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Follicular trachoma and trichiasis prevalence in an urban community in The Gambia, West Africa: is there a need to include urban areas in national trachoma surveillance?
Author(s) -
Quicke E.,
Sillah A.,
HardingEsch E. M.,
Last A.,
Joof H.,
Makalo P.,
Bailey R. L.,
Burr S. E.
Publication year - 2013
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12182
Subject(s) - trachoma , trichiasis , medicine , environmental health , population , cross sectional study , public health , risk factor , demography , pathology , sociology
Objectives Urban areas are traditionally excluded from trachoma surveillance activities, but due to rapid expansion and population growth, the urban area of Brikama in The Gambia may be developing social problems that are known risk factors for trachoma. It is also a destination for many migrants who may be introducing active trachoma into the area. This study aimed to determine the prevalence and risk factors for follicular trachoma and trichiasis in Brikama. Methods A community‐based cross‐sectional prevalence survey including 27 randomly selected households in 12 randomly selected enumeration areas ( EA s) of Brikama. Selected households were offered eye examinations, and the severity of trachoma was graded according to WHO 's simplified grading system. Risk factor data were collected from each household via a questionnaire. Results The overall prevalence of trachomatous inflammation–follicular ( TF ) in children aged 1–9 years was 3.8% (95% CI 2.5–5.6), and the overall prevalence of trichiasis in adults aged ≥15 years was 0.46% (95% CI 0.17–1.14). EA prevalence of TF varied from 0% to 8.4%. The major risk factors for TF were dirty faces ( P < 0.01, OR = 9.23, 95% CI 1.97–43.23), nasal discharge ( P = 0.039, OR = 5.11, 95% CI 1.08–24.10) and residency in Brikama for <1 year ( P = 0.047, OR = 7.78, 95% CI 1.03–59.03). Conclusions Follicular trachoma can be considered to have been eliminated as a public health problem in Brikama according to WHO criteria. However, as the prevalence in some EA s is >5%, it may be prudent to include Brikama in surveillance programmes. Trichiasis remains a public health problem (>0.1%), and active case finding needs to be undertaken.