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Bisanzio D, Butcher R, Turbé V, Matsumoto K, Dinesh C, Massae P, Dejene M, Jimenez C, Macleod C, Matayan E, Mpyet C, Pavluck A, Saboyá-Díaz MI, Tadesse F, Talero SL, Solomon AW, Ngondi J, Kabona G, Uisso C, Simon A, Mwingira U, Harding-Esch EM. Accuracy, acceptability and feasibility of photography for use in trachoma surveys: a mixed methods study in Tanzania. Int Health 2023:ihad111. [PMID: 38141035 DOI: 10.1093/inthealth/ihad111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/15/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Photography could be used to train individuals to diagnose trachomatous inflammation-follicular (TF) as trachoma prevalence decreases and to ensure accurate field TF grading in trachoma prevalence surveys. We compared photograph and field TF grading and determined the acceptability and feasibility of eyelid photography to community members and trachoma survey trainers. METHODS A total of 100 children ages 1-9 y were examined for TF in two Maasai villages in Tanzania. Two images of the right everted superior tarsal conjunctiva of each child were taken with a smartphone and a digital single-lens reflex (DSLR) camera. Two graders independently graded all photos. Focus group discussions (FGDs) were conducted with community members and Tropical Data trainers. RESULTS Of 391 photos, one-fifth were discarded as ungradable. Compared with field grading, photo grading consistently underdiagnosed TF. Compared with field grading, DSLR photo grading resulted in a higher prevalence and sensitivity than smartphone photo grading. FGDs indicated that communities and trainers found photography acceptable and preferred smartphones to DSLR in terms of practicalities, but image quality was of paramount importance for trainers. CONCLUSIONS Photography is acceptable and feasible, but further work is needed to ensure high-quality images that enable accurate and consistent grading before being routinely implemented in trachoma surveys.
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Affiliation(s)
| | - Robert Butcher
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Valérian Turbé
- Department of Medicine, University College London, London, UK
| | - Kenji Matsumoto
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Chaitra Dinesh
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Patrick Massae
- Department of Ophthalmology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | | | | | - Colin Macleod
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Einoti Matayan
- Department of Ophthalmology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Caleb Mpyet
- Department of Ophthalmology, University of Jos, Jos, Nigeria
- Sightsavers Nigeria Country Office, Kaduna, Nigeria
| | | | - Martha Idalí Saboyá-Díaz
- Communicable Diseases Prevention, Control, and Elimination Department, Pan American Health Organization, Washington, DC, USA
| | | | | | - Anthony W Solomon
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | | | - George Kabona
- Neglected Tropical Disease Control Program, Ministry of Health, Dodoma, Tanzania
| | - Cecilia Uisso
- Neglected Tropical Disease Control Program, Ministry of Health, Dodoma, Tanzania
| | - Alistidia Simon
- Neglected Tropical Disease Control Program, Ministry of Health, Dodoma, Tanzania
| | - Upendo Mwingira
- RTI International, Washington, DC, USA
- Neglected Tropical Disease Control Program, Ministry of Health, Dodoma, Tanzania
- National Institute for Medical Research, Dar-es-Salaam, Tanzania
| | - Emma M Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
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Mwangi G, Harding-Esch E, Kabona G, Watitu T, Mpyet C, Gemechu A, Abdeta A, Wamyil-Mshelia T, Ajege G, Kelly M, Abony M, Otinda P, Chege M, Courtright P, Geneau R. Explaining the continuing high prevalence of trachomatous trichiasis unknown to the health system in evaluation units: a mixed methods explanatory study in four trachoma-endemic countries. Int Health 2023; 15:ii44-ii52. [PMID: 38048377 PMCID: PMC10695428 DOI: 10.1093/inthealth/ihad085] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/14/2023] [Accepted: 09/05/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND We explored reasons for continuing higher-than-anticipated prevalence of trachomatous trichiasis (TT) unknown to the health system in population-based prevalence surveys in evaluation units where full geographical coverage of TT case finding was reported. METHODS A mixed-methods study in Ethiopia, Kenya, Nigeria and Tanzania was conducted. We compared data from clinical examination, campaign documentation and interviews with original trachoma impact survey (TIS) results. RESULTS Of 169 TT cases identified by TIS teams, 130 (77%) were examined in this study. Of those, 90 (69%) were a match (both TIS and study teams agreed on TT classification) and 40 (31%) were a mismatch. Of the 40 mismatches, 22 (55%) were identified as unknown to the health system by the study team but as known to the health system by the TIS team; 12 (30%) were identified as not having TT by the study team but as having TT by the TIS team; and six (15%) were identified as unknown to the health system in the TIS team but as known to the health system by the study team based on documentation reviewed. CONCLUSIONS Incorrectly reported geographical coverage of case-finding activities, and discrepancies in TT status between TIS results and more detailed assessments, are the key reasons identified for continuing high TT prevalence.
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Affiliation(s)
- Grace Mwangi
- Kilimanjaro Centre for Community Ophthalmology, Moshi, Tanzania
| | - Emma Harding-Esch
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - George Kabona
- Neglected Tropical Diseases Control Program, Ministry of Health, Dodoma, Tanzania
| | | | - Caleb Mpyet
- Sightsavers, Abuja, Nigeria
- Department of Ophthalmology, University of Jos, Plateau State, Nigeria
| | | | | | | | | | | | | | | | | | - Paul Courtright
- Kilimanjaro Centre for Community Ophthalmology, Moshi, Tanzania
- Sightsavers, Haywards Heath, UK
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Robert Geneau
- Kilimanjaro Centre for Community Ophthalmology, Moshi, Tanzania
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
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Mpyet C, Ateken K, Dejene M, Kelly M, Mwangi G, Schmidt E. Addressing the challenges of reaching trachoma elimination: leveraging on lessons learnt from programme implementation. Int Health 2023; 15:ii1-ii2. [PMID: 38048375 PMCID: PMC10695421 DOI: 10.1093/inthealth/ihad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 12/06/2023] Open
Affiliation(s)
- Caleb Mpyet
- College of Health Sciences, University of Jos, Nigeria
- Sightsavers, Abuja, Nigeria
| | - Kareen Ateken
- Department of Entomology, Center for Infectious Disease Dynamics. The Pennsylvania State University
| | | | | | - Grace Mwangi
- Kilimanjaro Center for Community Ophthalmology, Moshi, Tanzania
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Kanyi S, Hydara A, Sillah A, Mpyet C, Harte A, Bakhtiari A, Willis R, Jimenez C, Aboe A, Bailey R, Harding-Esch EM, Solomon AW, Joof BM. The Gambia Trachomatous Trichiasis Surveys: Results from Five Evaluation Units Confirm Attainment of Trachoma Elimination Thresholds. Ophthalmic Epidemiol 2023:1-9. [PMID: 37401113 DOI: 10.1080/09286586.2023.2213320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 04/12/2023] [Accepted: 05/09/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION Trichiasis is present when in-turned eyelashes touch the eyeball. It may result in permanent vision loss. Trachomatous trichiasis (TT) is caused by multiple rounds of inflammation associated with conjunctival Chlamydia trachomatis infection. Surveys have been designed to estimate the prevalence of TT in evaluation units (EUs) of trachoma-endemic countries in order to help develop appropriate programme-level plans. In this study, TT-only surveys were conducted in five EUs of The Gambia to determine whether further intensive programmatic action was required. METHODS Two-stage cluster sampling was used to select 27 villages per EU and ~25 households per village. Graders assessed the TT status of individuals aged ≥15 years in each selected household, including the presence or absence of conjunctival scarring in those with TT. RESULTS From February to March 2019, 11595 people aged ≥15 years were examined. A total of 34 cases of TT were identified. All five EUs had an age- and gender-adjusted prevalence of TT unknown to the health system <0.2%. Three of five EUs had a prevalence of 0.0%. CONCLUSION Using these and other previously collected data, in 2021, The Gambia was validated as having achieved national elimination of trachoma as a public health problem. Trachoma is still present in the population, but as its prevalence is low, it is unlikely that today's youth will experience the exposure to C. trachomatis required to precipitate TT. The Gambia demonstrates that with political will and consistent application of human and financial resources, trachoma can be eliminated as a public health problem.
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Affiliation(s)
- Sarjo Kanyi
- The National Eye Health Programme, Ministry of Health, Banjul, Kanifing, The Gambia
| | - Abba Hydara
- Sheikh Zayed Regional Eye Care Center, Banjul, Kanifing, The Gambia
| | - Ansumana Sillah
- The National Eye Health Programme, Ministry of Health, Banjul, Kanifing, The Gambia
| | - Caleb Mpyet
- Department of Ophthalmology, University of Jos, Jos, Nigeria
- Sightsavers Nigeria Country Office, Kaduna, Nigeria
| | - Anna Harte
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Ana Bakhtiari
- International Trachoma Initiative, Task Force for Global Health, Atlanta, Georgia, USA
| | - Rebecca Willis
- International Trachoma Initiative, Task Force for Global Health, Atlanta, Georgia, USA
| | | | - Agatha Aboe
- Department of Ophthalmology, University of Jos, Jos, Nigeria
| | - Robin Bailey
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Emma M Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Ul Hassan E, Apadinuwe SC, Bisanzio D, Dejene M, Downs P, Harding-Esch EM, Jimenez C, Kabona G, Kebede BN, Kelly M, Kivumbi P, Millar T, Mosher AW, Mpyet C, Mkocha H, Ngondi JM, Olobio N, Palmer S, Teyil WM, Courtright P. Impact of personal protective equipment on the clarity of vision among trachoma survey graders and trichiasis surgeons in the context of COVID-19. BMJ Open Ophthalmol 2023; 8:e001255. [PMID: 37493675 PMCID: PMC10255175 DOI: 10.1136/bmjophth-2023-001255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/20/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND/AIMS The COVID-19 pandemic necessitated the use of personal protective equipment for those involved in trachoma survey grading and trichiasis surgery. We sought to determine which configuration of a face shield would be less likely to impact grading accuracy and ability to conduct trichiasis surgery. The research also included assessment of comfort, ease of cleaning and robustness. METHODS There were three research phases. In phase 1, assessment of four potential face shield configurations was undertaken with principal trachoma graders and trichiasis surgeon trainers to decide which two options should undergo further testing. In phase 2, clarity of vision and comfort (in a classroom environment) of the two configurations were assessed compared with no face shield (control), while grading trachomatous inflammation-follicular (TF). The second phase also included the assessment of impact of the configurations while performing trichiasis surgery using a training model. In phase 3, face shield ease of use was evaluated during routine surgical programmes. RESULTS In phase 2, 124 trachoma graders and 28 trichiasis surgeons evaluated the 2 face shield configurations selected in phase 1. TF agreement was high (kappa=0.83 and 0.82) for both configurations compared with not wearing a face shield. Comfort was reported as good by 51% and 32% of graders using the two configurations. Trichiasis skill scores were similar for both configurations. CONCLUSION The face shield configuration that includes a cut-out for mounting the 2.5× magnifying loupes does not appear to impact the ability or comfort of trachoma graders or trichiasis surgeons to carry out their work.
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Affiliation(s)
| | | | - Donal Bisanzio
- Research Triangle Park, Research Triangle Institute, Durham, North Carolina, USA
| | - Michael Dejene
- Public Health Consultancy Services, Addis Ababa, Ethiopia
| | - Philip Downs
- Neglected Tropical Diseases, Sightsavers, Haywards Heath, UK
- Neglected Tropical Diseases, Sightsavers, Durham, North Carolina, USA
| | - Emma M Harding-Esch
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | | | - George Kabona
- Union Government of Tanzania Ministry of Health Community Development Gender Elderly Children, Dar es Salaam, Tanzania, United Republic of
| | | | - Michaela Kelly
- Neglected Tropical Diseases, Sightsavers, Haywards Heath, UK
| | - Peter Kivumbi
- Sightsavers, Dar es Salaam, United Republic of Tanzania
| | - Tom Millar
- Neglected Tropical Diseases, Sightsavers, Haywards Heath, UK
| | - Aryc W Mosher
- United States Agency for International Development, Washington, DC, USA
| | - Caleb Mpyet
- Neglected Tropical Diseases, Sightsavers, Kaduna, Nigeria
| | - Harran Mkocha
- Microbiology and Immunology, Kongwa Trachoma Project, Kongwa, Tanzania, United Republic of
| | - Jeremiah M Ngondi
- Research Triangle Park, Research Triangle Institute, Durham, North Carolina, USA
| | | | | | | | - Paul Courtright
- Kilimanjaro Centre for Community Ophthalmology, University of Cape Town, Observatory, South Africa
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Lar L, Stewart M, Isiyaku S, Dean L, Ozano K, Mpyet C, Theobald S. Does inter-border conflict influence the views of task sharing among community health volunteers in Nigeria? A qualitative study. Confl Health 2022; 16:43. [PMID: 35871004 PMCID: PMC9308912 DOI: 10.1186/s13031-022-00472-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/27/2022] [Indexed: 01/17/2023] Open
Abstract
Background Volunteer community health workers are increasingly being engaged in Nigeria, through the World Health Organization’s task sharing strategy. This strategy aims to address gaps in human resources for health, including inequitable distribution of health workers. Recent conflicts in rural and fragile border communities in northcentral Nigeria create challenges for volunteer community health workers to meet their community's increasing health needs. This study aimed to explore the perception of volunteers involved in task sharing to understand factors affecting performance and delivery in such contexts. Methods This was a qualitative study conducted in fragile border communities in north central Nigeria. Eighteen audio recorded, semi-structured interviews with volunteers and supervisors were performed. Their perceptions on how task sharing and allocation of tasks affect performance and delivery were elucidated. The transactional social framework was applied during the thematic analysis process to generate an explanatory account of the research data, which was analysed using NVivo software. Results Promotive and preventive tasks were shared among the predominantly agrarian respondents. There was a structured task allocation process that linked the community with the health system and mainly cordial relationships were in place. However, there were barriers related to ethnoreligious crises and current conflict, timing of task allocations, gender inequities in volunteerism, shortage of commodities, inadequate incentives, dwindling community support and negative attitudes of some volunteers. Conclusion The perception of task sharing was mainly positive, despite the challenges, especially the current conflict. In this fragile context, reconsideration of non-seasonal task allocations within improved community-driven selection and security systems should be encouraged. Supportive supervision and providing adequate and timely renumeration will also be beneficial in this fragile setting.
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Panshak TE, Akhiwu BI, Ramyil AV, Saleh N, Wade P, Ladeinde AL, Mpyet C. Ophthalmic Injuries in Patients with Maxillofacial Trauma Presenting to a Teaching Hospital in North Central Nigeria. J West Afr Coll Surg 2022; 12:17-23. [PMID: 36388734 PMCID: PMC9641739 DOI: 10.4103/jwas.jwas_91_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/08/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Ophthalmic injuries in patients with maxillofacial trauma are potential causes of a permanent visual loss. These injuries can easily be missed; hence, there is a need for the ophthalmic evaluation of patients with maxillofacial trauma. The main objective of this study was to determine the prevalence, patterns, etiology, and risk factors of ophthalmic injuries in patients presenting with maxillofacial trauma in a teaching hospital in North Central Nigeria. MATERIALS AND METHODS The study was a hospital-based, descriptive, cross-sectional study of 67 patients with maxillofacial trauma recruited over a 6-month study period. Information on the sociodemographic and clinical characteristics of the study participants was obtained. The data were analysed using SPSS version 20 statistical software. Pearson's chi-square test was used to test for statistical significance. RESULTS Ophthalmic involvement was seen in 77.6% of the study participants, with males and individuals aged 21-30 years being more commonly affected. The leading cause of ophthalmic injuries in patients with maxillofacial trauma was road traffic accident (RTA) (75.5%). Others included assaults and fall from heights. Amongst the RTA cases, 71.4% was due to motorcycle-related accident with 91.9% of the patients with ophthalmic injuries observed not to use helmet/seat belt. The use of alcohol and not wearing protective gears were seen as the risk factors. Simple zygomatic complex fracture was the most common trauma observed (44.2%). CONCLUSION Ophthalmologic assessment should be conducted for all patients presenting with maxillofacial trauma. The laws on the use of protective gears such as helmets and seat belts should be enforced.
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Affiliation(s)
| | - Benjamin Idemudia Akhiwu
- Department of Oral and Maxillofacial Surgery, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria,Address for correspondence: Dr. Benjamin Idemudia Akhiwu, Department of Oral and Maxillofacial Surgery, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria. E-mail:
| | - Alice Venyir Ramyil
- Ophthalmology Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Naomi Saleh
- Ophthalmology Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Patricia Wade
- Ophthalmology Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Akinola Ladipo Ladeinde
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Caleb Mpyet
- Ophthalmology Department, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
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9
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Macleod CK, Bailey RL, Dejene M, Shafi O, Kebede B, Negussu N, Mpyet C, Olobio N, Alada J, Abdala M, Willis R, Hayes R, Solomon AW. Estimating the Intracluster Correlation Coefficient for the Clinical Sign "Trachomatous Inflammation-Follicular" in Population-Based Trachoma Prevalence Surveys: Results From a Meta-Regression Analysis of 261 Standardized Preintervention Surveys Carried Out in Ethiopia, Mozambique, and Nigeria. Am J Epidemiol 2020; 189:68-76. [PMID: 31509177 PMCID: PMC7119302 DOI: 10.1093/aje/kwz196] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 09/03/2019] [Indexed: 11/13/2022] Open
Abstract
Sample sizes in cluster surveys must be greater than those in surveys using simple random sampling in order to obtain similarly precise prevalence estimates, because results from subjects examined in the same cluster cannot be assumed to be independent. Therefore, a crucial aspect of cluster sampling is estimation of the intracluster correlation coefficient (ρ): the degree of relatedness of outcomes in a given cluster, defined as the proportion of total variance accounted for by between-cluster variation. In infectious disease epidemiology, this coefficient is related to transmission patterns and the natural history of infection; its value also depends on particulars of survey design. Estimation of ρ is often difficult due to the lack of comparable survey data with which to calculate summary estimates. Here we use a parametric bootstrap model to estimate ρ for the ocular clinical sign “trachomatous inflammation—follicular” (TF) among children aged 1–9 years within population-based trachoma prevalence surveys. We present results from a meta-regression analysis of data from 261 such surveys completed using standardized methods in Ethiopia, Mozambique, and Nigeria in 2012–2015. Consistent with the underlying theory, we found that ρ increased with increasing overall TF prevalence and smaller numbers of children examined per cluster. Estimates of ρ for TF were independently higher in Ethiopia than in the other countries.
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Affiliation(s)
- Colin K Macleod
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Robin L Bailey
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Michael Dejene
- Michael Dejene Public Health Consultancy Services, Addis Ababa, Ethiopia
| | - Oumer Shafi
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | | | - Caleb Mpyet
- Department of Ophthalmology, Queen Mamohato Memorial Hospital, Maseru, Lesotho
- Sightsavers, Kaduna, Nigeria
- Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology, Groote Schuur Hospital, Cape Town, South Africa
| | - Nicholas Olobio
- National Trachoma Control Program, Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | - Joel Alada
- Department of Ophthalmology, Queen Mamohato Memorial Hospital, Maseru, Lesotho
| | - Mariamo Abdala
- Ophthalmology Department, Ministry of Health, Maputo, Mozambique
| | | | - Richard Hayes
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - 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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Khan AA, Florea VV, Hussain A, Jadoon Z, Boisson S, Willis R, Dejene M, Bakhtiari A, Mpyet C, Pavluck AL, Gillani M, Qureshi B, Solomon AW. Prevalence of Trachoma in Pakistan: Results of 42 Population-Based Prevalence Surveys from the Global Trachoma Mapping Project. Ophthalmic Epidemiol 2020; 27:155-164. [PMID: 31916887 PMCID: PMC7048080 DOI: 10.1080/09286586.2019.1708120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose: Previous phases of trachoma mapping in Pakistan completed baseline surveys in 38 districts. To help guide national trachoma elimination planning, we set out to estimate trachoma prevalence in 43 suspected-endemic evaluation units (EUs) of 15 further districts. Methods: We planned a population-based trachoma prevalence survey in each EU. Two-stage cluster sampling was employed, using the systems and approaches of the Global Trachoma Mapping Project. In each EU, residents aged ≥1 year living in 30 households in each of 26 villages were invited to be examined by trained, certified trachoma graders. Questionnaires and direct observation were used to evaluate household-level access to water and sanitation. Results: One EU was not completed due to insecurity. Of the remaining 42, three EUs had trichiasis prevalence estimates in ≥15-year-olds ≥0.2%, and six (different) EUs had prevalence estimates of trachomatous inflammation—follicular (TF) in 1–9-year-olds ≥5%; each EU requires trichiasis and TF prevalence estimates below these thresholds to achieve elimination of trachoma as a public health problem. All six EUs with TF prevalences ≥5% were in Khyber Pakhtunkhwa Province. Household-level access to improved sanitation ranged by EU from 6% to 100%. Household-level access to an improved source of water for face and hand washing ranged by EU from 37% to 100%. Conclusion: Trachoma was a public health problem in 21% (9/42) of the EUs. Because the current outbreak of extremely drug-resistant typhoid in Pakistan limits domestic use of azithromycin mass drug administration, other interventions against active trachoma should be considered here.
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Affiliation(s)
- Asad Aslam Khan
- Ministry of National Health Services, Regulations and Coordination, Islamabad, Pakistan.,College of Ophthalmology and Allied Vision Sciences, King Edward Medical University, Lahore, Pakistan.,Mayo Hospital, Lahore, Pakistan
| | - Victor V Florea
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Arif Hussain
- College of Ophthalmology and Allied Vision Sciences, King Edward Medical University, Lahore, Pakistan
| | - Zahid Jadoon
- Pakistan Institute of Community Ophthalmology, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Sophie Boisson
- Department of Public Health, The Environment and Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Rebecca Willis
- International Trachoma Initiative, Task Force for Global Health, Decatur, GA, USA
| | - Michael Dejene
- Michael Dejene Public Health Consultancy Services, Addis Ababa, Ethiopia
| | - Ana Bakhtiari
- International Trachoma Initiative, Task Force for Global Health, Decatur, GA, USA
| | - Caleb Mpyet
- Department of Ophthalmology, University of Jos, Jos, Nigeria.,Sightsavers, Kaduna, Nigeria.,Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Alexandre L Pavluck
- International Trachoma Initiative, Task Force for Global Health, Decatur, GA, USA
| | | | - Babar Qureshi
- Neglected Tropical Diseases, CBM, Oakington, Cambridge, UK.,Eastern Mediterranean Region Alliance for Trachoma Control, Cairo, Egypt
| | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.,Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.,London Centre for Neglected Tropical Disease Research, London, UK
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11
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Kello AB, Mpyet C. Ophthalmic nurses: meeting the need for human resources to end trachoma. Community Eye Health 2020; 33:56. [PMID: 34007113 PMCID: PMC8115716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Amir Bedri Kello
- MD, MSc, Medical Officer, Trachoma, WHO/AFRO ESPEN, Brazzaville, Republic of Congo
| | - Caleb Mpyet
- Professor of Ophthalmology, University of Jos, Jos, Nigeria
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12
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Flueckiger RM, Courtright P, Abdala M, Abdou A, Abdulnafea Z, Al-Khatib TK, Amer K, Amiel ON, Awoussi S, Bakhtiari A, Batcho W, Bella AL, Bennawi KH, Brooker SJ, Chu BK, Dejene M, Dezoumbe D, Elshafie BE, Elvis AA, Fabrice DN, Omar FJ, François M, François D, Garap J, Gichangi M, Goepogui A, Hammou J, Kadri B, Kabona G, Kabore M, Kalua K, Kamugisha M, Kebede B, Keita K, Khan AA, Kiflu G, Yibi M, Mackline G, Macleod C, Manangazira P, Masika MP, Massangaie M, Mduluza T, Meno N, Midzi N, Minnih AO, Mishra S, Mpyet C, Muraguri N, Mwingira U, Nassirou B, Ndjemba J, Nieba C, Ngondi J, Olobio N, Pavluck A, Phiri I, Pullan R, Qureshi B, Sarr B, Seiha D, Chávez GMS, Sharma S, Sisaleumsak S, Southisombath K, Stevens G, Woldendrias AT, Traoré L, Turyaguma P, Willis R, Yaya G, Yeo S, Zambroni F, Zhao J, Solomon AW. The global burden of trichiasis in 2016. PLoS Negl Trop Dis 2019; 13:e0007835. [PMID: 31765415 PMCID: PMC6901231 DOI: 10.1371/journal.pntd.0007835] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 12/09/2019] [Accepted: 10/08/2019] [Indexed: 11/19/2022] Open
Abstract
Background Trichiasis is present when one or more eyelashes touches the eye. Uncorrected, it can cause blindness. Accurate estimates of numbers affected, and their geographical distribution, help guide resource allocation. Methods We obtained district-level trichiasis prevalence estimates in adults for 44 endemic and previously-endemic countries. We used (1) the most recent data for a district, if more than one estimate was available; (2) age- and sex-standardized corrections of historic estimates, where raw data were available; (3) historic estimates adjusted using a mean adjustment factor for districts where raw data were unavailable; and (4) expert assessment of available data for districts for which no prevalence estimates were available. Findings Internally age- and sex-standardized data represented 1,355 districts and contributed 662 thousand cases (95% confidence interval [CI] 324 thousand–1.1 million) to the global total. Age- and sex-standardized district-level prevalence estimates differed from raw estimates by a mean factor of 0.45 (range 0.03–2.28). Previously non- stratified estimates for 398 districts, adjusted by ×0.45, contributed a further 411 thousand cases (95% CI 283–557 thousand). Eight countries retained previous estimates, contributing 848 thousand cases (95% CI 225 thousand-1.7 million). New expert assessments in 14 countries contributed 862 thousand cases (95% CI 228 thousand–1.7 million). The global trichiasis burden in 2016 was 2.8 million cases (95% CI 1.1–5.2 million). Interpretation The 2016 estimate is lower than previous estimates, probably due to more and better data; scale-up of trichiasis management services; and reductions in incidence due to lower active trachoma prevalence. As an individual with trichiasis blinks, the eyelashes abrade the cornea, which can lead to corneal opacity and blindness. Through high quality surgery, which involves altering the position of the eyelid margin, it is possible to reduce the number of people with trichiasis. Accurate estimates of the number of persons with trichiasis and their geographical distribution are needed in order to effectively align resources for surgery and other necessary services. We obtained district-level trichiasis prevalence estimates for 44 endemic and previously-endemic countries. We used the most recently available data and expert assessments to estimate the global burden of trichiasis. We estimated that in 2016 the global burden was 2.8 million cases (95% CI 1.1–5.2 million). The 2016 estimate is lower than previous estimates, probably due to more and better data; scale-up of trichiasis management services; and reductions in incidence due to lower active trachoma prevalence.
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Affiliation(s)
- Rebecca M. Flueckiger
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Paul Courtright
- Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Mariamo Abdala
- Ministerio da Saude, National Ophthalmology Program, Maputo, Mozambique
| | - Amza Abdou
- Ministère de la Santé et de la population, Niamey, Niger
| | | | - Tawfik K. Al-Khatib
- National Eye Health Programme, Ministry of Public Health and Population, Sana’a, Yemen
| | | | | | | | | | | | | | | | - Simon J. Brooker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Global Health, Neglected Tropical Diseases, Bill & Melinda Gates Foundation, Seattle, USA
| | - Brian K. Chu
- The Task Force for Global Health, Atlanta, GA, USA
| | - Michael Dejene
- Michael Dejene Public Health Consultancy Services, Addis Ababa, Ethiopia
| | | | | | - Aba Ange Elvis
- Programme National de la Santé Oculaire et de la lutte contre l'Onchocercose, Abidjan, Côte d'Ivoire
| | | | | | - Missamou François
- Bureau des Maladies Oculaires, Ministère de la Santé, Kinshasa, Democratic Republic of the Congo
| | - Drabo François
- Programme national de lutte contre les maladies tropicales négligées (PNMTN), Ouagadougou, Burkina Faso
| | - Jambi Garap
- National Department of Health, Port Moresby, Papua New Guinea
| | | | - André Goepogui
- Programme National de Lutte Contre l’Onchocercose et la Cécité et les Maladies Tropicales Négligées, Conakry, Guinea
| | | | - Boubacar Kadri
- Ministère de la Santé et de la population, Niamey, Niger
| | - George Kabona
- Ministry of Health, Dar es Salaam, United Republic of Tanzania
| | - Martin Kabore
- l'unité d'élimination du trachome, PNMTN, Ouagadougou, Burkina Faso
| | - Khumbo Kalua
- Department of Ophthalmology, University of Malawi, College of Medicine, Blantyre, Malawi
| | - Mathias Kamugisha
- National Institute for Medical Research, Dar es Salaam, United Republic of Tanzania
| | | | - Kaba Keita
- Programme National de Lutte Contre l’Onchocercose et la Cécité et les Maladies Tropicales Négligées, Conakry, Guinea
| | | | - Genet Kiflu
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | | | - Colin Macleod
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Portia Manangazira
- Department of Epidemiology and Disease Control, Ministry of Health & Child Welfare, Harare, Zimbabwe
| | | | - Marilia Massangaie
- Ministerio da Saude, Department of Neglected Tropical Diseases, Maputo, Mozambique
| | - Takafira Mduluza
- Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe
| | | | - Nicholas Midzi
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | | | - Caleb Mpyet
- Sightsavers Nigeria, Kaduna, Nigeria & Department of Ophthalmology, Jos University, Jos, Nigeria
| | | | - Upendo Mwingira
- Ministry of Health, Dar es Salaam, United Republic of Tanzania
| | - Beido Nassirou
- Ministère de la Santé et de la population, Niamey, Niger
| | - Jean Ndjemba
- Bureau des Maladies Oculaires, Ministère de la Santé, Kinshasa, Democratic Republic of the Congo
| | - Cece Nieba
- Programme National de Lutte Contre l’Onchocercose et la Cécité et les Maladies Tropicales Négligées, Conakry, Guinea
| | - Jeremiah Ngondi
- RTI International, Dar es Salaam, United Republic of Tanzania
| | | | | | - Isaac Phiri
- Department of Epidemiology and Disease Control, Ministry of Health & Child Welfare, Harare, Zimbabwe
| | - Rachel Pullan
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Boubacar Sarr
- Ministère de la santé et de l’Action Sociale, Dakar, Senegal
| | - Do Seiha
- Prevention of Blindness Programme, Ministry of Health, Phnom Penh, Cambodia
| | | | | | | | - Khamphoua Southisombath
- National Program for the Prevention of Blindness, Ministry of Health, Vientiane, Lao People’s Democratic Republic
| | - Gretchen Stevens
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Georges Yaya
- Ministère de la Santé Publique, Bangui, Central African Republic
| | - Souleymane Yeo
- Programme National de la Santé Oculaire et de la lutte contre l'Onchocercose, Abidjan, Côte d'Ivoire
| | | | - Jialiang Zhao
- Department of Ophthalmology, Peking Union Medical Colllege Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Anthony W. Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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13
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Muhammad N, Adamu MD, Mpyet C, Bounce C, Maishanu NM, Jabo AM, Rabiu MM, Bascaran C, Isiyaku S, Foster A. Impact of a 10-Year Eye Care Program in Sokoto, Nigeria: Changing Pattern of Prevalence and Causes of Blindness and Visual Impairment. Middle East Afr J Ophthalmol 2019; 26:101-106. [PMID: 31543668 PMCID: PMC6737780 DOI: 10.4103/meajo.meajo_113_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: This study was undertaken to ascertain the current magnitude and causes of blindness and visual impairment in persons aged 50 years and over and to assess the impact of a 10-year eye care program in Sokoto State, Nigeria. METHODS: A rapid assessment of avoidable blindness (RAAB) survey (in persons 50 years and over) was conducted in 2016. Participants were selected in Wurno health zone using a two-stage cluster randomized sampling with probability proportional to size. Operational definitions were based on RAAB and World Health Organization eye examination record definitions. Eye care program documents were reviewed and data from a baseline survey undertaken in 2005 were reanalyzed. RESULTS: A response of 89.1% (2405 of 2700 participants) was obtained in the 2016 survey. With available correction, the unadjusted prevalence of blindness was 7.7% (95% confidence interval [CI]: 6.4, 8.9). The odds of blindness were 1.8 times higher in females than males (95% CI: 1.3, 2.4; P < 0.001). Major causes of blindness were cataract (48.9%) corneal disease (20.1%), glaucoma (10.3%), and uncorrected refractive error/aphakia (8.7%). The age- and sex-adjusted prevalence of blindness has declined from 11.6% (95% CI: 7.4, 17.0) in 2005 to 6.8% (95% CI: 5.6, 8.0%) in 2016. CONCLUSION: The blindness prevalence is high, and the major causes are avoidable in the health zone. The findings suggest that investments in the program over the last 10 years might have led to almost a halving in the prevalence of blindness in th e population. However, the small sample size of persons 50+ years from Wurno zone in the 2005 survey necessitate caution when comparing the 2005 and the 2016 surveys.
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Affiliation(s)
- Nasiru Muhammad
- Department of Ophthalmology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Mohammed D Adamu
- Department of Ophthalmology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Caleb Mpyet
- Department of Ophthalmology, University of Jos, Jos, Nigeria.,Sightsavers Nigeria Office, Kaduna, Nigeria.,Division of Ophthalmology, Kilimanjaro Centre for Community Ophthalmology International, University of Cape Town, Cape Town, South Africa
| | - Catey Bounce
- Department of Primary Care and Public Health Sciences, King's College, London, United Kingdom
| | - Nuhu M Maishanu
- Sokoto State Eye Health Programme, Ministry of Health, Sokoto, Nigeria
| | | | | | - Covadonga Bascaran
- Clinical Research Department, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Allen Foster
- Clinical Research Department, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Alada JJ, Mpyet C, Florea VV, Boisson S, Willis R, Bakhtiari A, Muhammad N, Adamu MD, Umar MM, Olobio N, Isiyaku S, Adamani W, Amdife D, Solomon AW. Prevalence of Trachoma in Kogi State, Nigeria: Results of four Local Government Area-Level Surveys from the Global Trachoma Mapping Project. Ophthalmic Epidemiol 2019; 25:33-40. [PMID: 30806551 PMCID: PMC6444201 DOI: 10.1080/09286586.2017.1409359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE To determine the prevalence of trachoma in four Local Government Areas (LGAs) of Kogi State, Nigeria. METHODS In June 2014, we conducted population-based, cross-sectional surveys according to Global Trachoma Mapping Project (GTMP) protocols in selected LGAs of Kogi State. In each LGA, 25 clusters were selected with probability proportional to size. In each of these clusters, 25 households were enrolled for the survey. All residents of selected households aged ≥1 year were examined by GTMP-certified graders for trachomatous inflammation-follicular (TF) and trichiasis using the simplified trachoma grading scheme. Data on sources of household water and types of sanitation facilities were collected through questioning and direct observation. RESULTS The age-adjusted TF prevalence in 1-9-year-olds ranged from 0.4% (95% CI 0.1-0.8%) in Bassa to 1.0% (95% CI 0.3-1.9%) in Omala. Across all four LGAs, only one case of trichiasis was found; this individual was in Omala, giving that LGA a trichiasis prevalence in individuals aged ≥15 years of 0.02% (95% CI 0.00-0.07%). Between 77 and 88% of households had access to water for hygiene purposes, while only 10-30% had access to improved sanitation facilities. CONCLUSION Trachoma is not a public health problem in any of the 4 LGAs surveyed. There is, however, the need to increase access to adequate water and sanitation services to contribute to the health and social and economic well-being of these communities.
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Affiliation(s)
- Joel J Alada
- a Department of Ophthalmology , Federal Medical Centre , Makurdi , Nigeria
| | - Caleb Mpyet
- b Department of Ophthalmology , University of Jos , Jos , Nigeria.,c Sightsavers , Kaduna , Nigeria.,d Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Victor V Florea
- e Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
| | - Sophie Boisson
- f Department of Public Health, the Environment and Social Determinants of Health , World Health Organization , Geneva , Switzerland
| | - Rebecca Willis
- g International Trachoma Initiative, Task Force for Global Health , Decatur , GA , USA
| | - Ana Bakhtiari
- g International Trachoma Initiative, Task Force for Global Health , Decatur , GA , USA
| | - Nasiru Muhammad
- h Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | - Mohammed D Adamu
- h Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | | | | | | | | | | | - Anthony W Solomon
- e Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland.,l Clinical Research Department , London School of Hygiene & Tropical Medicine , London , United Kingdom.,m London Centre for Neglected Tropical Disease Research , London , United Kingdom
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16
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Mwale C, Mumbi W, Funjika M, Sokesi T, Silumesii A, Mulenga M, Mutati G, Kwendakwema D, Chelu C, Adamu Y, Alemayehu W, Al-Khatib T, Bakhtiari A, Dejene M, Massae PA, Mpyet C, Nwosu C, Willis R, Courtright P, Solomon AW. Prevalence of Trachoma in 47 Administrative Districts of Zambia: Results of 32 Population-Based Prevalence Surveys. Ophthalmic Epidemiol 2019; 25:171-180. [PMID: 30806543 PMCID: PMC6444202 DOI: 10.1080/09286586.2018.1546880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Purpose: A number of previous administrative-district-level baseline trachoma prevalence estimates in Zambia required verification. We used methodologies and systems for trachoma surveys considered to represent international best practice in order to generate reliable estimates of the prevalence of trachoma. Methods: Between March 2016 and July 2017, we undertook 32 population-based prevalence surveys covering 47 administrative districts. In each of the 32 evaluation units (EUs), we selected 31 households in each of 24 clusters. In selected households, trained, certified graders examined all residents aged 1 year and above for evidence of trachomatous inflammation—follicular (TF) and trichiasis. In eyes that had trichiasis, the presence or absence of trachomatous scarring (TS) was recorded, and the subject was asked about previous trichiasis management recommendations from health workers. Results: Five EUs (encompassing seven administrative districts) had prevalence estimates of trichiasis+TS unknown to the health system in ≥15-year-olds of ≥0.2%, and require public-health-level implementation of trichiasis surgery services. Eleven EUs (encompassing 16 administrative districts) had TF prevalence estimates in 1–9-year-olds of ≥5%. Intervention with the A, F and E components of the SAFE strategy for trachoma elimination is required for nearly 1.5 million people. Conclusion: Trachoma is a public health problem in some parts of Zambia. The Ministry of Health will continue to partner with other stakeholders to implement the multi-sectoral SAFE strategy. Consideration should be given to re-surveying other suspected-endemic administrative districts in which surveys using older methodologies returned TF prevalence estimates ≥5%.
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Affiliation(s)
- Consity Mwale
- a Lusaka Provincial Health Office , Lusaka , Zambia.,b University Teaching Eye Hospital , Lusaka , Zambia
| | - Willard Mumbi
- c Ophthalmology Unit , Kabwe General Hospital , Kabwe , Zambia
| | - Misa Funjika
- d Ophthalmology Unit , Ndola Teaching Hospital , Ndola , Zambia
| | - Teddy Sokesi
- d Ophthalmology Unit , Ndola Teaching Hospital , Ndola , Zambia
| | | | - Muma Mulenga
- b University Teaching Eye Hospital , Lusaka , Zambia
| | - Grace Mutati
- b University Teaching Eye Hospital , Lusaka , Zambia
| | | | | | - Yilikal Adamu
- g Department of Ophthalmology, Faculty of Medicine , Addis Ababa University , Addis Ababa , Ethiopia
| | - Wondu Alemayehu
- h The Fred Hollows Foundation , Addis Ababa , Ethiopia.,i Berhan Public Health and Eye Care Consultancy , Addis Ababa , Ethiopia
| | - Tawfik Al-Khatib
- j Prevention of Blindness Program , Ministry of Public Health & Population , Sana'a , Yemen.,k Department of Ophthalmology, College of Medicine , University of Sana'a , Sana'a , Yemen.,l Eye Unit , Al-Thawra Hospital , Sana'a , Yemen
| | | | - Michael Dejene
- n Michael Dejene Public Health Consultancy Services , Addis Ababa , Ethiopia
| | | | - Caleb Mpyet
- p Department of Ophthalmology , University of Jos , Jos , Nigeria.,q Sightsavers , Kaduna , Nigeria.,r Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | | | | | - Paul Courtright
- r Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Anthony W Solomon
- s Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.,t Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
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Alada JJ, Mpyet C, Florea VV, Boisson S, Willis R, Muhammad N, Bakhtiari A, Adamu MD, Pavluck AL, Umar MM, Isiyaku S, William A, Oyinloye FOP, Olobio N, Solomon AW. Prevalence of and risk factors for trachoma in Kwara state, Nigeria: Results of eight population-based surveys from the Global Trachoma Mapping Project. Ophthalmic Epidemiol 2019; 25:53-61. [PMID: 30806548 PMCID: PMC6444274 DOI: 10.1080/09286586.2018.1437188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose: To determine the prevalence of and risk factors for trachoma in selected local government areas (LGAs) of Kwara State, Nigeria. Methodology: Population-based cross-sectional surveys were conducted in eight LGAs of Kwara State using Global Trachoma Mapping Project (GTMP) protocols. In each LGA, 25 villages were selected using probability-proportional-to-size sampling; 25 households were selected from each village using compact segment sampling. All residents of selected households aged ≥1 year were examined by GTMP-certified graders for trachomatous inflammation—follicular (TF) and trichiasis using the simplified trachoma grading scheme. Water, sanitation, and hygiene (WASH) data were also collected. Results: A total of 28,506 residents were enumerated in 4769 households across the eight LGAs. TF prevalence in children aged 1–9 years ranged from 0.2% (95% CI 0.0–0.3%) to 1.3% (95% CI 0.7–2.1%), while trichiasis prevalence in persons ≥15 years was <0.2% in each LGA. Access to improved water source was the lowest in Edu (62%), while access to improved sanitation facilities was the lowest in Asa (6%) and the highest in Ilorin East (64%). Children aged 1–4 years had 0.63 (95% CI 0.40–0.99) times lower odds of having TF compared to children aged 5–9 years. Children in households with ≥5 resident 1–9-year-old children had 1.63 (95% CI 1.02–2.60) times greater odds of having TF compared to those in households with <5 resident children. Conclusion: Trachoma is not a public health problem in Kwara State. Provision of adequate water and sanitation services should be a priority here, as a foundation for the health of the population.
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Affiliation(s)
- Joel J Alada
- a Department of Ophthalmology , Federal Medical Centre , Makurdi , Nigeria
| | - Caleb Mpyet
- b Department of Ophthalmology , University of Jos , Jos , Nigeria.,c Sightsavers , Kaduna , Nigeria.,d Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Victor V Florea
- e Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
| | - Sophie Boisson
- f Department of Public Health, Environmental and Social Determinants of Health , World Health Organization , Geneva , Switzerland
| | | | - Nasiru Muhammad
- h Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | | | - Mohammed D Adamu
- h Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | | | | | | | | | | | | | - Anthony W Solomon
- e Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland.,l Clinical Research Department , London School of Hygiene & Tropical Medicine , London , United Kingdom.,m London Centre for Neglected Tropical Disease Research , London , United Kingdom
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18
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Flueckiger RM, Giorgi E, Cano J, Abdala M, Amiel ON, Baayenda G, Bakhtiari A, Batcho W, Bennawi KH, Dejene M, Elshafie BE, Elvis AA, François M, Goepogui A, Kalua K, Kebede B, Kiflu G, Masika MP, Massangaie M, Mpyet C, Ndjemba J, Ngondi JM, Olobio N, Turyaguma P, Willis R, Yeo S, Solomon AW, Pullan RL. Understanding the spatial distribution of trichiasis and its association with trachomatous inflammation-follicular. BMC Infect Dis 2019; 19:364. [PMID: 31039737 PMCID: PMC6492377 DOI: 10.1186/s12879-019-3935-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 03/24/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whilst previous work has identified clustering of the active trachoma sign "trachomatous inflammation-follicular" (TF), there is limited understanding of the spatial structure of trachomatous trichiasis (TT), the rarer, end-stage, blinding form of disease. Here we use community-level TF prevalence, information on access to water and sanitation, and large-scale environmental and socio-economic indicators to model the spatial variation in community-level TT prevalence in Benin, Cote d'Ivoire, DRC, Guinea, Ethiopia, Malawi, Mozambique, Nigeria, Sudan and Uganda. METHODS We fit binomial mixed models, with community-level random effects, separately for each country. In countries where spatial correlation was detected through a semi-variogram diagnostic check we then fitted a geostatistical model to the TT prevalence data including TF prevalence as an explanatory variable. RESULTS The estimated regression relationship between community-level TF and TT was significant in eight countries. We estimate that a 10% increase in community-level TF prevalence leads to an increase in the odds for TT ranging from 20 to 86% when accounting for additional covariates. CONCLUSION We find evidence of an association between TF and TT in some parts of Africa. However, our results also suggest the presence of additional, country-specific, spatial risk factors which modulate the variation in TT risk.
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Affiliation(s)
| | - Emanuele Giorgi
- Lancaster Medical School, Lancaster University, Lancaster, Lancashire, UK
| | - Jorge Cano
- London School of Hygiene and Tropical Medicine, London, UK
| | - Mariamo Abdala
- Ophthalmology Department, Ministry of Health, Maputo, Mozambique
| | | | | | | | - Wilfrid Batcho
- Programme National de Lutte contre les Maladies Transmissibles, Ministère de la Santé, Cotonou, Benin
| | | | - Michael Dejene
- Michael Dejene Public Health Consultancy Services, Addis Ababa, Ethiopia
| | | | - Aba Ange Elvis
- Programme National de la Santé Oculaire et de la lutte contre l'Onchocercose, Abidjan, Côte d'Ivoire
| | - Missamou François
- Direction de Lutte contre la Maladie, Kinshasa, Ministere de la Santé Publique, Kinshasa, Democratic Republic of Congo
| | - André Goepogui
- Programmes National de Lutte contre l'Onchocercoses et les autres Maladies Tropicales Négligées, Ministère de la Sante, Conakry, Guinea
| | - Khumbo Kalua
- Blantyre Institute for Community Outreach, Blantyre, Malawi
| | | | - Genet Kiflu
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | | | - Caleb Mpyet
- Sightsavers Nigeria, Kaduna, Nigeria.,Department of Ophthalmology, Jos University, Jos, Nigeria
| | - Jean Ndjemba
- Direction de Lutte contre la Maladie, Kinshasa, Ministere de la Santé Publique, Kinshasa, Democratic Republic of Congo
| | | | - Nicholas Olobio
- Nigeria Trachoma Elimination Program, Federal Ministry of Health, Abuja, Nigeria
| | | | | | - Souleymane Yeo
- Programme National de la Santé Oculaire et de la lutte contre l'Onchocercose, Abidjan, Côte d'Ivoire
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20
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Mpyet C, Tagoh S, Boisson S, Willis R, Muhammad N, Bakhtiari A, Adamu MD, Pavluck AL, Umar MM, Alada J, Isiyaku S, Adamani W, Jande B, Olobio N, Solomon AW. Prevalence of Trachoma and Access to Water and Sanitation in Benue State, Nigeria: Results of 23 Population-Based Prevalence Surveys. Ophthalmic Epidemiol 2019; 25:79-85. [PMID: 30806545 PMCID: PMC6444203 DOI: 10.1080/09286586.2018.1467466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Purpose: We sought to determine the prevalence of trachoma in each local government area (LGA) of Benue State, Nigeria. Methods: Two-stage cluster sampling was used to conduct a series of 23 population-based prevalence surveys. LGAs were the evaluation units surveyed. In each LGA, 25 households were selected in each of 25 clusters, and individuals aged 1 year and above resident in those households were invited to be examined for trachoma. Data on access to water and sanitation were also collected at household level. Results: A total of 91,888 people were examined from among 93,636 registered residents across the 23 LGAs. The LGA-level prevalence of trachomatous inflammation—follicular (TF) in 1–9 year olds ranged from 0.3% to 5.3%. Two LGAs had TF prevalences of 5.0–9.9%. The LGA-level prevalence of trichiasis in ≥15-year-olds ranged from 0.0% to 0.35%. Access to improved drinking water sources ranged from 0% in Gwer West to 99% in Tarka, while access to improved sanitation ranged from 1% in Gwer West to 92% in Oturkpo. Conclusion: There is a need for public health-level interventions against trachoma in three LGAs of Benue State.
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Affiliation(s)
- Caleb Mpyet
- a Department of Ophthalmology , University of Jos , Jos , Nigeria.,b Sightsavers , Kaduna , Nigeria.,c Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Selassie Tagoh
- d School of Public Health and Family Medicine , University of Cape Town , Cape Town , South Africa
| | - Sophie Boisson
- e Department of Public He\alth, The Environment and Social Determinants of Health , World Health Organization , Geneva , Switzerland
| | | | - Nasiru Muhammad
- g Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | | | - Mohammed D Adamu
- g Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | | | | | - Joel Alada
- i Department of Ophthalmology , Federal Medical Centre , Makurdi , Nigeria
| | | | | | - Betty Jande
- j Ministry of Health , Benue State , Makurdi , Nigeria
| | | | - Anthony W Solomon
- l Clinical Research Department , London School of Hygiene & Tropical Medicine , London , United Kingdom.,m London Centre for Neglected Tropical Disease Research , London , United Kingdom.,n Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
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- m London Centre for Neglected Tropical Disease Research , London , United Kingdom
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21
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Mpyet C, Ramyil A, Dami N, Courtright P. Use of an inexpensive magnifier with light source in the diagnosis of trichiasis among community-based case finders in Nigeria. Ophthalmic Epidemiol 2019; 25:138-142. [PMID: 30806539 DOI: 10.1080/09286586.2018.1546876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Trichiasis case finding is challenging in many trachoma endemic countries. We sought to determine how the use of an inexpensive hand-held magnifier with light source aids in the diagnosis of people with trichiasis. METHODS We undertook a study on the use of the "Wilson", an inexpensive hand-held magnifier with light source between two groups of trained case finders: community drug distributors (CDD) volunteers and non-health volunteers. Each group was randomly allocated to be provided a Wilson or not. We compared the number of people with suspected trichiasis and the proportion of true cases referred by each group. Focus group discussions explored the perceptions of the case finders that used the Wilson on its utility in the diagnosis of trichiasis and its ease of use. RESULTS Among the 121 case finders, 61 were CDD volunteers (31 were provided the Wilson) and 60 were non-health worker volunteers (30 were provided the Wilson). Case finders that used the Wilson were 4.57 times (95% CI 2.46-8.47) more likely to have patients presenting confirmed as trichiasis compared to those not using the Wilson. Case finders that used the Wilson felt the instrument was easy to use, enlarged the eyelashes and made diagnoses of trichiasis easier. DISCUSSION In Nigeria it appears that the Wilson is easy to handle and use among trichiasis case finders enhances the diagnosis of trichiasis.
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Affiliation(s)
- Caleb Mpyet
- a Department of Ophthalmology , University of Jos , Jos , Nigeria.,b Sightsavers , Kaduna , Nigeria.,c Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Alice Ramyil
- a Department of Ophthalmology , University of Jos , Jos , Nigeria
| | - Nantok Dami
- d Department of Community Health , University of Jos , Jos , Nigeria
| | - Paul Courtright
- c Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
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22
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Umar MM, Mpyet C, Muhammad N, Adamu MD, Muazu H, Onyebuchi U, William A, Isiyaku S, Flueckiger RM, Chu BK, Willis R, Pavluck AL, Olobio N, Apake E, Olamiju F, Solomon AW. Prevalence of trachoma in 13 Local Government Areas of Taraba State, Nigeria. Ophthalmic Epidemiol 2019; 25:18-24. [PMID: 30806533 PMCID: PMC6444197 DOI: 10.1080/09286586.2017.1368670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Purpose: The purpose of these surveys was to determine the prevalence of trachomatous inflammation—follicular (TF) in children aged 1–9 years and trichiasis prevalence in persons aged ≥15 years, in 13 Local Government Areas (LGAs) of Taraba State, Nigeria. Methods: The surveys followed Global Trachoma Mapping Project (GTMP) protocols. Twenty-five households were selected from each of 25 clusters in each LGA, using two-stage cluster sampling providing probability of selection proportional to cluster size. Survey teams examined all the residents of selected households aged ≥1 year for the clinical signs TF, trachomatous inflammation—intense (TI) and trichiasis. Results: The prevalence of TF in children aged 1–9 years in the 13 LGAs ranged from 0.0–5.0%; Ussa LGA had the highest prevalence of 5% (95%CI: 3.4–7.2). Trichiasis prevalence ranged from 0.0–0.8%; seven LGAs had trichiasis prevalences above the threshold for elimination. The backlog of trichiasis in the 13 LGAs (estimated combined population 1,959,375) was 3,185 people. There is need to perform surgery for at least 1,835 people to attain a trichiasis prevalence in each LGA of <0.2% in persons aged ≥15 years. In six of the 13 LGAs, 80% of households could access washing water within 1 km of the household, but only one LGA had >80% of households with access to improved latrines. Conclusion: One of 13 LGAs requires antibiotic mass drug administration for active trachoma. Community-based trichiasis surgery needs to be provided in seven LGAs. There is a need to increase household-level access to improved washing water and latrines across the State.
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Affiliation(s)
| | - Caleb Mpyet
- b Department of Ophthalmology , University of Jos , Jos , Nigeria.,c Sightsavers, Nigeria Country Office , Kaduna , Nigeria.,d Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , South Africa
| | - Nasiru Muhammad
- e Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | - Mohammed D Adamu
- e Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | | | | | | | - Sunday Isiyaku
- c Sightsavers, Nigeria Country Office , Kaduna , Nigeria
| | | | - Brian K Chu
- h Task Force for Global Health , Decatur , GA , USA
| | | | | | | | | | | | - Anthony W Solomon
- k Clinical Research Department , London School of Hygiene & Tropical Medicine , London , United Kingdom.,l London Centre for Neglected Tropical Disease Research , London , United Kingdom
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23
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Muhammad N, Mpyet C, Adamu MD, William A, Umar MM, Muazu H, Onyebuchi U, Isiyaku S, Flueckiger RM, Chu BK, Willis R, Pavluck A, Dalhatu A, Ogoshi C, Olobio N, Gordon BA, Solomon AW, For The Global Trachoma Mapping Project. Prevalence of trachoma in the area councils of the Federal Capital Territory, Nigeria: results of six population-based surveys. Ophthalmic Epidemiol 2019; 25:11-17. [PMID: 30806532 PMCID: PMC6444205 DOI: 10.1080/09286586.2017.1367409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Purpose: The World Health Organization’s (WHO’s) global trachoma elimination programme recommends mapping of trachoma at district level for planning of elimination activities in affected populations. This study aimed to provide data on trachoma prevalence for the Area Councils of Nigeria’s Federal Capital Territory (FCT). Methods: Using the Global Trachoma Mapping Project (GTMP) protocols, in March and April 2014, we conducted a population-based cross-sectional survey in each of the six Area Councils of FCT. Signs were defined based on the WHO simplified grading scheme. Results: 98% to 100% of the targeted households were enrolled in each Area Council. The number of children aged 1–9 years examined per Area Council ranged from 867 to 1248. The number of persons aged ≥15 years examined ranged from 1302 to 1836. The age-adjusted prevalence of trachomatous inflammation—follicular in 1–9-year-olds was <5% in each Area Council. The age- and gender-adjusted prevalence of trichiasis in those aged ≥15 years ranged from 0.0% to 0.3%; two Area Councils (Gwagwalada and Kwali) had prevalences above the 0.2% elimination threshold. The proportion of households with access to improved latrines and water sources ranged from 17 to 90% and 39 to 85% respectively. Conclusions: Gwagwalada and Kwali Area Councils need to perform more trichiasis surgeries to attain the trichiasis elimination prevalence target of 0.2% in persons aged ≥15 years. No Area Council requires mass antibiotic administration for the purposes of trachoma’s elimination as a public health problem. All Area Councils need to accelerate provision of access to improved water sources and latrine facilities, to achieve universal coverage.
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Affiliation(s)
- Nasiru Muhammad
- a Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | - Caleb Mpyet
- b Ophthalmology Department , University of Jos , Jos , Nigeria.,c Sightsavers , Kaduna , Nigeria.,d Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Mohammed Dantani Adamu
- a Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | - Adamani William
- b Ophthalmology Department , University of Jos , Jos , Nigeria
| | | | | | | | - Sunday Isiyaku
- b Ophthalmology Department , University of Jos , Jos , Nigeria
| | | | - Brian K Chu
- h Task Force for Global Health , Decatur , GA , USA
| | | | - Alex Pavluck
- h Task Force for Global Health , Decatur , GA , USA
| | - Abbas Dalhatu
- i Federal Capital Territory Health Services , Abuja , Nigeria
| | - Chris Ogoshi
- n Health and Development Support Programme , Jos , Nigeria
| | | | - Bruce A Gordon
- j Department of Public Health, Environmental and Social Determinants , World Health Organization , Geneva , Switzerland
| | - Anthony W Solomon
- k Clinical Research Department , London School of Hygiene & Tropical Medicine , London , United Kingdom.,l London Centre for Neglected Tropical Disease Research , London , United Kingdom.,m Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
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Tesfazion A, Zecarias A, Zewengiel S, Willis R, Mebrahtu G, Capa E, Mpyet C, Al-Khatib T, Courtright P, Solomon AW. Progress Towards Elimination of Trachoma as a Public Health Problem in Eritrea: Results of a Systematic Review and Nine Population-based Prevalence Surveys Conducted in 2014. Ophthalmic Epidemiol 2018; 25:121-130. [PMID: 30806541 PMCID: PMC6444204 DOI: 10.1080/09286586.2018.1545036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 09/21/2018] [Accepted: 11/01/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess Eritrea's progress towards elimination of trachoma as a public health problem, we reviewed and compiled current knowledge on the distribution and burden of trachoma in Eritrea, then undertook further population-based surveys where indicated, with support from the Global Trachoma Mapping Project (GTMP). METHODS For the systematic review, undertaken in March 2014, we searched (1) PubMed, using the terms ((blind* or trachoma or trichiasis) AND Eritrea); (2) the online database of rapid assessments of avoidable blindness; (3) our own grey literature collections; and (4) the Global Atlas of Trachoma database. In June and July 2014, we conducted nine population-based prevalence surveys, for each of which 30 villages were systematically selected with probability proportional to population size; in each village, 30 households were systematically selected. All consenting residents of selected households aged ≥1 year were examined by GTMP-certified graders for signs of trachoma. Data on household-level access to water and sanitation were also collected. RESULTS One previous rapid assessment of avoidable blindness, three peer-reviewed publications, and two grey literature reports detailing sets of trachoma prevalence surveys conducted in 2006 and 2011, respectively, were located. Post-intervention impact surveys were needed in seven evaluation units (EUs, framed at sub-Zoba-level: population range 40,000-120,000) of Debub and Northern Red Sea, while baseline surveys were needed in two EUs of Anseba. Four of the seven impact survey EUs and both baseline survey EUs returned trachomatous inflammation-follicular prevalences in 1-9-year-olds of ≥5%; six of the seven impact survey EUs and one of the two baseline survey EUs returned trichiasis prevalences in ≥15-year-olds of ≥0.2%. The prevalence of access to water and sanitation varied widely between EUs. CONCLUSION Interventions are still required in Eritrea to eliminate trachoma as a public health problem. Data from these surveys will guide the Ministry of Health to undertake programme planning using a sound evidence base.
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Affiliation(s)
- Andeberhan Tesfazion
- National Program for the Prevention of Blindness, Ministry of Health, Asmara, Eritrea
| | - Alem Zecarias
- National Program for the Prevention of Blindness, Ministry of Health, Asmara, Eritrea
| | - Solomon Zewengiel
- National Program for the Prevention of Blindness, Ministry of Health, Asmara, Eritrea
| | | | | | - Eva Capa
- The Fred Hollows Foundation, Sydney, Australia
| | - Caleb Mpyet
- Department of Ophthalmology, University of Jos, Jos, Nigeria
- Sightsavers, Kaduna, Nigeria
- Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Tawfik Al-Khatib
- Department of Ophthalmology, College of Medicine, University of Sana’a, Sana’a, Yemen
- Prevention of Blindness Program, Ministry of Public Health & Population, Sana’a, Yemen
- Eye Unit, Al-Thawra Hospital, Sana’a, Yemen
| | - 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
- London Centre for Neglected Tropical Diseases Research, London, UK
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Mpyet C, Muhammad N, Adamu MD, Umar MM, Tafida A, Ogoshi C, Maidaura A, Isiyaku S, William A, Willis R, Bakhtiari A, Olobio N, Solomon AW, for the Global Trachoma Mapping Project. Prevalence of Trachoma in Four Local Government Areas of Jigawa State, Nigeria. Ophthalmic Epidemiol 2018; 25:86-92. [PMID: 30806552 PMCID: PMC6444196 DOI: 10.1080/09286586.2018.1467468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 03/17/2018] [Accepted: 04/13/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine the prevalence of trachoma and water and sanitation coverage in four local government areas (LGAs) of Jigawa State, Nigeria: Birnin Kudu, Buji, Dutse and Kiyawa. METHODOLOGY A population-based cross-sectional survey was conducted in each LGA using Global Trachoma Mapping Project (GTMP) protocols. From each LGA, 25 villages were selected using probability-proportional-to-population size sampling; in each village, 25 households were selected using the random walk technique. All residents aged ≥1 year in selected households were examined by GTMP-certified graders for trachomatous inflammation - follicular (TF) and trichiasis, defined according to the WHO simplified trachoma grading scheme definitions. Water, sanitation and hygiene data were also collected through questioning and direct observation. RESULTS In 2458 households of four LGAs, 10,669 residents were enumerated. A total of 9779 people (92% of residents) were examined, with slightly more females examined (5012; 51%) than men. In children aged 1-9 years, the age-adjusted prevalence of TF ranged from 5.1% (95% CI 2.5-9.0%) in Birnin Kudu to 12.8% (95% CI 7.6-19.4%) in Kiyawa, while the age- and gender-adjusted trichiasis prevalence in persons aged ≥15 years ranged from 1.9% (95% CI 1.4-2.5%) in Birnin Kudu to 3.1% (95% CI 2.2-4.0) in Dutse. Access to improved water sources was above 80% in all LGAs surveyed but access to improved sanitation facilities was low, ranging from 23% in Buji to 50% in Kiyawa. CONCLUSION Trachoma is a public health problem in all four LGAs surveyed. The full SAFE strategy needs to be implemented to achieve trachoma elimination.
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Affiliation(s)
- Caleb Mpyet
- Department of Ophthalmology, University of Jos, Jos, Nigeria
- Sightsavers, Kaduna, Nigeria
- Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Nasiru Muhammad
- Ophthalmology Unit, Surgery Department, Usmanu Danfodiyo University, Sokoto, Nigeria
| | | | | | | | | | | | | | | | | | | | | | - 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
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Garn JV, Boisson S, Willis R, Bakhtiari A, al-Khatib T, Amer K, Batcho W, Courtright P, Dejene M, Goepogui A, Kalua K, Kebede B, Macleod CK, Madeleine KIIM, Mbofana MSA, Mpyet C, Ndjemba J, Olobio N, Pavluck AL, Sokana O, Southisombath K, Taleo F, Solomon AW, Freeman MC. Sanitation and water supply coverage thresholds associated with active trachoma: Modeling cross-sectional data from 13 countries. PLoS Negl Trop Dis 2018; 12:e0006110. [PMID: 29357365 PMCID: PMC5800679 DOI: 10.1371/journal.pntd.0006110] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 02/06/2018] [Accepted: 11/13/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Facial cleanliness and sanitation are postulated to reduce trachoma transmission, but there are no previous data on community-level herd protection thresholds. We characterize associations between active trachoma, access to improved sanitation facilities, and access to improved water sources for the purpose of face washing, with the aim of estimating community-level or herd protection thresholds. METHODS AND FINDINGS We used cluster-sampled Global Trachoma Mapping Project data on 884,850 children aged 1-9 years from 354,990 households in 13 countries. We employed multivariable mixed-effects modified Poisson regression models to assess the relationships between water and sanitation coverage and trachomatous inflammation-follicular (TF). We observed lower TF prevalence among those with household-level access to improved sanitation (prevalence ratio, PR = 0.87; 95%CI: 0.83-0.91), and household-level access to an improved washing water source in the residence/yard (PR = 0.81; 95%CI: 0.75-0.88). Controlling for household-level water and latrine access, we found evidence of community-level protection against TF for children living in communities with high sanitation coverage (PR80-90% = 0.87; 95%CI: 0.73-1.02; PR90-100% = 0.76; 95%CI: 0.67-0.85). Community sanitation coverage levels greater than 80% were associated with herd protection against TF (PR = 0.77; 95%CI: 0.62-0.97)-that is, lower TF in individuals whose households lacked individual sanitation but who lived in communities with high sanitation coverage. For community-level water coverage, there was no apparent threshold, although we observed lower TF among several of the higher deciles of community-level water coverage. CONCLUSIONS Our study provides insights into the community water and sanitation coverage levels that might be required to best control trachoma. Our results suggest access to adequate water and sanitation can be important components in working towards the 2020 target of eliminating trachoma as a public health problem.
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Affiliation(s)
- Joshua V. Garn
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Sophie Boisson
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Rebecca Willis
- International Trachoma Initiative, The Task Force for Global Health, Decatur, GA, United States of America
| | - Ana Bakhtiari
- International Trachoma Initiative, The Task Force for Global Health, Decatur, GA, United States of America
| | | | - Khaled Amer
- Department of Ophthalmology, Ministry of Health, Cairo, Egypt
| | - Wilfrid Batcho
- Programme National de Lutte contre les Maladies Transmissibles, Ministère de la Santé, Cotonou, Bénin
| | - Paul Courtright
- Division of Ophthalmology, Kilimanjaro Centre for Community Ophthalmology International, University of Cape Town, Cape Town, South Africa
| | - Michael Dejene
- Michael Dejene Public Health Consultancy Services, Addis Ababa, Ethiopia
| | - Andre Goepogui
- Ministère de la Santé, Programme Oncho-Cécité-MTN, Conakry, République de Guinée
| | - Khumbo Kalua
- Department of Ophthalmology, Blantyre Institute for Community Ophthalmology, College of Medicine, Blantyre, Malawi, Malawi
| | - Biruck Kebede
- Disease Prevention and Control Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
| | | | | | | | - Caleb Mpyet
- Division of Ophthalmology, Kilimanjaro Centre for Community Ophthalmology International, University of Cape Town, Cape Town, South Africa
- Department of Ophthalmology, University of Jos, Jos, Nigeria
- Sightsavers, Kaduna, Nigeria
| | - Jean Ndjemba
- Direction de Lutte contre la Maladie, Kinshasa, Ministere de la Santé Publique, Republique Democratique du Congo
| | - Nicholas Olobio
- Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | - Alexandre L. Pavluck
- International Trachoma Initiative, The Task Force for Global Health, Decatur, GA, United States of America
| | - Oliver Sokana
- Eye Department, Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Khamphoua Southisombath
- National Ophthalmology Center, Ministry of Health, Vientiane, Lao People’s Democratic Republic
| | | | - 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
| | - Matthew C. Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
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Mpyet C, Muhammad N, Adamu MD, Muazu H, Umar MM, Goyol M, Yahaya HB, Onyebuchi U, Ogoshi C, Hussaini T, Isiyaku S, William A, Flueckiger RM, Chu BK, Willis R, Pavluck AL, Olobio N, Phelan S, Macleod C, Solomon AW. Prevalence of Trachoma in Kano State, Nigeria: Results of 44 Local Government Area-Level Surveys. Ophthalmic Epidemiol 2017; 24:195-203. [PMID: 28276755 PMCID: PMC6837865 DOI: 10.1080/09286586.2016.1265657] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE We sought to determine the prevalence of trachoma in 44 Local Government Areas (LGAs) of Kano State, Nigeria. METHODS A population-based prevalence survey was conducted in each Kano LGA. We used a two-stage systematic and quasi-random sampling strategy to select 25 households from each of 25 clusters in each LGA. All consenting household residents aged 1 year and above were examined for trachomatous inflammation-follicular (TF), trachomatous inflammation-intense (TI) and trichiasis. RESULTS State-wide crude prevalence of TF in persons aged 1-9 years was 3.4% (95% CI 3.3-3.5%), and of trichiasis in those aged ≥15 years was 2.3% (95% CI 2.1-2.4%). LGA-level age- and sex-adjusted trichiasis prevalence in those aged ≥15 years ranged from 0.1% to 2.9%. All but 4 (9%) of 44 LGAs had trichiasis prevalences in adults above the elimination threshold of 0.2%. State-wide prevalence of trichiasis in adult women was significantly higher than in adult men (2.6% vs 1.8%; OR = 1.5, 95% CI 1.3-1.7; p = 0.001). Four of 44 LGAs had TF prevalences in 1-9-year-olds between 10 and 15%, while another six LGAs had TF prevalences between 5 and 9.9%. In 37 LGAs, >80% of households had access to water within 30 minutes round-trip, but household latrine access was >80% in only 19 LGAs. CONCLUSION Trichiasis is a public health problem in most LGAs in Kano. Surgeons need to be trained and deployed to provide community-based trichiasis surgery, with emphasis on delivery of such services to women. Antibiotics, facial cleanliness and environmental improvement are needed in 10 LGAs.
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Affiliation(s)
- Caleb Mpyet
- a Department of Ophthalmology , University of Jos , Jos , Nigeria.,b Sightsavers , Kaduna , Nigeria
| | - Nasiru Muhammad
- c Department of Ophthalmology , Usman Danfodiyo University Teaching Hospital , Sokoto , Nigeria
| | - Mohammed Dantani Adamu
- c Department of Ophthalmology , Usman Danfodiyo University Teaching Hospital , Sokoto , Nigeria
| | | | | | - Musa Goyol
- f Netherlands Leprosy Relief , Jos , Nigeria
| | - Hadi Bala Yahaya
- g Department of Ophthalmology , Murtala Mohammed Specialist Hospital , Kano , Nigeria
| | - Uwazoeke Onyebuchi
- h National Trachoma Control Program, Department of Public Health , Federal Ministry of Health , Abuja , Nigeria
| | | | | | | | | | | | - Brian K Chu
- k Task Force for Global Health , Decatur , GA , USA
| | | | | | - Nicholas Olobio
- h National Trachoma Control Program, Department of Public Health , Federal Ministry of Health , Abuja , Nigeria
| | - Sophie Phelan
- l Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
| | - Colin Macleod
- m Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK
| | - Anthony W Solomon
- l Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland.,m Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.,n London Centre for Neglected Tropical Disease Research , London , UK
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Ramyil A, Bascaran C, Bunce C, Alada J, Wade P, Mpyet C. Outcome of trachoma lid surgeries in Jigawa state, Nigeria. Cogent Medicine 2016. [DOI: 10.1080/2331205x.2016.1233683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Alice Ramyil
- Department of Ophthalmology, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Catey Bunce
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- University College London (UCL), London, UK
| | - Joel Alada
- Department of Ophthalmology, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
| | - Patricia Wade
- Department of Ophthalmology, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
| | - Caleb Mpyet
- Department of Ophthalmology, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
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Ramyil A, Bascaran C, Bunce C, Wade P, Oyediji F, Mpyet C. An assessment of trichiasis surgery workforce in Jigawa State, Nigeria. Cogent Medicine 2016. [DOI: 10.1080/2331205x.2016.1259145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- A.V. Ramyil
- Depatment of Ophthalmology, Jos UniversityTeaching Hospital, Jos, Nigeria
| | - C. Bascaran
- Clinical Research Department, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Catey Bunce
- Department of Medical statistics, King's college London,, London, UK
| | - P. Wade
- Depatment of Ophthalmology, Jos UniversityTeaching Hospital, Jos, Nigeria
| | - F. Oyediji
- Depatment of Ophthalmology, Jos UniversityTeaching Hospital, Jos, Nigeria
| | - C. Mpyet
- Depatment of Ophthalmology, Jos UniversityTeaching Hospital, Jos, Nigeria
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Muhammad N, Mpyet C, Adamu MD, William A, Umar MM, Goyol M, Muazu H, Onyebuchi U, Isiyaku S, Flueckiger RM, Chu BK, Willis R, Pavluck AL, Alhassan A, Olobio N, Gordon BA, Solomon AW. Mapping Trachoma in Kaduna State, Nigeria: Results of 23 Local Government Area-Level, Population-Based Prevalence Surveys. Ophthalmic Epidemiol 2016; 23:46-54. [PMID: 27918227 PMCID: PMC5706975 DOI: 10.1080/09286586.2016.1250918] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]
Abstract
INTRODUCTION To prepare for global elimination of trachoma by 2020, the World Health Organization (WHO) recommends mapping of trachoma at district-level to enable planning of elimination activities in affected populations. The aim of our study was to provide data on trachoma for each local government area (LGA) of Kaduna State, Nigeria, as such data were previously unavailable. METHOD As part of the Global Trachoma Mapping Project (GTMP), a population-based cross-sectional trachoma survey was conducted in each of the 23 LGAs of Kaduna State, between May and June 2013. The protocols of the GTMP were used. RESULTS The prevalence of trachomatous inflammation - follicular (TF) in children aged 1-9 years was between 0.03% and 8% across the LGAs, with only one LGA (Igabi) having a TF prevalence ≥5%. The LGA-level prevalences of trichiasis in persons aged 15 years and older were between 0.00% and 0.78%. Eleven LGAs had trichiasis prevalences of 0.2% and over in adults; a threshold equivalent to 1 case per 1000 total population. The LGA-level proportion of households with access to improved water sources ranged from 9% to 96%, while household access to latrines ranged from 5% to 99%. CONCLUSION Kaduna State has generally hypoendemic trachoma, but a few trichiasis surgeries are still required to attain the WHO elimination targets. Better access to improved water and sanitation is needed.
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Affiliation(s)
- Nasiru Muhammad
- a Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | - Caleb Mpyet
- b Sightsavers , Kaduna , Nigeria.,c Ophthalmology Department , University of Jos , Jos , Nigeria
| | - Mohammed Dantani Adamu
- a Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | | | | | | | | | | | | | | | - Brian K Chu
- h Task Force for Global Health , Decatur , GA , USA
| | | | | | | | | | - Bruce A Gordon
- j Water Sanitation and Hygiene, Department of Public Health , Social and Environmental Determinants of Health, World Health Organization , Geneva , Switzerland
| | - Anthony W Solomon
- k Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.,l London Centre for Neglected Tropical Disease Research , London , UK
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Adamu MD, Mpyet C, Muhammad N, Umar MM, Muazu H, Olamiju F, Isiyaku S, Onyebuchi U, Bosso UA, William A, Nwobi BC, Willis R, Flueckiger RM, Pavluck A, Chu BK, Olobio N, Solomon AW. Prevalence of Trachoma in Niger State, North Central Nigeria: Results of 25 Population-Based Prevalence Surveys Carried Out with the Global Trachoma Mapping Project. Ophthalmic Epidemiol 2016; 23:63-69. [PMID: 27918223 PMCID: PMC5706972 DOI: 10.1080/09286586.2016.1242757] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Purpose: To determine the prevalence of trachoma in each of the 25 local government areas (LGAs) of Niger State, Nigeria. Methods: A population-based cross-sectional survey was conducted in each Niger State LGA between March and April 2014, as part of the Global Trachoma Mapping Project (GTMP). GTMP protocols were used in planning and conduct of the surveys. Using probability proportional to size, 25 clusters were selected; in each of these clusters, 25 households were enrolled for the survey. All residents aged 1 year and older were examined by GTMP-certified graders for trachomatous inflammation – follicular (TF) and trichiasis using the World Health Organization simplified grading scheme. Additionally, we collected data on household water and sanitation facilities. Results: Only one LGA (Kontagora) had TF prevalence in 1–9-year-olds above 10%; one other LGA (Rafi) had TF prevalence between 5.0 and 9.9%. Six LGAs need trichiasis surgical services provided to achieve a prevalence of <1 case of trichiasis per 1000 total population. The proportion of households with access to improved water sources ranged from 23 to 100%, while household-level access to improved latrines ranged from 8 to 100% across the LGAs. Conclusion: The prevalence of trachoma is relatively low in most of Niger State. There is a need for community-based trichiasis surgical services in a small number of LGAs. The trachoma elimination program could engage water and sanitation agencies to augment access to improved water and sanitation facilities, for human rights reasons. Kontagora and Rafi need community-based interventions to reduce the prevalence of active trachoma.
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Affiliation(s)
- Mohammed Dantani Adamu
- a Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | - Caleb Mpyet
- b Sightsavers, Nigeria country office , Kaduna , Nigeria.,c Department of Ophthalmology , University of Jos , Jos , Nigeria
| | - Nasiru Muhammad
- a Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | | | | | | | - Sunday Isiyaku
- b Sightsavers, Nigeria country office , Kaduna , Nigeria
| | | | | | | | | | | | | | | | - Brian K Chu
- i Task Force for Global Health , Decatur, GA , USA
| | | | - Anthony W Solomon
- j Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK
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Mpyet C, Muhammad N, Adamu MD, Muazu H, Umar MM, Abdull M, Alada J, Goyol M, Onyebuchi U, Olamiju F, Isiyaku S, William A, Nwobi BC, Willis R, Flueckiger RM, Pavluck A, Chu BK, Olobio N, Solomon AW. Prevalence of Trachoma in Bauchi State, Nigeria: Results of 20 Local Government Area-Level Surveys. Ophthalmic Epidemiol 2016; 23:39-45. [PMID: 27846369 PMCID: PMC5706969 DOI: 10.1080/09286586.2016.1238945] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
PURPOSE To determine the prevalence of trachomatous inflammation - follicular (TF) and trichiasis in each of the 20 local government areas (LGAs) of Bauchi State, Nigeria. METHODS We undertook a population-based prevalence survey in each LGA in Bauchi State, employing the Global Trachoma Mapping Project methodology. We used a 2-stage, systematic and quasi-random sampling strategy. Using probability proportional to size, we selected 25 clusters, in each of which 25 households were selected by random walk. All residents of selected households 1 year and older were examined for TF, trachomatous inflammation - intense, and trichiasis, using the World Health Organization simplified grading scheme. RESULTS Only two LGAs in Bauchi State had TF prevalences in 1-9-year-olds over 5%, with none having TF prevalences of 10% or greater. Only one LGA had a trichiasis prevalence in adults below the elimination threshold; all the others had trichiasis at levels suggestive of public health significance. In all 20 LGAs, more than 60% of households were within 1 km of an improved source of water for hygiene. CONCLUSION Efforts need to be made in Bauchi State to provide trichiasis surgery in order to avert trachomatous blindness. Water supplies needs to be sustained and good personal hygiene practices assured so that elimination of trachoma as a public health problem will be achieved and sustained.
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Affiliation(s)
- Caleb Mpyet
- a Department of Ophthalmology , University of Jos , Jos , Nigeria.,b Sightsavers , Kaduna , Nigeria.,c Department of Ophthalmology , Jos University Teaching Hospital , Jos , Nigeria
| | - Nasiru Muhammad
- d Department of Ophthalmology , Usmanu Danfodiyo University Teaching Hospital, Sokoto , Nigeria
| | - Mohammed Dantani Adamu
- d Department of Ophthalmology , Usmanu Danfodiyo University Teaching Hospital, Sokoto , Nigeria
| | | | | | - Mohammed Abdull
- g Abubakar Tafawa Balewa University Teaching Hospital , Bauchi , Nigeria
| | - Joel Alada
- c Department of Ophthalmology , Jos University Teaching Hospital , Jos , Nigeria
| | - Musa Goyol
- h Netherlands Leprosy Relief, Jos , Nigeria
| | - Uwaezuoke Onyebuchi
- i National Trachoma Control Program, Department of Public Health, Federal Ministry of Health , Abuja , Nigeria
| | | | | | | | - Benjamin C Nwobi
- i National Trachoma Control Program, Department of Public Health, Federal Ministry of Health , Abuja , Nigeria
| | | | | | - Alex Pavluck
- k Task Force for Global Health , Decatur , GA , USA
| | - Brian K Chu
- k Task Force for Global Health , Decatur , GA , USA
| | - Nicholas Olobio
- i National Trachoma Control Program, Department of Public Health, Federal Ministry of Health , Abuja , Nigeria
| | - Anthony W Solomon
- l Clinical Research Department, London School of Hygiene & Tropical Medicine , London , UK.,m London Centre for Neglected Tropical Disease Research , London , UK
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Mpyet C, Muhammad N, Adamu MD, Muazu H, Umar MM, Goyol M, Onyebuchi U, Chima I, Idris H, William A, Isiyaku S, Nwobi B, Flueckiger RM, Willis R, Pavluck A, Chu BK, Olobio N, Solomon AW. Prevalence of Trachoma in Katsina State, Nigeria: Results of 34 District-Level Surveys. Ophthalmic Epidemiol 2016; 23:55-62. [PMID: 27775463 PMCID: PMC5751970 DOI: 10.1080/09286586.2016.1236975] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Purpose: To determine the local government area (LGA)-level prevalence of trachoma in all 34 LGAs of Katsina State. Methods: A population-based prevalence survey was conducted in each LGA of Katsina State, using the Global Trachoma Mapping Project methodology. We used a 3-stage cluster random sampling strategy to select 25 households from each of 25 clusters. We examined all residents of selected households aged 1 year and older for the clinical signs of trachomatous inflammation–follicular (TF), trachomatous inflammation–intense and trichiasis, using the World Health Organization (WHO) simplified grading scheme. Results: We examined 129,281 persons. Six LGAs had a TF prevalence ≥10%, and another six LGAs had a TF prevalence between 5% and 9.9%; all 12 require mass drug administration with azithromycin plus other interventions. The prevalence of trichiasis was ≥1.0% in 13 LGAs, and there is a need to perform trichiasis surgery in over 26,000 persons to reach targets set by the WHO for elimination of trichiasis. Conclusion: The prevalence of TF is generally low in Katsina state, but urgent steps must be taken to implement the full SAFE strategy (surgery, antibiotics, facial cleanliness, environmental improvement) in at least 12 LGAs while also stepping up efforts to provide community-based trichiasis surgery throughout the whole state, in order to make trachoma elimination by 2020 a reality.
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Affiliation(s)
- Caleb Mpyet
- a Department of Ophthalmology , University of Jos , Jos , Nigeria.,b Sightsavers , Kaduna , Nigeria
| | - Nasiru Muhammad
- c Ophthalmology Department , Usmanu Danfodiyo University Teaching Hospital , Sokoto , Nigeria
| | - Mohammed Dantani Adamu
- c Ophthalmology Department , Usmanu Danfodiyo University Teaching Hospital , Sokoto , Nigeria
| | | | | | - Musa Goyol
- f Netherlands Leprosy Relief, Jos , Nigeria
| | - Uwazoeke Onyebuchi
- g National Trachoma Control Program, Department of Public Health , Federal Ministry of Health , Abuja , Nigeria
| | - Ima Chima
- h Helen Keller International , Nigeria
| | - Haliru Idris
- i Katsina State Ministry of Health , Katsina , Nigeria
| | | | | | - Benjamin Nwobi
- g National Trachoma Control Program, Department of Public Health , Federal Ministry of Health , Abuja , Nigeria
| | | | | | | | - Brian K Chu
- j Task Force for Global Health , Decatur , GA , USA
| | - Nicholas Olobio
- g National Trachoma Control Program, Department of Public Health , Federal Ministry of Health , Abuja , Nigeria
| | - Anthony W Solomon
- k Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.,l London Centre for Neglected Tropical Diseases Research , London , UK
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Mpyet C, Muhammad N, Adamu MD, Muazu H, Umar MM, Alada J, Onyebuchi U, Olamiju F, Isiyaku S, William A, Willis R, Flueckiger RM, Pavluck A, Chu BK, Mohammed D, Olobio N, Solomon AW. Trachoma Mapping in Gombe State, Nigeria: Results of 11 Local Government Area Surveys. Ophthalmic Epidemiol 2016; 23:406-411. [PMID: 27726459 PMCID: PMC6839962 DOI: 10.1080/09286586.2016.1230633] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Purpose To determine the need or otherwise for establishment of a trachoma elimination program in Gombe State, Nigeria, by estimating the population-based prevalence of trachoma in each Local Government Area (LGA) of Gombe. Methods Using a multi-stage, systematic, random, and quasi-random sampling approach and Global Trachoma Mapping Project support, we selected 25 clusters in each LGA. In each cluster, we selected 25 households and all consenting residents aged 1 year and older were examined for trachomatous inflammation–follicular (TF) and trichiasis, using the World Health Organization simplified grading scheme. Results No LGA in Gombe State had a TF prevalence ≥5% in 1–9-year-olds. All LGAs had trichiasis prevalences above the elimination threshold and should be targeted for community-based delivery of trichiasis surgery. Only three LGAs had household-level improved wash water access of greater than 80%. Access to improved sanitation facilities was also poor as household access to improved sanitation facilities was above 80% in only one LGA. Conclusion A trachoma program focused on delivery of trichiasis surgery is required in Gombe. Improvements in water and sanitation, through engagement with other sectors, are necessary.
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Affiliation(s)
- Caleb Mpyet
- a Department of Ophthalmology , University of Jos , Jos , Nigeria.,b Sightsavers , Kaduna , Nigeria.,c Department of Ophthalmology , Jos University Teaching Hospital , Jos , Nigeria
| | - 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
- c Department of Ophthalmology , Jos University Teaching Hospital , Jos , Nigeria
| | - Uwazoeke Onyebuchi
- g National Trachoma Control Program, Department of Public Health , Federal Ministry of Health , Abuja , Nigeria
| | | | | | | | | | | | | | - Brian K Chu
- i Task Force for Global Health , Decatur , GA , USA
| | | | - Nicholas Olobio
- g National Trachoma Control Program, Department of Public Health , Federal Ministry of Health , Abuja , Nigeria
| | - Anthony W Solomon
- k Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.,l London Centre for Neglected Tropical Disease Research , London , UK
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Abstract
PURPOSE To determine the magnitude of trachoma and the prevalent forms of the disease, and to provide baseline data for the establishment of a trachoma control program in Jigawa State, northwestern Nigeria. METHODS A population-based cross-sectional survey was conducted in Jigawa State in May 2007 using a 2-stage cluster random sampling technique to select 4598 persons from 40 villages based on probability proportional to size. All participants were examined using a penlight and a 2.5 × binocular loupe for signs of trachoma, and graded using the World Health Organization (WHO) simplified grading system. RESULTS A total of 4598 people were seen with 99.96% coverage. Of these, 2460 (53.5%) were female and 2138 (46.5%) were male. Mean age was 21.6 years ( ± 19.8 years). The prevalence of follicular trachoma in children aged ≤9 years was 20.5% (95% confidence interval, CI, 18.7-22.4%) with no difference between the sexes. The prevalence of trichiasis in adults aged ≥15 years was 5%, and the prevalence was higher in females than males (odds ratio 2.60, 95% CI 2.06-3.28; p < 0.001). CONCLUSION Trachoma is a major problem in Jigawa State; there is a need to train trichiasis surgeons and empower them to carry out community-based surgery. District-level prevalence of trachoma needs to be determined to know which aspects of the WHO SAFE strategy (surgery, antibiotics, facial cleanliness and environmental improvements) need to be emphasized in each district.
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Affiliation(s)
- Alice Ramyil
- Department of Ophthalmology, University of Jos and Jos University Teaching Hospital , Jos , Nigeria
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Solomon AW, Pavluck AL, Courtright P, Aboe A, Adamu L, Alemayehu W, Alemu M, Alexander NDE, Kello AB, Bero B, Brooker SJ, Chu BK, Dejene M, Emerson PM, Flueckiger RM, Gadisa S, Gass K, Gebre T, Habtamu Z, Harvey E, Haslam D, King JD, Mesurier RL, Lewallen S, Lietman TM, MacArthur C, Mariotti SP, Massey A, Mathieu E, Mekasha A, Millar T, Mpyet C, Muñoz BE, Ngondi J, Ogden S, Pearce J, Sarah V, Sisay A, Smith JL, Taylor HR, Thomson J, West SK, Willis R, Bush S, Haddad D, Foster A. The Global Trachoma Mapping Project: Methodology of a 34-Country Population-Based Study. Ophthalmic Epidemiol 2016; 22:214-25. [PMID: 26158580 PMCID: PMC4687001 DOI: 10.3109/09286586.2015.1037401] [Citation(s) in RCA: 165] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose: To complete the baseline trachoma map worldwide by conducting population-based surveys in an estimated 1238 suspected endemic districts of 34 countries. Methods: A series of national and sub-national projects owned, managed and staffed by ministries of health, conduct house-to-house cluster random sample surveys in evaluation units, which generally correspond to “health district” size: populations of 100,000–250,000 people. In each evaluation unit, we invite all residents aged 1 year and older from h households in each of c clusters to be examined for clinical signs of trachoma, where h is the number of households that can be seen by 1 team in 1 day, and the product h × c is calculated to facilitate recruitment of 1019 children aged 1–9 years. In addition to individual-level demographic and clinical data, household-level water, sanitation and hygiene data are entered into the purpose-built LINKS application on Android smartphones, transmitted to the Cloud, and cleaned, analyzed and ministry-of-health-approved via a secure web-based portal. The main outcome measures are the evaluation unit-level prevalence of follicular trachoma in children aged 1–9 years, prevalence of trachomatous trichiasis in adults aged 15 + years, percentage of households using safe methods for disposal of human feces, and percentage of households with proximate access to water for personal hygiene purposes. Results: In the first year of fieldwork, 347 field teams commenced work in 21 projects in 7 countries. Conclusion: With an approach that is innovative in design and scale, we aim to complete baseline mapping of trachoma throughout the world in 2015.
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Affiliation(s)
- Anthony W Solomon
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine , London , UK
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Kalua K, Phiri M, Kumwenda I, Masika M, Pavluck AL, Willis R, Mpyet C, Lewallen S, Courtright P, Solomon AW. Baseline Trachoma Mapping in Malawi with the Global Trachoma Mapping Project (GTMP). Ophthalmic Epidemiol 2016; 22:176-83. [PMID: 26158575 PMCID: PMC4673584 DOI: 10.3109/09286586.2015.1035793] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: To determine the prevalence of trachoma in all suspected endemic districts in Malawi. Methods: A population-based survey conducted in 16 evaluation units from 12 suspected endemic districts in Malawi (population 6,390,517), using the standardized Global Trachoma Mapping Project (GTMP) protocol. A 2-stage cluster-random sampling design selected 30 households from each of 30 clusters per evaluation unit; all residents aged 1 year and older in selected households were examined for evidence of follicular trachoma (TF), intense trachomatous inflammation (TI), and trachomatous trichiasis (TT). Results: Four of the 16 evaluation units were found to be endemic for trachoma, with a prevalence range of 10.0–13.5% for TF and 0.2–0.6% for TT. Nine evaluation units had a TF prevalence between 5.0% and 9.9% while three evaluation units had a TF prevalence <5.0%. Conclusion: The prevalence rates of active trachoma in Malawi were not uniform among suspected endemic evaluation units, with rates higher than the World Health Organization (WHO) threshold for implementation of community-based control measures (TF ≥ 10.0%) in only 4 of the 16 evaluation units. Trachoma remains a disease of public health importance in some parts of Malawi and adjoining (unmapped) districts should be prioritized for mapping. According to the survey, an additional 3,169,362 people require intervention to reduce active disease and 1557 trichiasis surgeries are needed to reduce the prevalence of TT below WHO recommended thresholds.
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Affiliation(s)
- Khumbo Kalua
- Department of Ophthalmology, University of Malawi, College of Medicine , Blantyre , Malawi
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Mpyet C. RETINAL DISEASES: THE NEED TO BE BETTER PREPARED. J West Afr Coll Surg 2015; 5:x-xii. [PMID: 27830129 PMCID: PMC5036289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- C Mpyet
- Department of Ophthalmology, Jos University Teaching Hospital, Jos, Nigeria
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Abstract
Background In northern Nigeria, trachoma is an important public health problem, but there are currently few population-based data on prevalence of disease and no formal trachoma control programs. Methodology / Principal Findings In Kano state, Nigeria, we conducted a population-based cross-sectional survey using multistage cluster random sampling, combining examination for clinical signs of trachoma and application of questionnaires assessing potential household-level risk factors. A total of 4491 people were examined in 40 clusters, of whom 1572 were aged 1–9 years, and 2407 (53.6%) were female. In 1–9 year-olds, the prevalence of trachomatous inflammation–follicular (TF) was 17.5% (95% CI: 15.7–19.5%). In a multivariate model, independent risk factors for active trachoma were the presence of flies on the face (OR 1.98, 95% CI 1.30–3.02); a dirty face (OR 2.45, 95% CI 1.85–3.25) and presence of animal dung within the compound of residence (OR 3.46, 95% CI 1.62–7.41). The prevalence of trachomatous trichiasis in persons aged ≥15years was 10.9% (95% CI: 9.7–12.2%). Trichiasis was significantly more common in adult females than in adult males. Conclusion/Significance There is an urgent need for a trachoma control program in Kano state, with emphasis given to provision of good quality trichiasis surgery. Particular effort will need to be made to identify women with trichiasis and engage them with appropriate services while also taking steps to secure azithromycin for mass treatment and ensuring personal and environmental hygiene.
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Affiliation(s)
- Caleb Mpyet
- Department of Ophthalmology, Jos University Teaching Hospital, Jos, Nigeria.
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Mpyet C, Goyol M, Ogoshi C. Personal and environmental risk factors for active trachoma in children in Yobe state, north-eastern Nigeria. Trop Med Int Health 2010; 15:168-72. [DOI: 10.1111/j.1365-3156.2009.02436.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Affiliation(s)
- Caleb Mpyet
- Department of Ophthalmology, University of Jos Teaching Hospital, Jos, Nigeria
| | - Chris Ogoshi
- , CBM Vision2020 Support Programme, Jos, Nigeria
| | - Musa Goyol
- , CBM Vision2020 Support Programme, Jos, Nigeria
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Abstract
BACKGROUND To determine the indications and procedures used for removing the eye in adults in our environment. METHOD A retrospective study of destructive ocular surgeries carried out between January 1999 and December 2003. Theatre and case records of adult patients that underwent surgical removal of the eye over a five-year period were reviewed. Clinical and histological diagnoses were obtained as well as type of surgery and personal data. Results were analysed using simple percentages. RESULTS The most common indication for removing the eye in adults was due to trauma in 47 (45.6%) cases while evisceration was the most common surgery performed in 91 (88.3%) cases. Males were three times more likely to lose an eye than females. In 74.8% of cases, the loss of an eye was in young persons less than 50 years. CONCLUSION The economically productive age group are more likely to lose an eye. The reason for the loss of an eye in most cases is largely avoidable. Lack of education on ways to prevent ocular injuries and improved access to eye care services requires urgent attention.
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Affiliation(s)
- C Mpyet
- Department of Ophthalmology, University of Jos Teaching Hospital, Jos, Nigeria.
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Mpyet C, Langnap L, Akpan S. Outcome and benefits of small incision cataract surgery in Jos, Nigeria. Niger J Clin Pract 2007; 10:162-5. [PMID: 17902511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Cataract is the most common cause of blindness and cataract surgery is a common procedure. There is a need for a low cost, safe and effective form of cataract surgery for the developing world. This study reports the outcome of small incision cataract surgery in a developing country. METHODS Eyes without coexisting ocular disease but with mature cataracts were operated upon. Small incision cataract surgery technique was used and patients were prospectively followed up. The procedure involved whole nucleus delivery through a sclerocorneal tunnel wound and insertion of a posterior chamber lens. Eyes examined at five days and six weeks after surgery are reported on for uncorrected visual acuity, complications of surgery and causes of poor outcome where applicable. RESULTS Seventy-one eyes were included in this study. Uncorrected visual acuity at five days postop was good in 31 (43.7%) eyes and 49 (69.0%) eyes after six weeks of surgery. Six weeks postop, four (5.6%) eyes had poor outcome. The most common intraoperative complication was rupture of the posterior capsule while retinal lesions were the most common cause of poor visual outcome. CONCLUSION Small incision cataract surgery offers faster visual recovery, is cost effective and has the prospects for increasing the uptake of cataract surgery in a developing country.
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Affiliation(s)
- C Mpyet
- Department of Ophthalmology, University of Jos Teaching Hospital, Jos, Nigeria.
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Abstract
Corneal blindness is second only to cataract as a cause of blindness in leprosy patients. Eyelid surgery provided by trained paramedical staff can often prevent blindness in these patients. We sought to determine the extent to which paramedic personnel are meeting the eyelid surgical needs of these patients and to investigate the barriers that may be preventing them from seeking surgery. A total of eight leprosy settlements in north-eastern Nigeria were selected for this study. In these villages, 480 residents who were 30 years of age or older who had been diagnosed as having leprosy had their eyes examined for the presence of lagophthalmos, entropion/trichiasis and evidence of surgery for either of these conditions. Patients who had not been operated on for either of these conditions were questioned to determine their reasons for not seeking surgery. One hundred and sixteen (12.1 %) eyes were in need of surgery while 5.1 % of eyes had been operated upon. The surgical coverage for eyelid surgery was 30%; lagophthalmos had a better surgical coverage of 44.4% compared to entropion/trichiasis, which had 24.7% coverage. Lack of awareness about the treatment available was the most common reason given for not seeking surgery. This study shows that despite the presence of trained paramedical staff in the community, the eyelid surgical needs of these patients are not being met primarily because the level of awareness about the availability of effective treatment still remains low. In addition, the readiness of eye-care staff to visit these settlements was disappointing. Extra efforts will have to be made.
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Affiliation(s)
- Caleb Mpyet
- Department of Ophthalmology, University of Jos Teaching Hospital, Jos, Nigeria.
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Mpyet C, Dineen BP, Solomon AW. Cataract surgical coverage and barriers to uptake of cataract surgery in leprosy villages of north eastern Nigeria. Br J Ophthalmol 2005; 89:936-8. [PMID: 16024837 PMCID: PMC1772756 DOI: 10.1136/bjo.2004.062455] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To determine the coverage, outcome, and barriers to uptake of cataract surgery in leprosy villages of north eastern Nigeria. METHODS People 30 years and above resident in eight leprosy villages were examined. Cataract blind people were questioned about the reasons they had not been treated. Subjects who had received an operation for cataract were examined to determine the outcome and, where applicable, the causes of poor outcome. RESULTS 480 people were examined. Cataract was the commonest cause of blindness. The cataract surgical coverage (people) was 39.2% for orthodox surgery and 29.7% for couching. After surgery, visual acuity > or =3/60 had been restored to 82.1% of eyes that had had orthodox surgery, but only 58.6% of eyes that had been couched. Cost was the commonest reason given for not seeking treatment for cataract. CONCLUSIONS Cataract is the major cause of blindness in this population but cataract surgical needs are currently not being met. There is a need for better collaboration between leprosy control and ophthalmic services, improved education of people affected by leprosy, a commitment to improving orthodox cataract surgery outcomes, and consideration of a possible role for traditional healers as sources of referral for orthodox surgical services.
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Affiliation(s)
- C Mpyet
- Department of Opthamology, Jos University Teaching Hospital, Jos, Nigeria
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Abstract
AIMS To determine the prevalence and spectrum of ocular pathology, and the prevalence and causes of blindness and low vision in leprosy villages of north eastern Nigeria. METHODS People affected by leprosy, aged 30 years and above, resident in eight leprosy villages were invited to participate. Ocular examination was undertaken of each consenting individual. RESULTS 480 people were examined. 456 (48%) of 960 eyes had at least one ocular lesion, but only 37% of all lesions were leprosy related and potentially sight threatening. The prevalence of blindness (VA<3/60 with available correction) was 10.4%. An additional 7.5% of subjects were severely visually impaired (3/60< or =VA<6/60). Cataract was the commonest cause of blindness. Other major causes were non-trachomatous corneal opacity and trachoma. CONCLUSIONS Blindness and low vision are highly prevalent among leprosy patients in this setting. Only a third of the burden of ocular pathology is related to the direct effects of leprosy. Efforts to reduce the backlog of cataract and trichiasis, to improve early detection and management of lagophthalmos, and to provide refractive services are urgently required.
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Affiliation(s)
- C Mpyet
- Department of Ophthalmology, Jos University Teaching Hospital, Jos, Nigeria
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Mpyet C. Integration of eye care into a leprosy hospital service: experience in Mangu, Nigeria. LEPROSY REV 2004; 75:103-4. [PMID: 15072135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Mpyet C. Integration of eye care into a leprosy hospital service: experience in Mangu, Nigeria. LEPROSY REV 2004. [DOI: 10.47276/lr.75.1.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mpyet C, Oko H, Mypet C. Results of intra-operative 0.5mg/ml mitomycin C with 20mg depo steroid in the treatment of primary pterygium. Cent Afr J Med 2000; 46:330-2. [PMID: 11486474 DOI: 10.4314/cajm.v46i12.8580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The effectiveness of intra-operative mitomycin C on the recurrence rate of pterygium in patients undergoing primary pterygium excision was assessed. METHOD 51 consecutive primary pterygia of 46 patients were excised between April and December 1998. 0.5 mg/ml mitomycin C was applied on bare sclera for one minute and 20 mg depot steroid injected subconjunctivally. Post operatively patients were placed on Gutt Dexamethasone 0.1% with antazoline and chloramphenicol 1.0%. RESULTS Follow up ranged from four to 14 months. There was no recurrence of pterygium. Side effects of treatment included: delayed wound healing, avascularised sclera and pyogenic granuloma. CONCLUSION This study suggests that intraoperative application of 0.5 mg/ml mitomyin C with 20 mg depot steroid following primary pterygium excision is effective and safe in preventing recurrence.
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Affiliation(s)
- C Mpyet
- Department of Ophthalmology, Jos University Teaching Hospital, PMB 2076, Jos, Nigeria
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