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Clare G, Kempen JH, Pavésio C. Infectious eye disease in the 21st century-an overview. Eye (Lond) 2024; 38:2014-2027. [PMID: 38355671 PMCID: PMC11269619 DOI: 10.1038/s41433-024-02966-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 01/10/2024] [Accepted: 01/26/2024] [Indexed: 02/16/2024] Open
Abstract
Infectious diseases affecting the eye often cause unilateral or asymmetric visual loss in children and people of working age. This group of conditions includes viral, bacterial, fungal and parasitic diseases, both common and rare presentations which, in aggregate, may account for a significant portion of the global visual burden. Diagnosis is frequently challenging even in specialist centres, and many disease presentations are highly regional. In an age of globalisation, an understanding of the various modes of transmission and the geographic distribution of infections can be instructive to clinicians. The impact of eye infections on global disability is currently not sufficiently captured in global prevalence studies on visual impairment and blindness, which focus on bilateral disease in the over-50s. Moreover, in many cases it is hard to differentiate between infectious and immune-mediated diseases. Since infectious eye diseases can be preventable and frequently affect younger people, we argue that in future prevalence studies they should be considered as a separate category, including estimates of disability-adjusted life years (DALY) as a measure of overall disease burden. Numbers of ocular infections are uniquely affected by outbreaks as well as endemic transmission, and their control frequently relies on collaborative partnerships that go well beyond the remit of ophthalmology, encompassing domains as various as vaccination, antibiotic development, individual healthcare, vector control, mass drug administration, food supplementation, environmental and food hygiene, epidemiological mapping, and many more. Moreover, the anticipated impacts of global warming, conflict, food poverty, urbanisation and environmental degradation are likely to magnify their importance. While remote telemedicine can be a useful aide in the diagnosis of these conditions in resource-poor areas, enhanced global reporting networks and artificial intelligence systems may ultimately be required for disease surveillance and monitoring.
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Affiliation(s)
| | - John H Kempen
- Department of Ophthalmology and Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary; and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Sight for Souls, Bellevue, WA, USA
- MCM Eye Unit; MyungSung Christian Medical Center (MCM) Comprehensive Specialized Hospital and MyungSung Medical College, Addis Ababa, Ethiopia
- Department of Ophthalmology, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia
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Mpyet CD, Olobio N, Isiyaku S, Wamyil-Mshelia T, Ajege G, Ogoshi C, Olamiju F, Achu I, Adamu MD, Muhammad N, Jabo AM, Orji P, William A, Ramyil AV, Bakhtiari A, Boyd S, Kelly M, Jimenez C, Kello AB, Solomon AW, Harding-Esch EM, Courtright P. Progress towards the elimination of trachoma in Nigeria. Int Health 2024:ihae035. [PMID: 38815996 DOI: 10.1093/inthealth/ihae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/09/2024] [Accepted: 04/26/2024] [Indexed: 06/01/2024] Open
Abstract
Trachoma is targeted for elimination as a public health problem worldwide by 2030. In Nigeria, elimination activities are implemented at the local government area (LGA) level. They started in 2002 by conducting baseline population-based prevalence surveys (PBPSs), which continued in a systematic manner with engagement from the Global Trachoma Mapping Project in 2013, and subsequently Tropical Data. The results led to the development of Nigeria's first trachoma action plan and its subsequent revision with additional information. Following 449 baseline PBPSs, 122 LGAs had an active trachoma prevalence above the elimination threshold, requiring interventions, while 231 LGAs required community-based interventions for trichiasis management. By 2021, >34 million antibiotic treatments had been provided in 104 LGAs, with 89 LGAs eliminating active trachoma. Nationally, water and sanitation coverages increased by 3% and 18%, respectively, in 7 y. Systematic trichiasis case finding and management were carried out in 231 LGAs, resulting in the management of 102 527 people. Fifty-four LGAs decreased trichiasis prevalence unknown to the health system to <0.2% in persons ≥15 y of age. Where this elimination prevalence threshold was reached, trichiasis services were transitioned to routine eye/healthcare systems. Such progress relied on strong leadership and coordination from the national trachoma program and tremendous support provided by partners. Attaining elimination of trachoma as a public health problem in Nigeria by 2030 is feasible if funding support is sustained.
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Affiliation(s)
- Caleb D Mpyet
- Sightsavers, Nigeria Country Office, Kaduna, Nigeria
- Department of Ophthalmology, University of Jos, Jos, Nigeria
| | - Nicholas Olobio
- Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | | | | | - Grace Ajege
- Sightsavers, Nigeria Country Office, Kaduna, Nigeria
| | | | | | | | | | - Nasiru Muhammad
- Ophthalmology Department, Usmanu Danfodiyo University, Sokoto, Nigeria
| | | | | | | | | | | | - Sarah Boyd
- Task Force for Global Health, Decatur, GA, USA
| | | | | | - Amir Bedri Kello
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Anthony W Solomon
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - Emma M Harding-Esch
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Paul Courtright
- Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
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3
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Gebreselassie G, Negash K, Tsegaye S, Makonnen M, Deneke B, Desalegn M, Harding-Esch EM, Harte A, Solomon AW, Boyd S, Bakhtiari A, Hassen MA, Hambali A, Dejene M, Beckwith C, Tadesse F, Seifu F, Kiflu G, Kebede F. Prevalence of trachoma in Somali region, Ethiopia: results from trachoma impact surveys in 50 woredas. Int Health 2023; 15:ii30-ii37. [PMID: 38048381 PMCID: PMC10695430 DOI: 10.1093/inthealth/ihad063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/16/2023] [Accepted: 08/01/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Following interventions to eliminate trachoma in Somali region, Ethiopia, we aimed to re-estimate the prevalence of trachomatous trichiasis (TT) and trachomatous inflammation-follicular (TF) at woreda level and identify the factors associated with the disease. METHODS We implemented cross-sectional community-based surveys in 50 trachoma-endemic woredas, using a standardized survey. Households were the secondary sampling unit. Surveys were undertaken through a combination of interviews of household heads and direct inspection of water, sanitation and hygiene (WASH) access, plus clinical evaluation of eligible household members for TT and TF. RESULTS Overall, 41 (82%) of the 50 woredas had met the WHO-recommended active trachoma elimination threshold (prevalence of TF <5% in 1-9-y-olds) and 42 (84%) had met the TT threshold (prevalence of TT unknown to the health system <0.2% in ≥15-y-olds). Only 18% of households had access to an improved drinking water source within a 30-min trip and only 25% had an improved latrine. CONCLUSIONS Additional rounds of antibiotic mass drug administration, plus interventions to enhance facial cleanliness and improve the environment, are required in nine woredas. TT surgical campaigns are needed in eight woredas. Greater access to WASH is required across all the woredas that were surveyed.
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Affiliation(s)
| | | | | | | | | | | | - Emma M Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Anna Harte
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Anthony W Solomon
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - Sarah Boyd
- Task Force for Global Health, Decatur GA, USA
| | | | | | | | | | | | | | - Fikre Seifu
- Ethiopia Ministry of Health, Addis Ababa, Ethiopia
| | - Genet Kiflu
- Ethiopia Ministry of Health, Addis Ababa, Ethiopia
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Miecha H, Dejene M, Adugna D, Kebede A, Yadeta D, Alemayehu A, Abateneh A, Dayessa M, Shafi M, Taye E, Balcha L, Negussu N, Mengistu B, Willis R, Jimenez C, Bakhtiari A, Boyd S, Kebede B, Tadesse F, Mamo A, Bekele M, Sinke Z, Solomon AW, Harding-Esch EM. Prevalence of Trachoma in Pre-validation Surveillance Surveys in 11 Evaluation Units (Covering 12 Districts) in Oromia Regional State, Ethiopia: Results from 2018-2020. Ophthalmic Epidemiol 2023; 30:655-662. [PMID: 36519777 PMCID: PMC10581667 DOI: 10.1080/09286586.2022.2119258] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 08/06/2022] [Accepted: 08/25/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Interventions to reduce the prevalence of trachoma and transmission of ocular Chlamydia trachomatis have been implemented in Oromia Region, Ethiopia. Following an impact survey in which the trachomatous inflammation-follicular (TF) prevalence in 1-9-year-olds is <5%, a surveillance survey is recommended 2 years later, without additional antibiotic treatment. We report results of surveillance surveys in 11 evaluation units (EUs) covering 12 districts in Oromia Region, to plan whether future interventions are needed. METHOD We use a two-stage cluster-sampling cross-sectional survey design. In each EU, 26 clusters (villages) were systematically selected with probability proportional to size; from each cluster, 30 households were selected using compact segment sampling. Water, sanitation and hygiene (WASH) access was assessed in all selected households. All residents of selected households aged ≥1 year were examined for TF and trachomatous trichiasis (TT) by certified graders. RESULT Of 31,991 individuals enumerated, 29,230 (91% of) individuals were examined. Eight EUs had an age-adjusted TF prevalence in 1-9-year-olds of ≥5% and seven had a TT prevalence unknown to the health system among adults aged ≥15 years of ≥0.2%. About one-third of visited households had access to an improved water source for drinking, and 5% had access to an improved latrine. CONCLUSION Despite TF reductions to <5% at impact survey, prevalence recrudesced to ≥5% in all but three of the 11 EUs. Operational research is needed to understand transmission dynamics and epidemiology, in order to optimise elimination strategies in high-transmission settings like these.
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Affiliation(s)
- Hirpa Miecha
- Oromia Regional State Health Bureau, Addis Ababa, Ethiopia
| | | | - Dereje Adugna
- Oromia Regional State Health Bureau, Addis Ababa, Ethiopia
| | - Ageru Kebede
- The Fred Hollows Foundation, Addis Ababa, Ethiopia
| | - Damtew Yadeta
- Oromia Regional State Health Bureau, Addis Ababa, Ethiopia
| | | | | | | | | | | | - Leta Balcha
- The Fred Hollows Foundation, Addis Ababa, Ethiopia
| | | | | | - Rebecca Willis
- International Trachoma Initiative, Task Force for Global Health, Decatur, GA, USA
| | | | - Ana Bakhtiari
- International Trachoma Initiative, Task Force for Global Health, Decatur, GA, USA
| | - Sarah Boyd
- International Trachoma Initiative, Task Force for Global Health, Decatur, GA, USA
| | | | | | - Ayele Mamo
- Oromia Regional State Health Bureau, Addis Ababa, Ethiopia
| | | | - Zelalem Sinke
- Oromia Regional State Health Bureau, Addis Ababa, Ethiopia
| | - Anthony W. Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Emma M. Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
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Bundy DAP, Schultz L, Antoninis M, Barry FBM, Burbano C, Croke K, Drake L, Gyapong J, Karutu C, Kihara J, Lo MM, Makkar P, Mwandawiro C, Ossipow SJ, Bento AR, Rollinson D, Shah H, Turner HC. A positive consequence of the COVID-19 pandemic: how the counterfactual experience of school closures is accelerating a multisectoral response to the treatment of neglected tropical diseases. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220282. [PMID: 37598709 PMCID: PMC10440164 DOI: 10.1098/rstb.2022.0282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/07/2023] [Indexed: 08/22/2023] Open
Abstract
Global access to deworming treatment is one of the public health success stories of low-income countries in the twenty-first century. Parasitic worm infections are among the most ubiquitous chronic infections of humans, and early success with mass treatment programmes for these infections was the key catalyst for the neglected tropical disease (NTD) agenda. Since the launch of the 'London Declaration' in 2012, school-based deworming programmes have become the world's largest public health interventions. WHO estimates that by 2020, some 3.3 billion school-based drug treatments had been delivered. The success of this approach was brought to a dramatic halt in April 2020 when schools were closed worldwide in response to the COVID-19 pandemic. These closures immediately excluded 1.5 billion children not only from access to education but also from all school-based health services, including deworming. WHO Pulse surveys in 2021 identified NTD treatment as among the most negatively affected health interventions worldwide, second only to mental health interventions. In reaction, governments created a global Coalition with the twin aims of reopening schools and of rebuilding more resilient school-based health systems. Today, some 86 countries, comprising more than half the world's population, are delivering on this response, and school-based coverage of some key school-based programmes exceeds those from January 2020. This paper explores how science, and a combination of new policy and epidemiological perspectives that began in the 1980s, led to the exceptional growth in school-based NTD programmes after 2012, and are again driving new momentum in response to the COVID-19 pandemic. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.
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Affiliation(s)
- Donald A. P. Bundy
- Research Consortium for School Health and Nutrition, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Linda Schultz
- Research Consortium for School Health and Nutrition, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | | | | | | | - Kevin Croke
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | | | - John Gyapong
- University of Health and Allied Sciences, PMB 31, Ho, Volta Region, Ghana
| | | | | | | | | | | | | | | | | | | | - Hugo C. Turner
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London SW7 2BX, UK
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Al-Khateeb T, Al-Haidari S, Butcher R, Rajamani A, Mahdy MAK, Jimenez C, Dejene M, Boyd S, Bakhtiari A, Solomon AW, Thabit A, Harding-Esch EM, Al-Shami R. Prevalence of Trachoma in Four Evaluation Units in Yemen after Implementation of Trachoma Elimination Measures. Ophthalmic Epidemiol 2023:1-9. [PMID: 36908236 DOI: 10.1080/09286586.2023.2180805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 02/10/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND In baseline trachoma prevalence surveys, six districts in two governorates of Yemen were identified as requiring interventions. We set out to estimate the prevalence of trachoma 6-12 months after one round of antibiotic mass drug administration (MDA) and implementation of measures to encourage facial cleanliness. METHODS A population-based prevalence survey was conducted in each of the four evaluation units in October 2019. Contemporary World Health Organization recommendations for trachoma surveys were followed. Participants were selected using a two-stage cluster sampling process. The prevalence of inflammatory and late-stage trachoma was measured through eye examination. Water, sanitation, and hygiene facility access among visited households was estimated. RESULTS The prevalence of trachomatous inflammation-,follicular (TF) in 1-9-year-olds per EU was <5.0% in three EUs (Al Mighlaf, Al Munirah, and As Salif; Az Zaydiyah; and Mudhaykhirah districts) and 5.0-9.9% in one EU (Far Al Udayn District). The prevalence of TT unknown to the health system in ≥15-year-olds per EU was <0.2% in all four EUs. Per EU, the proportion of households with an improved drinking water source ranged from 40% to 100%; access to an improved drinking water source within 30-minute return journey of the household ranged from 45% to 100%; and with an improved latrine ranged from 32% to 83%. CONCLUSION An additional round of antibiotic MDA should be administered in Far Al Udayn district before it is resurveyed. In the other surveyed districts, pre-validation surveillance surveys should be conducted in 2 years' time to determine if the TF prevalence <5% has been maintained.
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Affiliation(s)
- Tawfik Al-Khateeb
- Prevention of Blindness Program, Ministry of Public Health & Population, Sana'a, Yemen
| | - Sami Al-Haidari
- Neglected Tropical Diseases Directorate Ministry of Public Health & Population, Sana'a, Yemen
| | - Robert Butcher
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Anusha Rajamani
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | - Sarah Boyd
- Task Force for Global Health, Decatur, Georgia, USA
| | | | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Adnan Thabit
- Ophthalmology Department, Sana'a University, Sana'a, Yemen
| | - Emma M Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Rasheed Al-Shami
- Taskforce for Trachoma Control Program, Ministry of Public Health & Population, Sana'a, Yemen
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Melo GBT, Angulo-Tuesta A, da Silva EN, Santos TDS, Uchimura LYT, Obara MT. Evolution of research funding for neglected tropical diseases in Brazil, 2004-2020. PLoS Negl Trop Dis 2023; 17:e0011134. [PMID: 36928796 PMCID: PMC10019684 DOI: 10.1371/journal.pntd.0011134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/01/2023] [Indexed: 03/18/2023] Open
Abstract
Neglected tropical diseases are a global public health problem. Although Brazil is largely responsible for their occurrence in Latin America, research funding on the subject does not meet the population's health needs. The present study analyzed the evolution of research funding for neglected tropical diseases by the Ministry of Health and its partners in Brazil, from 2004 to 2020. This is a retrospective study of data from investigations registered on Health Research (Pesquisa Saúde in Portuguese), a public repository for research funded by the Ministry of Health's Department of Science and Technology. The temporal trend of funding and the influence of federal government changes on funding were analyzed using Prais-Winster generalized linear regression. From 2004 to 2020, 1,158 studies were financed (purchasing power parity (PPP$) 230.9 million), with most funding aimed at biomedical research (81.6%) and topics involving dengue, leishmaniasis and tuberculosis (60.2%). Funding was stationary (annual percent change of -5.7%; 95%CI -54.0 to 45.0) and influenced by changes to the federal government. Research funding was lacking for chikungunya, Chagas disease, schistosomiasis, malaria and taeniasis/cysticercosis, diseases with a high prevalence, burden or mortality rates in Brazil. Although the Ministry of Health had several budgetary partners, it was the main funder, with 69.8% of investments. The study revealed that research funding for neglected tropical diseases has stagnated over the years and that diseases with a high prevalence, burden and mortality rate receive little funding. These findings demonstrate the need to strengthen the health research system by providing sustainable funding for research on neglected tropical diseases that is consistent with the population's health needs.
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Affiliation(s)
- Gabriela Bardelini Tavares Melo
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia - University of Brasilia, Federal District, Brasilia, Brazil
- Department of Science and Technology, Ministry of Health, Federal District, Brasilia, Brazil
- * E-mail:
| | - Antonia Angulo-Tuesta
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia - University of Brasilia, Federal District, Brasilia, Brazil
| | - Everton Nunes da Silva
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia - University of Brasilia, Federal District, Brasilia, Brazil
| | - Thaís da Silva Santos
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia - University of Brasilia, Federal District, Brasilia, Brazil
| | | | - Marcos Takashi Obara
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia - University of Brasilia, Federal District, Brasilia, Brazil
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Velleman Y, Blair L, Fleming F, Fenwick A. Water-, Sanitation-, and Hygiene-Related Diseases. Infect Dis (Lond) 2023. [DOI: 10.1007/978-1-0716-2463-0_547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Mengistu B, Wirtu F, Alemayehu A, Alene S, Asmare A, Backers S, Bakhtiari A, Brady M, Butcher RMR, Dayessa M, Frawley H, Gebru G, Jimenez C, Kebede F, Kejela A, McPherson S, Mihret A, Negussu N, Ngondi JM, Taddese F, Willis R, Wondimu A, Dejene M, Solomon AW, Harding-Esch EM. Prevalence of Trachoma in Benishangul Gumuz Region, Ethiopia, after Implementation of the SAFE Strategy: Results of Four Population-Based Surveys. Ophthalmic Epidemiol 2022:1-9. [PMID: 36511584 PMCID: PMC10578310 DOI: 10.1080/09286586.2022.2140439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 09/02/2022] [Accepted: 10/21/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE We aimed to estimate the prevalence of trachomatous inflammation-follicular (TF) in 1-9-year-olds and trachomatous trichiasis (TT) unknown to the health system in ≥15-year-olds in Benishangul Gumuz (BGZ) region, Ethiopia. This will help to assess progress towards the elimination of trachoma as a public health problem and determine the need for future interventions against trachoma in the region. METHODS Cross-sectional population-based trachoma prevalence surveys were conducted in four evaluation units (EUs) of BGZ using World Health Organization-recommended survey methodologies. Individuals were examined for clinical signs of trachoma. Household access to water, sanitation and hygiene facilities (WaSH) was assessed. RESULTS A total of 11,778 people aged ≥1 year were examined. The prevalence of TF in 1-9-year-olds was <5% in three EUs and ≥5% in one EU. The prevalence of TT unknown to the health system in people aged ≥15-years was ≥0.2% in all four EUs. The proportion of households with an improved drinking water source within a 30-minute round-trip ranged from 27-60%. The proportion of households with an improved latrine ranged from <1-6%. CONCLUSIONS Surgical interventions for TT are required in all EUs in BGZ. One annual round of mass drug administration (MDA) of azithromycin is required in one EU before resurvey to reassess progress in lowering TF prevalence below the WHO elimination threshold of 5% in 1-9-year-olds. MDA should be stopped in the other three EUs and trachoma surveillance surveys should be conducted at least 24 months after the surveys described here. Ongoing strengthening of WaSH infrastructure may help sustain the low prevalence of trachoma.
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Affiliation(s)
- Belete Mengistu
- Act to End NTDs East, RTI International, Addis Ababa, Ethiopia
| | - Fikru Wirtu
- Health Promotion and Disease Prevention Core Process, Benishangul-Gumuz Regional Health Bureau, Ethiopia
| | | | - Shigute Alene
- Act to End NTDs East, RTI International, Addis Ababa, Ethiopia
| | - Aemiro Asmare
- Act to End NTDs East, RTI International, Addis Ababa, Ethiopia
| | - Sharone Backers
- Act to End NTDs East, RTI International, Addis Ababa, Ethiopia
| | | | - Molly Brady
- Act to End NTDs East, RTI International, Washington, DC, USA
| | - Robert M. R. Butcher
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Hannah Frawley
- Act to End NTDs East, RTI International, Washington, DC, USA
| | - Genet Gebru
- Neglected Tropical Diseases Team, Disease Prevention and Control Directorate, Ministry of Health, Ethiopia
| | | | - Fikreab Kebede
- Neglected Tropical Diseases Team, Disease Prevention and Control Directorate, Ministry of Health, Ethiopia
| | - Asfaw Kejela
- Act to End NTDs East, RTI International, Addis Ababa, Ethiopia
| | - Scott McPherson
- Act to End NTDs East, RTI International, Washington, DC, USA
| | | | - Nebiyu Negussu
- Neglected Tropical Diseases Team, Disease Prevention and Control Directorate, Ministry of Health, Ethiopia
| | | | - Fentahun Taddese
- Neglected Tropical Diseases Team, Disease Prevention and Control Directorate, Ministry of Health, Ethiopia
| | | | - Asfaw Wondimu
- Asfaw Wondimu Health Research and Consultancy, Addis Ababa, Ethiopia
| | | | - Anthony W. Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Emma M. Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
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Gupta N, Vashist P, Senjam SS, Gupta V, Wadhwani M, Manna S, Grover S, Bhardwaj A. Current status of trachoma in India: Results from the National Trachoma Prevalence Survey. Indian J Ophthalmol 2022; 70:3260-3265. [PMID: 36018099 DOI: 10.4103/ijo.ijo_503_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose In the mid-twentieth century, trachoma was endemic in the northwestern states of India. We aimed to generate recent estimates of prevalence of trachomatous inflammation, follicular (TF) and trachomatous trichiasis (TT) in ten suspected-endemic districts across seven previously hyper-endemic states and union territories for trachoma in India including Delhi, Rajasthan, Haryana, Punjab, Gujarat, Uttarakhand and the Andaman and Nicobar Islands. Methods Population-based prevalence surveys were undertaken in 10 districts. In each of those districts, two-stage cluster sampling was used to select a sample of 2000 children aged 1-9 years and all adults aged ≥15 years in the enumerated households from a total of 20 clusters per district. Consenting eligible participants were examined for trachoma by trained ophthalmologists using the World Health Organization's simplified grading system. Data were analyzed at the district level. Results A total of 13,802 households were surveyed in which 19,662 children were examined for TF and 44,135 adults aged ≥15 years were examined for TT. District-level TF prevalence in 1-9-year-olds ranged from 0.1% in Bikaner (95% CI: 0.01-0.3) to 2.1% in Dholpur (95% CI: 1.6-2.8) and that of trichiasis ranged from 0.7 per 1000 in Pauri Garhwal (95% CI: 0.01-1.4) to 22.1 per 1000 (95% CI: 15.8-28.4) in Car Nicobar. In four districts (Car Nicobar, Dholpur, Hoshiarpur, Tonk), trichiasis prevalence in adults aged ≥15 years was ≥0.2%. Conclusion TF was not a public health problem in any of the districts surveyed; thus, antibiotic mass drug administration is not needed. However, TT among adults was found to be above 0.2% in four districts; thus, further trichiasis surgery interventions at the public health level are warranted to achieve elimination. These findings will facilitate planning for elimination of trachoma as a public health problem in India.
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Affiliation(s)
- Noopur Gupta
- Cornea, Cataract & Refractive Surgery Services, Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Praveen Vashist
- Cornea, Cataract & Refractive Surgery Services, Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Suraj S Senjam
- Cornea, Cataract & Refractive Surgery Services, Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Gupta
- Cornea, Cataract & Refractive Surgery Services, Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Meenakshi Wadhwani
- Cornea, Cataract & Refractive Surgery Services, Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Souvik Manna
- Cornea, Cataract & Refractive Surgery Services, Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sumit Grover
- Cornea, Cataract & Refractive Surgery Services, Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Bhardwaj
- Cornea, Cataract & Refractive Surgery Services, Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Abstract
Trachoma is a neglected tropical disease caused by infection with conjunctival strains of Chlamydia trachomatis. It can result in blindness. Pathophysiologically, trachoma is a disease complex composed of two linked chronic processes: a recurrent, generally subclinical infectious-inflammatory disease that mostly affects children, and a non-communicable, cicatricial and, owing to trichiasis, eventually blinding disease that supervenes in some individuals later in life. At least 150 infection episodes over an individual's lifetime are needed to precipitate trichiasis; thus, opportunity exists for a just global health system to intervene to prevent trachomatous blindness. Trachoma is found at highest prevalence in the poorest communities of low-income countries, particularly in sub-Saharan Africa; in June 2021, 1.8 million people worldwide were going blind from the disease. Blindness attributable to trachoma can appear in communities many years after conjunctival C. trachomatis transmission has waned or ceased; therefore, the two linked disease processes require distinct clinical and public health responses. Surgery is offered to individuals with trichiasis and antibiotic mass drug administration and interventions to stimulate facial cleanliness and environmental improvement are designed to reduce infection prevalence and transmission. Together, these interventions comprise the SAFE strategy, which is achieving considerable success. Although much work remains, a continuing public health problem from trachoma in the year 2030 will be difficult for the world to excuse.
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Joshi G, Quadir SS, Yadav KS. Road map to the treatment of neglected tropical diseases: Nanocarriers interventions. J Control Release 2021; 339:51-74. [PMID: 34555491 DOI: 10.1016/j.jconrel.2021.09.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 12/11/2022]
Abstract
Neglected tropical disease (NTD) is a set of 20 deadliest endemic diseases which shows its presence in most of the developing countries worldwide. Nearly 1 billion of the population are affected by it and suffered from poverty yearly. These diseases offer their own unique challenges and limitations towards effective prevention and treatment methods. Neglected tropical diseases are severe infections they may not kill the patient but debilitate the patient by causing severe skin deformities, disfigurement and horrible risks for several infections. Existing therapies for neglected diseases suffer from the loopholes like high degree of toxicity, side effects, low bioavailability, improper targeting and problematic application for affected populations. Progress in the field of nanotechnology in last decades suggested the intervention of nanocarriers to take over and drive the research and development to the next level by incorporating established drugs into the nanocarriers rather than discovering the newer drugs which is an expensive affair. These nanocarriers are believed to be a sure shot technique to fight infections at root level by virtue of its nanosize and ability to reach at cellular level. This article highlights the recent advances, rationale, targets and the challenges that are being faced to fight against NTDs and how the novel therapy tactics are able to contribute to its importance in prevention and treatment of NTDs.
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Affiliation(s)
- Garima Joshi
- Department of Pharmaceutical Sciences, Mohanlal Sukhadia University, Udaipur, Rajasthan 313001, India
| | - Sheikh Shahnawaz Quadir
- Department of Pharmaceutical Sciences, Mohanlal Sukhadia University, Udaipur, Rajasthan 313001, India
| | - Khushwant S Yadav
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS (Deemed to be University), Mumbai 400056, India.
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