Prevalence and Risk Factors for Trachoma in Central and Southern Malawi

Khumbo Kalua,Mavuto Mukaka,Sam Abbenyi,Tobias Chirwa,Robin Bailey,Linda Kalilani,Jeremiah M Ngondi

doi:10.1371/journal.pone.0009067

Abstract

BackgroundTrachoma, one of the neglected tropical diseases is suspected to be endemic in Malawi. Objectives: To determine the prevalence of trachoma and associated risk factors in central and southern Malawi.Methodology/Principal FindingsA population based survey conducted in randomly selected clusters in Chikwawa district (population 438,895), southern Malawi and Mchinji district (population 456,558), central Malawi. Children aged 1–9 years and adults aged 15 and above were assessed for clinical signs of trachoma. In total, 1010 households in Chikwawa and 1016 households in Mchinji districts were enumerated within 108 clusters (54 clusters in each district). A total of 6,792 persons were examined for ocular signs of trachoma. The prevalence of trachomatous inflammation, follicular (TF) among children aged 1–9 years was 13.6% (CI 11.6–15.6) in Chikwawa and 21.7% (CI 19.5–23.9) in Mchinji districts respectively. The prevalence of trachoma trichiasis (TT) in women and men aged 15 years and above was 0.6% (CI 0.2–0.9) in Chikwawa and 0.3% (CI 0.04–0.6) in Mchinji respectively. The presence of a dirty face was significantly associated with trachoma follicular (TF) in both Chikwawa and Mchinji districts (P<0.001).Conclusion/SignificancePrevalence rates of trachoma follicles (TF) in Central and Southern Malawi exceeds the WHO guidelines for the intervention with mass antibiotic distribution (TF>10%), and warrants the trachoma SAFE control strategy to be undertaken in Chikwawa and Mchinji districts.

Highlights

Trachoma is an infectious disease that is caused by serotypes A, B, Ba and C of the bacterium Chlamydia trachomatis [1,2]
Trachoma is among the many neglected tropical diseases (NTD’s) that are associated with poverty and produce a disease burden almost as great as that associated with human immunodeficiency virus/AIDS, tuberculosis, or malaria [10] and may be treated simultaneously with other diseases
This study was conducted to determine the prevalence of trachoma infections (TF/Trachomatous inflammation intense (TI)) among children aged 1–9 years, the prevalence of trachoma scaring (TS),trachoma trichiasis (TT) and cornea opacity (CO) among adult men and women aged 15 years and above and association with the risk factors for trachoma in Chikwawa and Mchinji districts

Summary

Introduction

Trachoma is an infectious disease that is caused by serotypes A, B, Ba and C of the bacterium Chlamydia trachomatis [1,2]. Trachoma is still considered a leading cause of preventable blindness in sub-Saharan Africa especially in countries that have poor environmental sanitation, inadequate water supply and poor socio-economic status [6,7]. Blinding trachoma remains a problem where living conditions facilitate continuous transmission of Chlamydia trachomatis among family members [9]. Trachoma is among the many neglected tropical diseases (NTD’s) that are associated with poverty and produce a disease burden almost as great as that associated with human immunodeficiency virus/AIDS, tuberculosis, or malaria [10] and may be treated simultaneously with other diseases. One of the neglected tropical diseases is suspected to be endemic in Malawi. Objectives: To determine the prevalence of trachoma and associated risk factors in central and southern Malawi

Objectives

Methods

Results

Conclusion