4.1 Article

The Prevalence of Trachomatous Trichiasis in People Aged 15 Years and Over in Six Evaluation Units of Gaoual, Labe, Dalaba and Beyla Districts, Guinea

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OPHTHALMIC EPIDEMIOLOGY
卷 -, 期 -, 页码 -

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TAYLOR & FRANCIS INC
DOI: 10.1080/09286586.2023.2192269

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Elimination; epidemiology; Guinea; trachomatous trichiasis; TT-only surveys

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This study aims to assess the progress of trachoma elimination in Guinea. The study found that the inflammatory trachoma prevalence in Guinea was below the WHO elimination threshold, but the trachomatous trichiasis (TT) prevalence was above it. These survey results provide critical data for evaluating Guinea's achievement of trachoma elimination targets.
PurposeTrachoma is a public health problem in 42 countries. Inflammation associated with repeated ocular infection with Chlamydia trachomatis can cause the eyelid to scar and turn inwards, resulting in the eyelashes rubbing against the eyeball, known as trachomatous trichiasis (TT). In Guinea, baseline surveys conducted in 2013 reported inflammatory trachoma prevalences below the World Health Organization (WHO) threshold for elimination, but TT prevalences above threshold. Given this epidemiological context and time since baseline survey, TT-only surveys were conducted in selected districts to determine current TT prevalence. The results of this study provide critical data for assessing Guinea's achievement of trachoma elimination targets.MethodsFour health districts, consisting of six evaluation units (EU), were surveyed. In each EU, field teams visited 29 clusters with a minimum 30 households included in each. Participants aged & GE;15 years were examined by certified graders trained to identify TT and determine whether management had been offered.ResultsA total of 22,476 people were examined, with 48 TT cases across the six EUs identified. Five of six EUs had an age-and-gender adjusted TT-prevalence unknown to the health system less than 0.2%, whereas one EU, Beyla 2, had an adjusted TT prevalence of 0.24%.ConclusionThese TT-only surveys, along with findings from other trachoma interventions, suggest that Guinea is close to achieving elimination of trachoma as a public health problem. This study demonstrates the value of undertaking TT-only surveys in settings where baseline surveys indicated active trachoma prevalences below WHO elimination threshold, but TT prevalences above it.

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