Prevalence of Trachoma following Implementation of the SAFE Strategy in Three Local Government Areas of Taraba State, North Eastern Nigeria

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.