Abstract
BackgroundDespite historical evidence of blinding trachoma, there have been no widespread contemporary surveys of trachoma prevalence in the northern states of Sudan. We aimed to conduct district-level surveys in this vast region in order to map the extent of the problem and estimate the need for trachoma control interventions to eliminate blinding trachoma.Methods and FindingsSeparate, population based cross-sectional surveys were conducted in 88 localities (districts) in 12 northern states of Sudan between 2006 and 2010. Two-stage cluster random sampling with probability proportional to size was used to select the sample. Trachoma grading was done using the WHO simplified grading system. Key prevalence indicators were trachomatous inflammation-follicular (TF) in children aged 1–9 years and trachomatous trichiasis (TT) in adults aged 15 years and above. The sample comprised 1,260 clusters from which 25,624 households were surveyed. A total of 106,697 participants (81.6% response rate) were examined for trachoma signs. TF prevalence was above 10% in three districts and between 5% and 9% in 11 districts. TT prevalence among adults was above 1% in 20 districts (which included the three districts with TF prevalence >10%). The overall number of people with TT in the population was estimated to be 31,072 (lower and upper bounds = 26,125–36,955).ConclusionTrachoma mapping is complete in the northern states of Sudan except for the Darfur States. The survey findings will facilitate programme planning and inform deployment of resources for elimination of trachoma from the northern states of Sudan by 2015, in accordance with the Sudan Federal Ministry of Health (FMOH) objectives.
Highlights
Trachoma is an eye disease caused by ocular infection with Chlamydia trachomatis, which can result in blindness after cycles of repeated infections
Trachoma mapping is complete in the northern states of Sudan except for the Darfur States
The 1975 study surveyed children aged 0–15 years in Atbara Town and revealed findings similar to those reported a decade earlier by Majcuk [5]. While this evidence demonstrates the historical presence of trachoma in Sudan, these earlier studies used trachoma diagnostic criteria which differ from the current World Health Organization (WHO) simplified grading system [7], and reflect a pattern of disease that may no longer be relevant
Summary
Trachoma is an eye disease caused by ocular infection with Chlamydia trachomatis, which can result in blindness after cycles of repeated infections. Surveys undertaken by the WHO in the Northern Province between 1963 and 1964 in Atbara Town and surrounding villages revealed trachoma to be a serious public health problem [5]. The 1975 study surveyed children aged 0–15 years in Atbara Town and revealed findings similar to those reported a decade earlier by Majcuk [5]. While this evidence demonstrates the historical presence of trachoma in Sudan, these earlier studies used trachoma diagnostic criteria which differ from the current WHO simplified grading system [7], and reflect a pattern of disease that may no longer be relevant. We aimed to conduct district-level surveys in this vast region in order to map the extent of the problem and estimate the need for trachoma control interventions to eliminate blinding trachoma
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