Prevalence of trachoma in the Kayes region of Mali eight years after stopping mass drug administration

PLoS Negl Trop Dis. 2018 Feb 12;12(2):e0006289. doi: 10.1371/journal.pntd.0006289. eCollection 2018 Feb.

Abstract

Background: In 2009, three years after stopping mass treatment with azithromycin, a trachoma impact survey in four health districts in the Kayes region of Mali found a prevalence of trachomatous inflammation-follicular (TF) among children aged 1 to 9 years of >5% and a trachomatous trichiasis (TT) prevalence within the general population (≥1-year-old) of <1%. As a result, the government's national trachoma program expanded trichiasis surgery and related activities required to achieve trachoma elimination.

Methodology/principal findings: In 2015, to assess progress towards elimination, a follow-up impact survey was conducted in the Kayes, Kéniéba, Nioro and Yélimané health districts. The survey used district level two-stage cluster random sampling methodology with 20 clusters of 30 households in each evaluation unit. Subjects were eligible for examination if they were ≥1 year. TF and TT cases were identified and confirmed by experienced ophthalmologists. In total 14,159 people were enumerated and 11,620 (82%) were examined. TF prevalence (95% confidence interval (CI)) was 0.5% (0.3-1%) in Kayes, 0.8% (0.4-1.7%) in Kéniéba, 0.2% (0-0.9%) in Nioro and 0.3% (0.1-1%) in Yélimané. TT prevalence (95% CI) was 0.04% (0-0.25%) in Kayes, 0.29% (0.11-0.6%) in Kéniéba, 0.04% (0-0.25%) in Nioro and 0.07% (0-0.27%) in Yélimané.

Conclusions/significance: Eight years after stopping MDA and intensifying trichiasis surgery outreach campaigns, all four districts reached the TF elimination threshold of <5% and three of four districts reached the TT elimination threshold of <0.1%.

MeSH terms

  • Adolescent
  • Brazil / epidemiology
  • Child
  • Clinical Laboratory Techniques
  • Communicable Disease Control / methods*
  • Female
  • Fluorescent Antibody Technique
  • Health Education / methods*
  • Humans
  • Male
  • Mass Drug Administration / methods*
  • Prevalence
  • Schools
  • Students
  • Trachoma / diagnosis
  • Trachoma / epidemiology*
  • Trachoma / pathology
  • Trachoma / prevention & control*

Grants and funding

The 2015 survey reported in this paper was funded by the Conrad N Hilton Foundation through a grant to Helen Keller International (Grant number: 20130058). The integrated NTD program in Mali was funded by the United States Agency for International Development (USAID) ENVISION Project through Helen Keller International. ENVISION is a global project led by RTI International in partnership with CBM International, The Carter Center, Helen Keller International, IMA World Health, Light for the World, Sightsavers, and World Vision. ENVISION is funded by the USAID project under cooperative agreement number AID-OAA-A-11- 00048. The period of performance for ENVISION is September 30, 2011 through September 29, 2019. The national trachoma program also received financial support from the International Trachoma Initiative and from the Conrad N Hilton Foundation through Helen Keller International, the Carter Center and Sightsavers. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.