Prevalence of Trachoma in Pakistan: Results of 42 Population-Based Prevalence Surveys from the Global Trachoma Mapping Project. (3rd March 2020)

• Record Type: Journal Article
• Authors: Khan, Asad Aslam; Florea, Victor V.; Hussain, Arif; Jadoon, Zahid; Boisson, Sophie; Willis, Rebecca; Dejene, Michael; Bakhtiari, Ana; Mpyet, Caleb; Pavluck, Alexandre L.; Gillani, Munazza; Qureshi, Babar; Solomon, Anthony W.
• Is Part Of: Ophthalmic epidemiology. Volume 27:Number 2(2020)
• Page Start: 155
• Page End: 164
• Publication Date: 2020-03-03
• Subjects: Pakistan -- trachoma -- trichiasis -- Global Trachoma Mapping Project -- water -- sanitation; Blindness -- Prevention -- Periodicals; Eye -- Diseases -- Epidemiology -- Periodicals; Ophthalmology -- Periodicals; 614.5997
• DOI: 10.1080/09286586.2019.1708120
• Languages: English
• ISSNs: 0928-6586

Abstract

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.