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Maciel AMS, Ferreira AF, Almeida NMGSD, Maciel MMS, Silva TL, Araújo MC, Pires Neto RDJ, Ramos AN. Trachoma-associated morbidity and mortality in Brazil: an ecological study focusing on hospitalization and mortality data, 2000-2022. Rev Soc Bras Med Trop 2024; 57:e004142024. [PMID: 39230161 PMCID: PMC11374125 DOI: 10.1590/0037-8682-0158-2024] [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: 05/23/2024] [Accepted: 07/18/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Trachoma is the leading infectious cause of blindness worldwide. It is a neglected tropical disease caused by Chlamydia trachomatis. The objective of this study was to analyze the trachoma-associated morbidity and mortality in Brazil from 2000 to 2022. This ecological time-series study was based on secondary data on trachoma obtained from hospital admissions (trachoma as the primary or secondary cause) and death certificates (trachoma as the underlying or associated cause). METHODS We calculated the sex- and age-standardized rates of hospital admissions and trachoma-specific mortality according to sociodemographic variables and analyzed the spatial distribution. RESULTS We identified 141/263,292,807 hospital admissions (primary cause: 83.0%) and 126/27,596,830 death certificates (associated cause: 91.3%) related to trachoma. Trachoma-related sequelae were reported in 8.5% of hospital admissions and 6.3% of death certificates. Trachoma was more common in males (hospital admissions and death certificates), people aged ≥70 years (hospital admissions and death certificates), those with brown skin (hospital admissions and death certificates), and those living in the North (hospital admissions) and Northeast (death certificates) regions of Brazil. CONCLUSIONS Despite the relatively low rates of trachoma morbidity in Brazil, the associated mortality rates are of concern. The heterogeneous patterns of occurrence in the country in terms of population and territory reinforce the need to evaluate and monitor the available data, despite the low prevalence, in order to achieve and maintain the elimination targets in Brazil in the future.
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Affiliation(s)
- Adjoane Maurício Silva Maciel
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Fortaleza, CE, Brasil
- Secretaria Municipal de Saúde, Russas, CE, Brasil
| | - Anderson Fuentes Ferreira
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Fortaleza, CE, Brasil
| | | | | | - Taynara Lais Silva
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Fortaleza, CE, Brasil
| | - Mirele Coelho Araújo
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Fortaleza, CE, Brasil
| | - Roberto da Justa Pires Neto
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Fortaleza, CE, Brasil
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Saúde Comunitária, Fortaleza, CE, Brasil
| | - Alberto Novaes Ramos
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Fortaleza, CE, Brasil
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Saúde Comunitária, Fortaleza, CE, Brasil
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Nasir MA, Elsawy F, Omar A, Haque SO, Nadir R. Eliminating Trachoma by 2020: Assessing Progress in Nigeria. Cureus 2020; 12:e9450. [PMID: 32760636 PMCID: PMC7392186 DOI: 10.7759/cureus.9450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Trachoma is a neglected tropical disease that causes an eye infection which can lead to blindness if left untreated. In 1998, the World Health Organisation (WHO) launched a new goal to eradicate trachoma by 2020. Over the years, in partnership with the WHO, an effective strategy plan was devised to help tackle and control the disease. This involved surgery for trichiasis, antibiotic treatment, facial cleanliness, and environmental improvement (SAFE). Consequently, the number of people affected by trachoma has significantly decreased in recent times. Despite this, trachoma remains a major public health concern in 44 countries worldwide, including Nigeria. Although improvements have been seen throughout Nigeria, the disjointed application of the SAFE strategy has delayed progress compared to other countries. Providing quality treatment to those with trachoma, in addition to improving preventative measures are challenges faced throughout the country. However, a multi-pronged approach emulating the methods of other countries is recommended to achieve trachoma elimination. This review aims to evaluate the progress and challenges faced in Nigeria with regards to eliminating trachoma.
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Affiliation(s)
| | - Fayez Elsawy
- Medicine, Manchester University, Manchester, GBR
| | | | - Shah O Haque
- Medicine, Manchester University, Manchester, GBR
| | - Rans Nadir
- Medicine, Imperial College London, London, GBR
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Amnie AG, Emerson P, McFarland D, King J, Miri E, Dickman L. An impact evaluation of two rounds of mass drug administration on the prevalence of active trachoma: A clustered cross sectional survey. PLoS One 2018; 13:e0201911. [PMID: 30157193 PMCID: PMC6114510 DOI: 10.1371/journal.pone.0201911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 07/24/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION We investigated the impact of two round of mass drug administration on trachoma prevalence in Plateau and Nasarawa States of Nigeria. The mass drug administration was conducted as a component of the SAFE Strategy, a combination of interventions recommended for the global elimination of blinding trachoma. METHODS The study consisted of a two-stage cross-sectional clustered sample survey in which 3990 people from 793 households were screened for clinical signs of trachoma. RESULTS Of the total 3990 people examined, 1530 were children, of which 808 (53%) were boys and 704 (47%) were girls. The impact of intervention as measured by the changes in overall prevalence of follicular trachoma were as follows: At baseline the overall prevalence of follicular trachoma among children 1-9 years of age was 6.4%, 95% CI [5.8, 7.0]; the overall prevalence of trachomatous trichiasis in the total population was 0.20%, 95% CI [0.16, 0.25]. At follow up, the overall prevalence of follicular trachoma among children 1-9 years of age was 3.4%, 95% CI [1.9, 4.9]; the overall prevalence of trachomatous trichiasis in the total population was 0.20%, 95% CI [0.00, 0.05]. The highest statistically significant reduction (96%) in follicular trachoma prevalence was observed in Doma Local Government Area of Nasarawa State from baseline prevalence of 13.6%, 95% CI [9.7, 17.5] to follow-up prevalence of 0.5%, 95% CI [0.0, 1.5] and the lowest reduction (58%) in follicular trachoma prevalence was observed in Langtang North Local Government Area of Plateau State from baseline prevalence of 15.8%, 95% CI [9.3, 22.3] to 6.6%, 95% CI [1.6, 11.6], (p<0.05). CONCLUSION A significant reduction in the overall prevalence of follicular trachoma was achieved after two rounds of mass drug administration. In the absence of significant activities pertaining to facial cleanliness and environmental sanitation components of the SAFE strategy in the intervention areas, the observed deep reductions in prevalence could mainly be attributed to mass drug administration. Therefore, two rounds of mass azithromycin administration may be as effective as guideline-recommended three or more rounds in reducing active trachoma prevalence but findings should be replicated in more robustly designed studies.
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Affiliation(s)
- Asrat Genet Amnie
- Health Education Unit, Education Department, Eugenio María de Hostos Community College, The City University of New York, New York, NY, United States
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Ramyil A, Bascaran C, Bunce C, Alada J, Wade P, Mpyet C. Outcome of trachoma lid surgeries in Jigawa state, Nigeria. COGENT MEDICINE 2016. [DOI: 10.1080/2331205x.2016.1233683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Alice Ramyil
- Department of Ophthalmology, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Catey Bunce
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- University College London (UCL), London, UK
| | - Joel Alada
- Department of Ophthalmology, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
| | - Patricia Wade
- Department of Ophthalmology, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
| | - Caleb Mpyet
- Department of Ophthalmology, University of Jos and Jos University Teaching Hospital, Jos, Nigeria
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Thompson K, Hutchins H, Baio A, Cassama E, Nabicassa M, Bailey R, Last AR. Health Beliefs and Perceptions of Trachoma in Communities on the Bijagos Archipelago of Guinea Bissau. Ophthalmic Epidemiol 2016; 22:190-9. [PMID: 26158577 PMCID: PMC4784498 DOI: 10.3109/09286586.2015.1036889] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Purpose: The World Health Organization aims to eliminate blinding trachoma by 2020 using the SAFE strategy: Surgery for trichiasis, Antibiotics, Facial cleanliness and Environmental improvement. Trachoma is hyperendemic on the remote Bijagos Archipelago of Guinea-Bissau, West Africa. Sociocultural factors remain unexplored here, despite their potential impact on disease control, particularly through the “F” and “E” aspects. By examining these, we aim to illuminate this population's unreported health beliefs, hygiene behaviors and disease perceptions. This understanding will help to optimize future public health interventions, and guide the distribution of limited healthcare resources. Methods: Two unmatched interview series were conducted 1 year apart on Bubaque Island in the Bijagos Archipelago; one in rural villages using purposive snowball sampling, the other in a semi-urban settlement, using random-cluster sampling. Interviews were conducted and recorded in Kriolu, the local dialect, by a supervised local field assistant before translation into English for conventional content analysis. Results: Trachoma was unheard of in either series, despite ongoing local trachoma research. A heterogeneous range of disease etiology and preventative measures were suggested, but the importance of hygiene was more widely reported by semi-urban interviewees. Although western medicine was well regarded, traditional practices continued, particularly in the rural populations. Conclusions: Differences in knowledge, beliefs and behaviors were apparent between the two series. Despite widespread rudimentary knowledge of disease prevention, targeted education might benefit both communities, particularly basic hygiene education for rural communities. Healthcare access should also be improved for rural populations. The impact of these measures could be assessed by future fieldwork.
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Affiliation(s)
- Katie Thompson
- University of Birmingham Medical School , Birmingham, UK
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