Follicular trachoma and trichiasis prevalence in an urban community in The Gambia, West Africa: is there a need to include urban areas in national trachoma surveillance?

• Published in: Tropical medicine & international health 2013-11, Vol.18 (11), p.1344-1352
• Main Authors: Quicke, E., Sillah, A., Harding‐Esch, E. M., Last, A., Joof, H., Makalo, P., Bailey, R. L., Burr, S. E.
• Format: Article
• Language: English
• Subjects: Bacterial diseases; Bacterial diseases of the eye and orbit; Biological and medical sciences; Blindness - etiology; Blindness - prevention & control; Child; Child, Preschool; Chlamydia trachomatis; Cross-Sectional Studies; Emigration and Immigration; Eyes & eyesight; Face; Female; Gambia - epidemiology; General aspects; Health Surveys; Human bacterial diseases; Humans; Hygiene; Infant; Infectious diseases; Male; Medical sciences; Mucus; Nose; Population Surveillance; Prevalence; Risk Factors; Surveys and Questionnaires; The Gambia; trachoma; Trachoma - epidemiology; Trachoma - etiology; Trachoma - microbiology; Transients and Migrants; trichiasis; Trichiasis - epidemiology; Trichiasis - etiology; Trichiasis - microbiology; Tropical diseases; urban; Urban areas; Urban Population
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.12182

Objectives Urban areas are traditionally excluded from trachoma surveillance activities, but due to rapid expansion and population growth, the urban area of Brikama in The Gambia may be developing social problems that are known risk factors for trachoma. It is also a destination for many migrants who may be introducing active trachoma into the area. This study aimed to determine the prevalence and risk factors for follicular trachoma and trichiasis in Brikama. Methods A community‐based cross‐sectional prevalence survey including 27 randomly selected households in 12 randomly selected enumeration areas (EAs) of Brikama. Selected households were offered eye examinations, and the severity of trachoma was graded according to WHO's simplified grading system. Risk factor data were collected from each household via a questionnaire. Results The overall prevalence of trachomatous inflammation–follicular (TF) in children aged 1–9 years was 3.8% (95% CI 2.5–5.6), and the overall prevalence of trichiasis in adults aged ≥15 years was 0.46% (95% CI 0.17–1.14). EA prevalence of TF varied from 0% to 8.4%. The major risk factors for TF were dirty faces (P 0.1%), and active case finding needs to be undertaken. Objectifs Les zones urbaines sont traditionnellement exclues des activités de surveillance du trachome, mais en raison de l'expansion rapide et de la croissance de la population, la zone urbaine de Brikama en Gambie pourrait être entrain de développer des problèmes sociaux connus comme facteurs de risque pour le trachome. C'est aussi une destination pour de nombreux migrants qui peuvent ainsi introduisent le trachome actif dans la zone. Cette étude visait à déterminer les facteurs de risque et la prévalence du trachome folliculaire et du trichiasis à Brikama. Méthodes Enquête de prévalence transversale communautaire portant sur 27 ménages choisis au hasard dans 12 secteurs de dénombrement (SD) aussi choisis au hasard à Brikama. Les ménages sélectionnés ont reçu des examens de la vue et la sévérité du tra