in-country expenditure was spent on personnel (per diems, accommodation, meals and beverages) (49%) and local transportation (44%) and that the median survey expenditure was US$11,675 per district (or US$15,839 per evaluation unit, US$625 per cluster and US$4.9 per person examined). There were large variations in survey unit costs across settings, based on local geographic, demographic, seasonal effects and local operational characteristics. In addition, the resources required for the global support and coordination of the GTMP were analysed and amounted to US$5.1m (US$3,318 per district or US$5,668 per EU). Global support expenses can be substantial for a large multi-country mapping exercise conducted in a limited period of time such as the GTMP. Findings from this study can be used to inform other disease mapping projects, and to inform planning and budgeting for the prevalence surveys that will assess the impact of trachoma elimination interventions.
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Affiliation(s)
| | - Ellen Jones
- Neglected Tropical Diseases Department, Sightsavers, Haywards Heath, United Kingdom
| | - Thomas Engels
- Research Department, Sightsavers, Haywards Heath, United Kingdom
| | - Elena Schmidt
- Research Department, Sightsavers, Haywards Heath, United Kingdom
| | - Deborah A. McFarland
- Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Colin K. Macleod
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Khaled Amer
- Prevention of Blindness Programme, Ministry of Health, Cairo, Egypt
| | - Amadou A. Bio
- Programme National de Lutte Contre les Maladies Transmissibles, Ministère de la Santé, Cotonou, Benin
| | - Ana Bakhtiari
- Task Force for Global Health, Atlanta, GA, United States of America
| | - Sarah Bovill
- Neglected Tropical Diseases Department, Sightsavers, Haywards Heath, United Kingdom
| | - Amy H. Doherty
- RTI International, Washington, D.C., United States of America
| | | | - Mariamo Mbofana
- Health Programa Nacional de Oftalmologia, Ministerio da Saude, Maputo, Moçambique
| | - Siobhain McCullagh
- Neglected Tropical Diseases Department, Sightsavers, Haywards Heath, United Kingdom
| | - Tom Millar
- Neglected Tropical Diseases Department, Sightsavers, Haywards Heath, United Kingdom
| | | | - Lisa A. Rotondo
- RTI International, Washington, D.C., United States of America
| | - Angela Weaver
- United States Agency for International Development, Washington, D.C., United States of America
| | - Rebecca Willis
- Task Force for Global Health, Atlanta, GA, United States of America
| | - Anthony W. Solomon
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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