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Trachoma among children in community surveys from four African countries and implications of using school surveys for evaluating prevalence.

Abstract

BACKGROUND: School surveys provide a convenient platform to obtain large child cohorts from multiple communities and are widely used as a proxy to determine community prevalence of neglected tropical diseases. The purpose of this study was to compare trachoma prevalence between preschool- and school-aged children and children who attend and do not attend school.

METHODS: We analysed data from community-based trachoma surveys conducted from 2008-2011 in Ethiopia, Mali, Niger and Nigeria. The surveys utilised a cross-sectional, randomised cluster design. Individual-level data on school attendance was collected.

RESULTS: Overall, 75 864 children aged 1-15 years from 2100 communities were included in the analysis. The prevalence of trachomatous inflammation follicular (TF) among these children in surveyed districts was 19.1% (95% CI 17.9-20.2%) in Ethiopia, 6.2% (95% CI 5.4-6.9%) in Niger, 4.6% (95% CI 4.2-4.9%) in Mali and 4.2% (95% CI 3.5-4.9%) in Nigeria. Controlling for age, sex and clustering, the OR of TF for school-attendees compared to non-attendees was 0.64 (95% CI 0.56-0.73) in Ethiopia, 0.67 (95% CI 0.56-0.80) in Mali, 1.03 (95% CI 0.81-1.16) in Niger and 1.06, (95% CI 0.65-1.73) in Nigeria.

CONCLUSION: Estimating the prevalence of trachoma through examination of only school-going children risks underestimating the true prevalence.

More information

Type
Journal Article
Author
King JD
Odermatt P
Utzinger J
Ngondi J
Bamani S
Kamissoko Y
Boubicar K
Hassan AS
Nwobi BC
Jip N
Amnie A
Teferi T
Mosher AW
Stewart AE P
Cromwell EA
Emerson PM
Year of Publication
2013
Journal
International health
Volume
5
Issue
4
Number of Pages
280-7
Language
eng
ISSN Number
1876-3405
DOI
10.1093/inthealth/iht027
Alternate Journal
Int Health
Publication Language
eng