Oman’s Progress Towards Reaching “Ultimate Intervention Goals” for the Surgery “S” Component of SAFE Strategy for the Elimination of Blinding Trachoma in 2008

Abstract

Background: A community based survey for Trachomatous Trichiasis (TT) was conducted in the high (TT >5% in 1997) and meso endemic areas (TT 1% to 5% in 1997) of Oman during 2008–09.Methods: Investigators examined Omanis 40 age years and older from randomly selected villages. Eyes were examined for TT and vision. The medical history of surgery and advice given for TT surgery were recorded. The TT cases that were unadvised by health staff were defined as un-approached cases. Cluster adjusted prevalence of TT and risk of TT by gender were estimated.Result: We examined 4,951of 5,268 persons in high-endemic areas and 965 of 993 (97.2%) persons in meso-endemic areas. The cluster adjusted prevalence of TT in the high and meso endemic areas were 7.54% (95% Confidence Interval [CI] 6.78–8.30) and 1.69% (95% CI 0.88–2.50) respectively. There were 5 TT patients in high endemic areas and none in meso-endemic areas who were not approached or managed in the past. The prevalence of TT across all ages was less than 1 per 1,000 of the population in all wilayats of Oman. Females had a significantly higher risk of cluster adjusted TT compared to males (Odds Ratio = 1.87 [95% CI 1.85–1.89]). The prevalence of blindness was 0.5% among TT cases in high endemic areas.Conclusion: Oman seems to have reached the Ultimate Intervention Goals (UIGs) of the “S” (Surgery) component in 2008 in high and meso-endemic areas. The efforts of existing eye services could be better evaluated if un-approached TT cases are used to calculate the TT prevalence. Oman needs to focus more on females with TT to reach the UIGs.