1921
Volume 77, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

We aimed to investigate prevalence of potential risk factors, and associations between risk factors and active trachoma in southern Sudan. Surveys were undertaken in ten sites and children aged 1–9 years examined for trachoma. Risk factors were assessed through interviews and observations. Using ordinal logistic regression, associations between severity of active trachoma and risk factors were explored. Trachomatous inflammation-intense (TI) was considered more severe than trachomatous inflammation-follicular (TF). A total of 7,418 children were included in the analysis. Risk factors and prevalences were unclean face, 52.3%; face washed less than twice daily, 50.8%; water collection > 30 minutes, 38.1%; absence of latrines, 95.4%; garbage disposal within 20 m, 74.4%; cattle ownership, 69.2%; and flies, 83.3%. After adjusting for age and sex, unclean face, less frequent face washing, cattle ownership, and increasing fly density were found to be independently associated with severity of active trachoma. Our study suggests that facial hygiene and environmental sanitation are priority trachoma-control interventions in southern Sudan.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2007.77.126
2007-07-01
2017-11-18
Loading full text...

Full text loading...

/deliver/fulltext/14761645/77/1/0770126.html?itemId=/content/journals/10.4269/ajtmh.2007.77.126&mimeType=html&fmt=ahah

References

  1. Prüss A, Mariotti SP, 2000. Preventing trachoma through environmental sanitation: a review of the evidence base. Bull World Health Organ 78 : 258–266.
  2. Emerson PM, Cairncross S, Bailey RL, Mabey DC, 2000. Review of the evidence base for the “F” and “E” components of the SAFE strategy for trachoma control. Trop Med Int Health 5 : 515–527.
  3. Frick KD, Mecaskey JW, 2002. Resource allocation to prevent trachomatous low vision among older individuals in rural areas of less developed countries. Doc Ophthalmol 105 : 1–21.
  4. Tizazu T, Mburu FM, 1983. Prevalence and causes of vision loss in southern Sudan. Soc Sci Med 17 : 1785–1788.
  5. New Sudan Center for Statistics and Evaluation/UNICEF, 2004. Towards a Baseline: Best Estimates of Social Indicators for Southern Sudan. Available at: http://www.unsudanig.org/docs/Towards%20A%20Baseline%20Best%20Estimates%20of%20Social%20Indicators%20for%20Southern%20Sudan,%202004,%20NSCSE,%20UNICEF.pdf. Accessed October 20, 2005.
  6. MacCallan A, 1931. The epidemiology of trachoma. Br J Oph-thalmol 15 : 369–411.
  7. Thylefors B, Dawson C, Jones B, West S, Taylor H, 1987. A simple system for the assessment of trachoma and its complications. Bull World Health Organ 65 : 477–483.
  8. West SK, Muñoz B, Mkocha H, Hsieh YH, Lynch MC, 2001. Progression of active trachoma to scarring in a cohort of Tan-zanian children. Ophthalmic Epidemiol 8 : 137–144.
  9. Solomon AW, Peeling RW, Foster A, Mabey DC, 2004. Diagnosis and assessment of trachoma. Clin Microbiol Rev 17 : 982–1011.
  10. Solomon AW, Holland MJ, Burton MJ, West SK, Alexander ND, Aguirre A, Massae PA, Mkocha H, Muñoz B, Johnson GJ, Peeling RW, Bailey RL, Foster A, Mabey DC, 2003. Strategies for control of trachoma: observational study with quantitative PCR. Lancet 362 : 198–204.
  11. Burton MJ, Holland MJ, Faal N, Aryee EA, Alexander ND, Bah M, Faal H, West SK, Foster A, Johnson GJ, Mabey DC, Bailey RL, 2003. Which members of a community need antibiotics to control trachoma? Conjunctival Chlamydia trachomatis infection load in Gambian villages. Invest Ophthalmol Vis Sci 44 : 4215–4222.
  12. Ngondi J, Onsarigo A, Adamu L, Matende I, Baba S, Reacher M, Emerson P, Zingeser J, 2005. The epidemiology of trachoma in Eastern Equatoria and Upper Nile States, southern Sudan. Bull World Health Organ 83 : 904–912.
  13. Ngondi J, Ole-Sempele F, Onsarigo A, Matende I, Baba S, Reacher M, Matthews F, Brayne EP, 2006. Blinding trachoma in post-conflict southern Sudan. PLoS Med 3 : e478.
  14. World Health Organization, 1991. Training for Mid-level Managers: The EPI Coverage Survey. Geneva: WHO. WHO document WHO/EPI/MLM/91.10.
  15. Armstrong BK, White E, Saracci R, 1992. The design of questionnaires. Principles of Exposure Measurement in Epidemiology. New York: Oxford University Press, 137–168.
  16. McCullagh P, Nelder J, 1989. Generalized Linear Models. New York: Chapman and Hall.
  17. Hosmer D, Lemeshow S, 2000. Applied Logistic Regression. New York: John Wiley & Sons, Inc.
  18. Ngondi J, Onsarigo A, Matthews F, Reacher M, Brayne C, Baba S, Solomon AW, Zingeser J, Emerson PM, 2006. Effect of 3 years of SAFE (surgery, antibiotics, facial cleanliness, and environmental change) strategy for trachoma control in southern Sudan: a cross-sectional study. Lancet 368 : 589–595.
  19. Bailey R, Downes B, Downes R, Mabey D, 1991. Trachoma and water use; a case control study in a Gambian village. Trans R Soc Trop Med Hyg 85 : 824–828.
  20. Polack S, Kuper H, Solomon AW, Massae PA, Abuelo C, Cam-eron E, Valdmanis V, Mahande M, Foster A, Mabey D, 2006. The relationship between prevalence of active trachoma, water availability and its use in a Tanzanian village. Trans R Soc Trop Med Hyg 100 : 1075–1083.
  21. West S, Lynch M, Turner V, Muñoz B, Rapoza P, Mmbaga BB, Taylor HR, 1989. Water availability and trachoma. Bull World Health Organ 67 : 71–75.
  22. McCauley AP, Lynch M, Pounds MB, West S, 1990. Changing water-use patterns in a water-poor area: lessons for a trachoma intervention project. Soc Sci Med 31 : 1233–1238.
  23. Hafez M, Attia M, 1958. Studies on the ecology of Musca sorbens Wied. in Egypt. Bull Soc Entomol Egypte 42 : 83–121.
  24. Emerson PM, Bailey RL, Walraven GE, Lindsay SW, 2001. Human and other faeces as breeding media of the trachoma vector Musca sorbens. Med Vet Entomol 15 : 314–320.
  25. Tielsch JM, West KP Jr, Katz J, Keyvan-Larijani E, Tizazu T, Schwab L, Johnson GJ, Chirambo MC, Taylor HR, 1988. The epidemiology of trachoma in southern Malawi. Am J Trop Med Hyg 38 : 393–399.
  26. Zerihun N, 1997. Trachoma in Jimma zone, south western Ethio-pia. Trop Med Int Health 2 : 1115–1121.
  27. Sahlu T, Larson C, 1992. The prevalence and environmental risk factors for moderate and severe trachoma in southern Ethio-pia. J Trop Med Hyg 95 : 36–41.
  28. Luna EJ, Medina NH, Oliveira MB, de Barros OM, Vranjac A, Melles HH, West S, Taylor HR, 1992. Epidemiology of tra-choma in Bebedouro State of Sao Paulo, Brazil: prevalence and risk factors. Int J Epidemiol 21 : 169–177.
  29. Katz J, West KP Jr, Khatry SK, LeClerq SC, Pradhan EK, Thapa MD, Ram SS, Taylor HR, 1996. Prevalence and risk factors for trachoma in Sarlahi district, Nepal. Br J Ophthalmol 80 : 1037–1041.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2007.77.126
Loading
/content/journals/10.4269/ajtmh.2007.77.126
Loading

Data & Media loading...

  • Received : 03 Jan 2007
  • Accepted : 27 Mar 2007

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error