1
|
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.
Collapse
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
| |
Collapse
|
2
|
Vasconcelos A, King JD, Nunes-Alves C, Anderson R, Argaw D, Basáñez MG, Bilal S, Blok DJ, Blumberg S, Borlase A, Brady OJ, Browning R, Chitnis N, Coffeng LE, Crowley EH, Cucunubá ZM, Cummings DAT, Davis CN, Davis EL, Dixon M, Dobson A, Dyson L, French M, Fronterre C, Giorgi E, Huang CI, Jain S, James A, Kim SH, Kura K, Lucianez A, Marks M, Mbabazi PS, Medley GF, Michael E, Montresor A, Mutono N, Mwangi TS, Rock KS, Saboyá-Díaz MI, Sasanami M, Schwehm M, Spencer SEF, Srivathsan A, Stawski RS, Stolk WA, Sutherland SA, Tchuenté LAT, de Vlas SJ, Walker M, Brooker SJ, Hollingsworth TD, Solomon AW, Fall IS. Accelerating Progress Towards the 2030 Neglected Tropical Diseases Targets: How Can Quantitative Modeling Support Programmatic Decisions? Clin Infect Dis 2024; 78:S83-S92. [PMID: 38662692 PMCID: PMC11045030 DOI: 10.1093/cid/ciae082] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
Over the past decade, considerable progress has been made in the control, elimination, and eradication of neglected tropical diseases (NTDs). Despite these advances, most NTD programs have recently experienced important setbacks; for example, NTD interventions were some of the most frequently and severely impacted by service disruptions due to the coronavirus disease 2019 (COVID-19) pandemic. Mathematical modeling can help inform selection of interventions to meet the targets set out in the NTD road map 2021-2030, and such studies should prioritize questions that are relevant for decision-makers, especially those designing, implementing, and evaluating national and subnational programs. In September 2022, the World Health Organization hosted a stakeholder meeting to identify such priority modeling questions across a range of NTDs and to consider how modeling could inform local decision making. Here, we summarize the outputs of the meeting, highlight common themes in the questions being asked, and discuss how quantitative modeling can support programmatic decisions that may accelerate progress towards the 2030 targets.
Collapse
Affiliation(s)
- Andreia Vasconcelos
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
- Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
| | - Jonathan D King
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - Cláudio Nunes-Alves
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
| | - Roy Anderson
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, London, United Kingdom
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Daniel Argaw
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - Maria-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, London, United Kingdom
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Shakir Bilal
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, USA
| | - David J Blok
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Seth Blumberg
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Anna Borlase
- Department of Biology, University of Oxford, Oxford, United Kingdom
| | - Oliver J Brady
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Raiha Browning
- The Department of Statistics, The University of Warwick, Coventry, United Kingdom
| | - Nakul Chitnis
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Emily H Crowley
- Zeeman Institute for System Biology and Infectious Disease Epidemiology Research, The University of Warwick, Coventry, United Kingdom
- Mathematics Institute, The University of Warwick, Coventry, United Kingdom
| | - Zulma M Cucunubá
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Universidad Pontificia Javeriana, Bogotá, Colombia
| | - Derek A T Cummings
- Department of Biology, University of Florida, Gainesville, Florida, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
| | - Christopher Neil Davis
- Zeeman Institute for System Biology and Infectious Disease Epidemiology Research, The University of Warwick, Coventry, United Kingdom
- Mathematics Institute, The University of Warwick, Coventry, United Kingdom
| | - Emma Louise Davis
- Mathematics Institute, The University of Warwick, Coventry, United Kingdom
| | - Matthew Dixon
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, London, United Kingdom
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Andrew Dobson
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, USA
| | - Louise Dyson
- Zeeman Institute for System Biology and Infectious Disease Epidemiology Research, The University of Warwick, Coventry, United Kingdom
- Mathematics Institute, The University of Warwick, Coventry, United Kingdom
| | - Michael French
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, St Mary's Campus, Imperial College London, London, United Kingdom
- RTI International, Washington, D.C., USA
| | - Claudio Fronterre
- CHICAS, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Emanuele Giorgi
- CHICAS, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Ching-I Huang
- Zeeman Institute for System Biology and Infectious Disease Epidemiology Research, The University of Warwick, Coventry, United Kingdom
- Mathematics Institute, The University of Warwick, Coventry, United Kingdom
| | - Saurabh Jain
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - Ananthu James
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sung Hye Kim
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - Klodeta Kura
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, London, United Kingdom
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Ana Lucianez
- Communicable Diseases Prevention, Control, and Elimination, Pan American Health Organization, Washington D.C., USA
| | - Michael Marks
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Pamela Sabina Mbabazi
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - Graham F Medley
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Edwin Michael
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Antonio Montresor
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - Nyamai Mutono
- Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
- Paul G. Allen School for Global Health, Washington State University, Pullman, Washington, USA
| | - Thumbi S Mwangi
- Centre for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
- Paul G. Allen School for Global Health, Washington State University, Pullman, Washington, USA
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Kat S Rock
- Zeeman Institute for System Biology and Infectious Disease Epidemiology Research, The University of Warwick, Coventry, United Kingdom
- Mathematics Institute, The University of Warwick, Coventry, United Kingdom
| | - Martha-Idalí Saboyá-Díaz
- Communicable Diseases Prevention, Control, and Elimination, Pan American Health Organization, Washington D.C., USA
| | - Misaki Sasanami
- Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Markus Schwehm
- ExploSYS GmbH, Interdisciplinary Institute for Exploratory Systems, Leinfelden-Echterdingen, Germany
| | - Simon E F Spencer
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ariktha Srivathsan
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Robert S Stawski
- Institute of Public Health and Wellbeing, School of Health and Social Care, University of Essex, Essex, United Kingdom
| | - Wilma A Stolk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Samuel A Sutherland
- Zeeman Institute for System Biology and Infectious Disease Epidemiology Research, The University of Warwick, Coventry, United Kingdom
- Warwick Medical School, The University of Warwick, Coventry, United Kingdom
| | | | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Martin Walker
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, London, United Kingdom
| | | | - T Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, United Kingdom
| | - Anthony W Solomon
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - Ibrahima Socé Fall
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| |
Collapse
|
3
|
Cochrane GM, Mangot M, Houinei W, Susapu M, Cama A, Le Mesurier R, Webster S, Hillgrove T, Barton J, Butcher R, Harding-Esch EM, Mabey D, Bakhtiari A, Müller A, Yajima A, Solomon AW, Kaldor J, Koim SP, Ko R, Garap J. Corneal pannus, Herbert's pits and conjunctival inflammation in older children in Papua New Guinea. Ophthalmic Epidemiol 2024:1-8. [PMID: 38329811 DOI: 10.1080/09286586.2023.2273507] [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] [Indexed: 02/10/2024]
Abstract
PURPOSE The prevalence of trachomatous inflammation-follicular (TF) in Papua New Guinea (PNG) suggests antibiotic mass drug administration (MDA) is needed to eliminate trachoma as a public health problem but the burden of trichiasis is low. As a result, WHO issued bespoke recommendations for the region. If ≥ 20% of 10-14-year-olds have both any conjunctival scarring (C1 or C2 or C3) and corneal pannus and/or Herbert's pits, MDA should be continued. Equally, if ≥ 5% of that group have both moderate/severe conjunctival scarring (C2 or C3) and corneal pannus and/or Herbert's pits, MDA should be continued. METHODS We identified 14 villages where > 20% of 1-9-year-olds had TF during baseline mapping undertaken 4 years and 1 month previously. Every child aged 10-14 years in those villages was eligible to be examined for clinical signs of corneal pannus, Herbert's pits and conjunctival scarring. A grading system that built on existing WHO grading systems was used. RESULTS Of 1,293 resident children, 1,181 (91%) were examined. Of 1,178 with complete examination data, only one (0.08%) individual had concurrent scarring and limbal signs. CONCLUSIONS The WHO-predefined criteria for continuation of MDA were not met. Ongoing behavioural and environmental improvement aspects of the SAFE strategy may contribute to integrated NTD control. Surveillance methods should be strengthened to enable PNG health authorities to identify future changes in disease prevalence.
Collapse
Affiliation(s)
| | - Magdelene Mangot
- National Prevention of Blindness Committee, Port Moresby, Papua New Guinea
| | - Wendy Houinei
- National Department of Health, Port Moresby, Papua New Guinea
| | - Melinda Susapu
- National Department of Health, Port Moresby, Papua New Guinea
| | | | | | | | | | | | - Robert Butcher
- Clinical Research Department, London School of Hygiene & Tropical Medicine, UK
| | - Emma M Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, UK
| | - David Mabey
- Clinical Research Department, London School of Hygiene & Tropical Medicine, UK
| | - Ana Bakhtiari
- International Trachoma Initiative,Task Force for Global Health, Atlanta, USA
| | - Andreas Müller
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Aya Yajima
- Division of Programmes for Disease Control, Western Pacific Regional Office, World Health Organization, Manila, Philippines
| | - Anthony W Solomon
- Global Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - John Kaldor
- Kirby Institute, University of New South Wales, Sydney, Australia
| | | | - Robert Ko
- National Department of Health, Port Moresby, Papua New Guinea
| | - Jambi Garap
- National Prevention of Blindness Committee, Port Moresby, Papua New Guinea
| |
Collapse
|
4
|
Olamiju F, Isiyaku S, Olobio N, Mogaji H, Achu I, Muhammad N, Boyd S, Bakhtiari A, Ebenezer A, Jimenez C, Solomon AW, Harding-Esch EM, Mpyet CD. Prevalence of Trachoma following Implementation of the SAFE Strategy in Three Local Government Areas of Taraba State, North Eastern Nigeria. Ophthalmic Epidemiol 2023; 30:619-627. [PMID: 35353025 DOI: 10.1080/09286586.2022.2045025] [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: 07/07/2021] [Accepted: 02/10/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION In 2019-2020, one round of antibiotic mass drug administration (MDA) was implemented for trachoma elimination purposes in Donga, Gashaka, and Ussa local government areas (LGAs) of Taraba State, Nigeria, following baseline surveys in 2009 (Donga and Gashaka) and 2013-2014 (Ussa). Here, trachoma prevalence post-MDA in these three LGAs is reported. METHODS In 2019 (Gashaka and Ussa) and 2020 (Donga), population-based, cross-sectional surveys were conducted following World Health Organization (WHO) guidance. A two-stage cluster sampling strategy was used. All residents of selected households aged ≥1 year were examined by Tropical Data-certified graders for trachomatous inflammation-follicular (TF) and trachomatous trichiasis (TT) using the WHO simplified trachoma grading scheme. Data on water, sanitation, and hygiene (WASH) access were also collected. RESULTS A total of 1,883 households participated. From these households, 4,885 children aged 1-9 years were enumerated, and 4,866 (99.6%) examined. There were 5,050 eligible adults (aged ≥15 years) enumerated in the same households, of whom 4,888 (96.8%) were examined. Age-adjusted TF prevalence in children aged 1-9 years was 0.22% (95% CI: 0.00-0.65) in Donga, 0.0% in Gashaka, and 0.19% (95% CI: 0.00-0.44) in Ussa. The age- and gender-adjusted TT prevalence unknown to the health system in adults aged ≥15 years was 0.08% (95% CI: 0.00-0.19) in Donga, 0.02% (95% CI: 0.00-0.06) in Gashaka, and 0.10% (95% CI: 0.01-0.18) in Ussa. In Donga, Gashaka, and Ussa, respectively, 66%, 49% and 63% of households had access to an improved drinking water source, and 68%, 56% and 29% had access to an improved latrine. CONCLUSION In all LGAs, the elimination thresholds for TF and TT unknown to the health system have been attained in the target age groups. These LGAs should be re-surveyed after 2 years to show that reductions in TF prevalence have been sustained in the absence of MDA. Health authorities should continue to improve WASH facilities to reduce the risk of later recrudescence.
Collapse
Affiliation(s)
| | | | | | - Hammed Mogaji
- Department of Animal and Environmental Biology, Federal University Oye-Ekiti, Ekiti, Nigeria
| | - Ijeoma Achu
- Mission To Save The Helpless (MITOSATH), Jos, Nigeria
| | - Nasiru Muhammad
- Ophthalmology Department, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Sarah Boyd
- International Trachoma Initiative, Task Force for Global Health, Decatur, Georgia, USA
| | - Ana Bakhtiari
- International Trachoma Initiative, Task Force for Global Health, Decatur, Georgia, USA
| | | | | | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Emma M Harding-Esch
- London Centre for Neglected Tropical Disease Research, London, UK
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Caleb D Mpyet
- Sightsavers, Nigeria Country Office, Kaduna, Nigeria
- Department of Ophthalmology, College of Health Sciences, University of Jos, Jos, Nigeria
| |
Collapse
|
5
|
Seyum D, Fetene N, Kifle T, Negash H, Kabeto T, Gebre M, Data T, Tadele T, Abayo G, Wondimu A, Butcher R, Bakhtiari A, Willis R, Boyd S, Jimenez C, Negussu N, Tadesse F, Kebede F, Dejene M, Solomon AW, Harding-Esch EM, Sisay A. Prevalence of Trachoma from 66 Impact Surveys in 52 Woredas of Southern Nations, Nationalities and Peoples' and Sidama Regions of Ethiopia, 2017-2019. Ophthalmic Epidemiol 2023; 30:637-646. [PMID: 35473569 PMCID: PMC10581674 DOI: 10.1080/09286586.2022.2065313] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 04/01/2022] [Accepted: 04/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Trachoma is endemic in Southern Nations, Nationalities and Peoples' (SNNP) and Sidama regions of Ethiopia. We aimed to measure the prevalence of trachomatous inflammation-follicular (TF) among children aged 1 - 9 years and the prevalence of trachomatous trichiasis (TT) unknown to the health system among people aged ≥15 years following interventions for trachoma in 52 woredas of SNNP and Sidama regions. METHODS From 2017 - 2019, 66 two-stage cluster sampling cross-sectional population-based surveys were carried out in 52 woredas (third-level administrative divisions) using a standardized World Health Organization-recommended survey methodology. This included one impact survey in 40 woredas, two consecutive impact surveys in 10 woredas and three consecutive impact surveys in two woredas. Water, sanitation and Hygiene (WASH) access was assessed using a modified version of the United Nations Children's Fund/WHO Joint Monitoring Programme questionnaire. RESULTS By the end of this survey series, 15 (23%) of the woredas had met the active trachoma elimination threshold (TF prevalence <5%) and 12 (18%) had met the TT threshold (TT ≤ 0.2%). Regarding WASH coverage, 20% of households had access to an improved drinking water source within a 30-min journey and 3% had an improved latrine. There was strong evidence that TF was less common in 4 - 6-year-olds and 7 - 9-year-olds than 1 - 3-year-olds. CONCLUSION Based on the findings, further antibiotic mass drug administration is required in 37 woredas and active TT case finding is needed in 40 woredas. In these surveys, access to WASH facilities was very low; WASH improvements are required.
Collapse
Affiliation(s)
- Dawit Seyum
- Orbis International Ethiopia, Orbis International Ethiopia, Addis Ababa, Ethiopia
| | - N Fetene
- Orbis International Ethiopia, Orbis International Ethiopia, Addis Ababa, Ethiopia
| | - Tezera Kifle
- Orbis International Ethiopia, Orbis International Ethiopia, Addis Ababa, Ethiopia
| | - Habtamu Negash
- Orbis International Ethiopia, Orbis International Ethiopia, Addis Ababa, Ethiopia
| | - Temesgen Kabeto
- Orbis International Ethiopia, Orbis International Ethiopia, Addis Ababa, Ethiopia
| | - Mulatu Gebre
- Orbis International Ethiopia, Orbis International Ethiopia, Addis Ababa, Ethiopia
| | - Tadesse Data
- Orbis International Ethiopia, Orbis International Ethiopia, Addis Ababa, Ethiopia
| | - Tafese Tadele
- Southern Nations, Nationalities and Peoples’ Regional Health Bureau, Hawassa, Ethiopia
| | | | | | | | - Ana Bakhtiari
- ITI, Task Force for Global Health, Decatur, GEORGIA, USA
| | - Rebecca Willis
- ITI, Task Force for Global Health, Decatur, GEORGIA, USA
| | - Sarah Boyd
- ITI, Task Force for Global Health, Decatur, GEORGIA, USA
| | | | - Nebiyu Negussu
- Ministry of Health, Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Fentahun Tadesse
- Ministry of Health, Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Fikreab Kebede
- Ministry of Health, Federal Ministry of Health, 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
| | - Alemayehu Sisay
- Orbis International Ethiopia, Orbis International Ethiopia, Addis Ababa, Ethiopia
| |
Collapse
|
6
|
Harding-Esch EM, Burgert-Brucker CR, Jimenez C, Bakhtiari A, Willis R, Dejene Bejiga M, Mpyet C, Ngondi J, Boyd S, Abdala M, Abdou A, Adamu Y, Alemayehu A, Alemayehu W, Al-Khatib T, Apadinuwe SC, Awaca N, Awoussi MS, Baayendag G, Badiane Mouctar D, Bailey RL, Batcho W, Bay Z, Bella A, Beido N, Bol YY, Bougouma C, Brady CJ, Bucumi V, Butcher R, Cakacaka R, Cama A, Camara M, Cassama E, Chaora SG, Chebbi AC, Chisambi AB, Chu B, Conteh A, Coulibaly SM, Courtright P, Dalmar A, Dat TM, Davids T, DJAKER MEA, de Fátima Costa Lopes M, Dézoumbé D, Dodson S, Downs P, Eckman S, Elshafie BE, Elmezoghi M, Elvis AA, Emerson P, Epée EEE, Faktaufon D, Fall M, Fassinou A, Fleming F, Flueckiger R, Gamael KK, Garae M, Garap J, Gass K, Gebru G, Gichangi MM, Giorgi E, Goépogui A, Gómez DVF, Gómez Forero DP, Gower EW, Harte A, Henry R, Honorio-Morales HA, Ilako DR, Issifou AAB, Jones E, Kabona G, Kabore M, Kadri B, Kalua K, Kanyi SK, Kebede S, Kebede F, Keenan JD, Kello AB, Khan AA, KHELIFI H, Kilangalanga J, KIM SH, Ko R, Lewallen S, Lietman T, Logora MSY, Lopez YA, MacArthur C, Macleod C, Makangila F, Mariko B, Martin DL, Masika M, Massae P, Massangaie M, Matendechero HS, Mathewos T, McCullagh S, Meite A, Mendes EP, Abdi HM, Miller H, Minnih A, Mishra SK, Molefi T, Mosher A, M’Po N, Mugume F, Mukwiza R, Mwale C, Mwatha S, Mwingira U, Nash SD, NASSA C, Negussu N, Nieba C, Noah Noah JC, Nwosu CO, Olobio N, Opon R, Pavluck A, Phiri I, Rainima-Qaniuci M, Renneker KK, Saboyá-Díaz MI, Sakho F, Sanha S, Sarah V, Sarr B, Szwarcwald CL, Shah Salam A, Sharma S, Seife F, Serrano Chavez GM, Sissoko M, Sitoe HM, Sokana O, Tadesse F, Taleo F, Talero SL, Tarfani Y, Tefera A, Tekeraoi R, Tesfazion A, Traina A, Traoré L, Trujillo-Trujillo J, Tukahebwa EM, Vashist P, Wanyama EB, WARUSAVITHANA SD, Watitu TK, West S, Win Y, Woods G, YAJIMA A, Yaya G, Zecarias A, Zewengiel S, Zoumanigui A, Hooper PJ, Millar T, Rotondo L, Solomon AW. Tropical Data: Approach and Methodology as Applied to Trachoma Prevalence Surveys. Ophthalmic Epidemiol 2023; 30:544-560. [PMID: 38085791 PMCID: PMC10751062 DOI: 10.1080/09286586.2023.2249546] [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: 03/09/2023] [Accepted: 08/11/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys. METHODS Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations. Founding principles are health ministry ownership, partnership and collaboration, and quality assurance and quality control at every step of the survey process. Support covers survey planning, survey design, training, electronic data collection and fieldwork, and data management, analysis and dissemination. Methods are adapted to meet local context and needs. Customisations, operational research and integration of other diseases into routine trachoma surveys have also been supported. RESULTS Between 29th February 2016 and 24th April 2023, 3373 trachoma surveys across 50 countries have been supported, resulting in 10,818,502 people being examined for trachoma. CONCLUSION This health ministry-led, standardised approach, with support from the start to the end of the survey process, has helped all trachoma elimination stakeholders to know where interventions are needed, where interventions can be stopped, and when elimination as a public health problem has been achieved. Flexibility to meet specific country contexts, adaptation to changes in global guidance and adjustments in response to user feedback have facilitated innovation in evidence-based methodologies, and supported health ministries to strive for global disease control targets.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Amza Abdou
- Programme National de Santé Oculaire, Niger
| | | | | | | | | | | | - Naomie Awaca
- Ministère de la Santé Publique, Democratic Republic of Congo
| | | | | | | | | | | | | | | | | | | | - Clarisse Bougouma
- Programme national de lutte contre les maladies tropicales négligées (PNMTN), Burkina Faso
| | | | - Victor Bucumi
- National Integrated Programme for the Control of Neglected Tropical Diseases and Blindness (PNIMTNC), Burundi
| | | | | | | | | | | | | | | | | | - Brian Chu
- International Trachoma Initiative, USA
| | | | | | - Paul Courtright
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa, South Africa
| | - Abdi Dalmar
- Ministry of Human Development and Public Services, Somalia
| | | | | | | | | | | | | | | | | | | | | | - Ange Aba Elvis
- Programme National de la Santé Oculaire et de la lutte contre l’Onchocercose, Côte d’Ivoire
| | | | | | | | | | | | | | | | | | | | - Jambi Garap
- Port Moresby General Hospital, Papua New Guinea
| | | | | | | | | | | | | | | | | | - Anna Harte
- London School of Hygiene & Tropical Medicine, UK
| | - Rob Henry
- U.S. Agency for International Development, USA
| | | | | | | | | | | | - Martin Kabore
- Programme national de lutte contre les maladies tropicales négligées (PNMTN), Burkina Faso
| | | | - Khumbo Kalua
- Blantyre Institute for Community Outreach, Malawi
| | | | | | | | | | | | | | | | | | | | - Robert Ko
- Port Moresby General Hospital, Papua New Guinea
| | - Susan Lewallen
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa, South Africa
| | | | | | - Yuri A Lopez
- SACAICET / MINISTERIO DEL PODER POPULAR PARA LA SALUD, Venezuela
| | | | | | | | | | | | | | | | | | | | | | | | - Aboulaye Meite
- Ministère de la Santé et de l’Hygiène Publique, Cote d’Ivoire
| | | | | | | | | | | | | | - Aryc Mosher
- U.S. Agency for International Development, USA
| | | | | | | | | | | | | | | | | | | | - Cece Nieba
- Ministère de la Santé et de l’Hygiene Publique, Guinea
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Oliver Sokana
- Solomon Islands Ministry of Health and Medical Services, Solomon Islands
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Bucumi V, Muhimpundu E, Bio Issifou AA, Akweyu S, Burn N, Willems J, Niyongabo J, Elvis A, Koizan G, Harte A, Boyd S, Willis R, Bakhtiari A, Jimenez C, Burgert-Brucker C, Kollmann KHMM, Solomon AW, Harding-Esch EM, Gashikanyi RM. Baseline, Impact and Surveillance Trachoma Prevalence Surveys in Burundi, 2018-2021. Ophthalmic Epidemiol 2023:1-10. [PMID: 37401094 PMCID: PMC10581665 DOI: 10.1080/09286586.2023.2213776] [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: 11/10/2022] [Revised: 03/23/2023] [Accepted: 05/09/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE Trachoma is an eye disease caused by the bacterium Chlamydia trachomatis (Ct). It can lead to permanent vision loss. Since 2007, Burundi has included trachoma elimination as part of its fight against neglected tropical diseases and blindness. This study presents the results of trachoma baseline, impact and surveillance surveys conducted in Burundi between 2018 and 2021. METHODS Areas were grouped into evaluation units (EU) with resident populations of between 100,000 and 250,000 people. Baseline surveys were conducted in 15 EUs, impact surveys in 2 EUs and surveillance surveys in 5 EUs; in each survey, 23 clusters of about 30 households were included. Consenting residents of those households were screened for clinical signs of trachoma. Access to water, sanitation and hygiene (WASH) was recorded. RESULTS A total of 63,800 individuals were examined. The prevalence of TF in 1-9-year-olds was above the elimination threshold of 5% in a single EU at baseline, but fell below the threshold in subsequent impact and surveillance surveys. The prevalence of TT was below the 0.2% elimination threshold in ≥15-year-olds in all EUs surveyed. A high proportion (83%) of households had access to safe drinking water, while only a minority (~8%) had access to improved latrines. CONCLUSION Burundi has demonstrated the prevalence levels necessary for trachoma elimination status. With continued effort and the maintenance of existing management plans, trachoma elimination in Burundi is within reach.
Collapse
Affiliation(s)
- Victor Bucumi
- Département En Charge des Maladies Tropicales, National Integrated Programme for the Control of Neglected Tropical Diseases and Blindness (PNIMTNC), Bujumbura, Burundi
| | - Elvis Muhimpundu
- Département En Charge des Maladies Tropicales, National Integrated Programme for the Control of Neglected Tropical Diseases and Blindness (PNIMTNC), Bujumbura, Burundi
| | | | - Stephanie Akweyu
- Inclusive Eye Health and Neglected Tropical Diseases Initiative, CBM international
| | - Nick Burn
- Inclusive Eye Health and Neglected Tropical Diseases Initiative, CBM international
| | - Johan Willems
- Inclusive Eye Health and Neglected Tropical Diseases Initiative, CBM international
| | - Junénal Niyongabo
- Département En Charge des Maladies Tropicales, National Integrated Programme for the Control of Neglected Tropical Diseases and Blindness (PNIMTNC), Bujumbura, Burundi
| | - Aba Elvis
- Programme National de la Santé Oculaire et de la lutte contre l’Onchocercose, Côte d’Ivoire
| | - Gamael Koizan
- Ministère de la Santé et de l’Hygiène Publique, Cote d’Ivoire
| | - Anna Harte
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarah Boyd
- International Trachoma Initiative, Task Force for Global Health, Atlanta, Georgia, USA
| | - Rebecca Willis
- International Trachoma Initiative, Task Force for Global Health, Atlanta, Georgia, USA
| | - Ana Bakhtiari
- International Trachoma Initiative, Task Force for Global Health, Atlanta, Georgia, USA
| | | | | | - KHM Martin Kollmann
- Inclusive Eye Health and Neglected Tropical Diseases Initiative, CBM international
| | - 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
| | - Rose Marie Gashikanyi
- Département En Charge des Maladies Tropicales, National Integrated Programme for the Control of Neglected Tropical Diseases and Blindness (PNIMTNC), Bujumbura, Burundi
| |
Collapse
|
8
|
Ul Hassan E, Apadinuwe SC, Bisanzio D, Dejene M, Downs P, Harding-Esch EM, Jimenez C, Kabona G, Kebede BN, Kelly M, Kivumbi P, Millar T, Mosher AW, Mpyet C, Mkocha H, Ngondi JM, Olobio N, Palmer S, Teyil WM, Courtright P. Impact of personal protective equipment on the clarity of vision among trachoma survey graders and trichiasis surgeons in the context of COVID-19. BMJ Open Ophthalmol 2023; 8:e001255. [PMID: 37493675 PMCID: PMC10255175 DOI: 10.1136/bmjophth-2023-001255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/20/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND/AIMS The COVID-19 pandemic necessitated the use of personal protective equipment for those involved in trachoma survey grading and trichiasis surgery. We sought to determine which configuration of a face shield would be less likely to impact grading accuracy and ability to conduct trichiasis surgery. The research also included assessment of comfort, ease of cleaning and robustness. METHODS There were three research phases. In phase 1, assessment of four potential face shield configurations was undertaken with principal trachoma graders and trichiasis surgeon trainers to decide which two options should undergo further testing. In phase 2, clarity of vision and comfort (in a classroom environment) of the two configurations were assessed compared with no face shield (control), while grading trachomatous inflammation-follicular (TF). The second phase also included the assessment of impact of the configurations while performing trichiasis surgery using a training model. In phase 3, face shield ease of use was evaluated during routine surgical programmes. RESULTS In phase 2, 124 trachoma graders and 28 trichiasis surgeons evaluated the 2 face shield configurations selected in phase 1. TF agreement was high (kappa=0.83 and 0.82) for both configurations compared with not wearing a face shield. Comfort was reported as good by 51% and 32% of graders using the two configurations. Trichiasis skill scores were similar for both configurations. CONCLUSION The face shield configuration that includes a cut-out for mounting the 2.5× magnifying loupes does not appear to impact the ability or comfort of trachoma graders or trichiasis surgeons to carry out their work.
Collapse
Affiliation(s)
| | | | - Donal Bisanzio
- Research Triangle Park, Research Triangle Institute, Durham, North Carolina, USA
| | - Michael Dejene
- Public Health Consultancy Services, Addis Ababa, Ethiopia
| | - Philip Downs
- Neglected Tropical Diseases, Sightsavers, Haywards Heath, UK
- Neglected Tropical Diseases, Sightsavers, Durham, North Carolina, USA
| | - Emma M Harding-Esch
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | | | - George Kabona
- Union Government of Tanzania Ministry of Health Community Development Gender Elderly Children, Dar es Salaam, Tanzania, United Republic of
| | | | - Michaela Kelly
- Neglected Tropical Diseases, Sightsavers, Haywards Heath, UK
| | - Peter Kivumbi
- Sightsavers, Dar es Salaam, United Republic of Tanzania
| | - Tom Millar
- Neglected Tropical Diseases, Sightsavers, Haywards Heath, UK
| | - Aryc W Mosher
- United States Agency for International Development, Washington, DC, USA
| | - Caleb Mpyet
- Neglected Tropical Diseases, Sightsavers, Kaduna, Nigeria
| | - Harran Mkocha
- Microbiology and Immunology, Kongwa Trachoma Project, Kongwa, Tanzania, United Republic of
| | - Jeremiah M Ngondi
- Research Triangle Park, Research Triangle Institute, Durham, North Carolina, USA
| | | | | | | | - Paul Courtright
- Kilimanjaro Centre for Community Ophthalmology, University of Cape Town, Observatory, South Africa
| |
Collapse
|
9
|
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.
Collapse
|
10
|
Gallini JW, Sata E, Zerihun M, Melak B, Haile M, Zeru T, Gessese D, Ayele Z, Tadesse Z, Callahan EK, Nash SD, Weiss PS. Optimizing cluster survey designs for estimating trachomatous inflammation-follicular within trachoma control programs. Int J Infect Dis 2021; 116:101-107. [PMID: 34965463 DOI: 10.1016/j.ijid.2021.12.355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The World Health Organization recommends mass drug administration (MDA) with azithromycin to eliminate trachoma as a public health problem. MDA decisions are based on prevalence estimates from two-stage cluster surveys. Work remains to mathematically evaluate current trachoma survey designs. We aimed to characterize the effects of the number of units sampled on the precision and cost of trachomatous inflammation-follicular (TF) estimates. METHODS We simulated a population of 30 districts to represent the breadth of possible TF distributions in Amhara, Ethiopia. Samples of varying numbers of clusters (14-34) and households (10-60) were selected. Sampling schemes were evaluated on precision, proportion of incorrect and low MDA decisions made, and estimated cost. RESULTS Number of clusters sampled had a greater impact on precision than number of households. The most efficient scheme depended on the underlying TF prevalence in a district. For lower prevalence areas (<10%) the most cost efficient (providing adequate precision while minimizing cost) design was 20 clusters of 20-30 households. For higher prevalence areas (>10%), the most efficient design was 15-20 clusters of 20-30 households. CONCLUSIONS For longer-running programs, using context-specific survey designs would allow for practical precision while reducing survey costs. Sampling 15 clusters of 20-30 households in suspected moderate to high prevalence districts and 20 clusters of 20-30 households in districts suspected to be near the 5% threshold appears to be a balanced approach.
Collapse
Affiliation(s)
- Julia W Gallini
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Eshetu Sata
- Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia
| | - Mulat Zerihun
- Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia
| | - Berhanu Melak
- Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia
| | - Mahteme Haile
- Amhara Public Health Institute, Bahir Dar, Amhara, Ethiopia
| | - Taye Zeru
- Amhara Public Health Institute, Bahir Dar, Amhara, Ethiopia
| | - Demelash Gessese
- Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia
| | - Zebene Ayele
- Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia
| | - Zerihun Tadesse
- Trachoma Control Program, The Carter Center, Addis Ababa, Ethiopia
| | - E Kelly Callahan
- Trachoma Control Program, The Carter Center, Atlanta, Georgia, USA
| | - Scott D Nash
- Trachoma Control Program, The Carter Center, Atlanta, Georgia, USA.
| | - Paul S Weiss
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| |
Collapse
|