Study shows necessity of evidence-based planning in trachoma control programs

Researchers conducted surveys in two north-central Nigerian states between March 2007 and November 2008 to determine the prevalence of trachoma and quantify the interventions necessary to eliminate the disease. Using a random cluster sampling technique, they assessed the steps required to support the World Health Organization (WHO) SAFE (surgery, mass administration of antibiotics, promotion of facial cleanliness and environmental improvements) strategy for eradicating blinding trachoma by 2020 (GET 2020).

A total of 46,960 people were examined across the 30 local government areas in the Plateau and Nasarawa states. Clinical signs of trachoma were assessed using the WHO Simplified Grading System.

The prevalence of trachomatous inflammation follicular in children aged 1 to 9 was found to be 6.4 percent. Trachomatous trichiasis prevalence in adults ages 15 years and older was 0.34 percent. By local government area, trachomatous inflammation follicular prevalence ranged between 1.7 and 15.8 percent and trachomatous trichiasis prevalence between 0.0 and 2.1 percent. Of the 7883 households visited during the three surveys conducted, 49.1 percent had a latrine and 52.6 percent had access to an improved water source of a covered bore hole, protected well, hand pump or town supply.

Based on WHO guidelines, the study's authors projected that trachoma control interventions were required in seven local government areas targeting 5409 people for trichiasis surgery, 778,698 people for at least three rounds of mass antibiotic distribution, 855 villages for promotion of face washing and sanitation and 102,751 households for latrine construction. Community assessment and community-based interventions may be needed in the remaining 23 local government areas.

The authors conclude that their mapping surveys may serve as a model for other areas yet to be mapped for trachoma in order to provide measurable targets for eliminating the blinding disease.