Blinding Trachoma in Katsina State, Nigeria: Population-Based Prevalence Survey in Ten Local Government Areas

Abstract

Purpose: To assess the prevalence of trachomatous inflammation follicular (TF) in children aged 1–9 years and trachomatous trichiasis (TT) in adults aged 15 years or more in Katsina State, Nigeria. Methods: Cross sectional population-based trachoma prevalence surveys were conducted using multistage cluster random sampling methodology and the WHO simplified grading system for trachoma in ten local government areas (LGAs). Individual and household risk factors were recorded using a standard questionnaire. Results: A total of 11,407 children and 8,901 adults from 2,244 households were surveyed. Prevalence of TF in children aged 1–9 years ranged from 5.0 to 24.0%. Five LGAs exceeded the 10% threshold for intervention and a further three exceeded 10% in the 95% confidence limits. The prevalence of TT in adults aged 15 years or more ranged from 2.3 to 8.0%: all ten LGAs exceeded the 1% intervention threshold. Analysis of risk factors for active trachoma (TF and/or TI) in children showed the following significant independent associations: Presence of ocular discharge OR = 2.34 (95%CI 1.81–3.03); presence of nasal discharge OR = 1.44 (1.22–1.70); reported frequency of face washing once versus at least twice per day OR = 1.27 (1.02–1.58); disposal of trash inside the compound OR = 1.23 (1.02–1.48); and the absence of a household latrine OR = 1.43 (1.15–1.78). Conclusions: A trachoma control program is warranted in Katsina. Surgical interventions to correct TT are needed immediately in all LGAs surveyed and the full SAFE strategy is justified for five of the ten LGAs, and possibly for another three.