Building on a decade of progress in water, sanitation and hygiene to control, eliminate and eradicate neglected tropical diseases

Boisson, Sophie; Wohlgemuth, Leah; Yajima, Aya; Peralta, Genandrialine L.; Obiageli, Nebe; Matendechero, Sultani; Baayenda, Gilbert; Seife, Fikre; Hamilton, Helen; Chase, Claire; Barry, Fatoumata Binta; Solomon, Anthony W.; Velleman, Yael

doi:10.1093/trstmh/trab001

Cited by 17 publications

(6 citation statements)

References 5 publications

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“…In addition, efforts to implement the F and E components of the SAFE strategy (or, more generally, improve access to WASH) are needed across all of the area surveyed, not just for trachoma elimination purposes. 17 , 18 In the 41 woredas that have met the WHO-recommended TF elimination target, further rounds of antibiotic MDA are not needed, but trachoma surveillance surveys should be conducted at least 2 y after the impact surveys took place, in order to check for recrudescence. 19…”

Section: Discussionmentioning

confidence: 99%

Prevalence of trachoma in Somali region, Ethiopia: results from trachoma impact surveys in 50 woredas

Gebreselassie,

Negash,

Tsegaye

et al. 2023

International Health

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Background Following interventions to eliminate trachoma in Somali region, Ethiopia, we aimed to re-estimate the prevalence of trachomatous trichiasis (TT) and trachomatous inflammation—follicular (TF) at woreda level and identify the factors associated with the disease. Methods We implemented cross-sectional community-based surveys in 50 trachoma-endemic woredas, using a standardized survey. Households were the secondary sampling unit. Surveys were undertaken through a combination of interviews of household heads and direct inspection of water, sanitation and hygiene (WASH) access, plus clinical evaluation of eligible household members for TT and TF. Results Overall, 41 (82%) of the 50 woredas had met the WHO-recommended active trachoma elimination threshold (prevalence of TF <5% in 1–9-y-olds) and 42 (84%) had met the TT threshold (prevalence of TT unknown to the health system <0.2% in ≥15-y-olds). Only 18% of households had access to an improved drinking water source within a 30-min trip and only 25% had an improved latrine. Conclusions Additional rounds of antibiotic mass drug administration, plus interventions to enhance facial cleanliness and improve the environment, are required in nine woredas. TT surgical campaigns are needed in eight woredas. Greater access to WASH is required across all the woredas that were surveyed.

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Section: Discussionmentioning

confidence: 99%

Prevalence of trachoma in Somali region, Ethiopia: results from trachoma impact surveys in 50 woredas

Gebreselassie,

Negash,

Tsegaye

et al. 2023

International Health

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“… 42–46 It is also clear that improvements in WASH are needed, not just for trachoma elimination purposes or for the broader neglected tropical disease agenda, but to achieve general improvement in the quality of life of people living in this region. 47 …”

Section: Discussionmentioning

confidence: 99%

Prevalence of Trachoma in Pre-validation Surveillance Surveys in 11 Evaluation Units (Covering 12 Districts) in Oromia Regional State, Ethiopia: Results from 2018−2020

Miecha

Dejene²,

Adugna

et al. 2022

Ophthalmic Epidemiology

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Purpose Interventions to reduce the prevalence of trachoma and transmission of ocular Chlamydia trachomatis have been implemented in Oromia Region, Ethiopia. Following an impact survey in which the trachomatous inflammation—follicular (TF) prevalence in 1–9-year-olds is <5%, a surveillance survey is recommended 2 years later, without additional antibiotic treatment. We report results of surveillance surveys in 11 evaluation units (EUs) covering 12 districts in Oromia Region, to plan whether future interventions are needed. Method We use a two-stage cluster-sampling cross-sectional survey design. In each EU, 26 clusters (villages) were systematically selected with probability proportional to size; from each cluster, 30 households were selected using compact segment sampling. Water, sanitation and hygiene (WASH) access was assessed in all selected households. All residents of selected households aged ≥1 year were examined for TF and trachomatous trichiasis (TT) by certified graders. Result Of 31,991 individuals enumerated, 29,230 (91% of) individuals were examined. Eight EUs had an age-adjusted TF prevalence in 1−9-year-olds of ≥5% and seven had a TT prevalence unknown to the health system among adults aged ≥15 years of ≥0.2%. About one-third of visited households had access to an improved water source for drinking, and 5% had access to an improved latrine. Conclusion Despite TF reductions to <5% at impact survey, prevalence recrudesced to ≥5% in all but three of the 11 EUs. Operational research is needed to understand transmission dynamics and epidemiology, in order to optimise elimination strategies in high-transmission settings like these.

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“…Concerted synergistic action from water, sanitation and hygiene (WASH) departments locally and environmental improvement would go a long way in sustenance of efforts leading to low TF. [ 10 ]…”

Section: Discussionmentioning

confidence: 99%

Current status of trachoma in India: Results from the National Trachoma Prevalence Survey

Vashist

Gupta

Senjam

et al. 2022

Indian Journal of Ophthalmology

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Purpose: In the mid-twentieth century, trachoma was endemic in the northwestern states of India. We aimed to generate recent estimates of prevalence of trachomatous inflammation, follicular (TF) and trachomatous trichiasis (TT) in ten suspected-endemic districts across seven previously hyper-endemic states and union territories for trachoma in India including Delhi, Rajasthan, Haryana, Punjab, Gujarat, Uttarakhand and the Andaman and Nicobar Islands. Methods: Population-based prevalence surveys were undertaken in 10 districts. In each of those districts, two-stage cluster sampling was used to select a sample of 2000 children aged 1–9 years and all adults aged ≥15 years in the enumerated households from a total of 20 clusters per district. Consenting eligible participants were examined for trachoma by trained ophthalmologists using the World Health Organization’s simplified grading system. Data were analyzed at the district level. Results: A total of 13,802 households were surveyed in which 19,662 children were examined for TF and 44,135 adults aged ≥15 years were examined for TT. District-level TF prevalence in 1–9-year-olds ranged from 0.1% in Bikaner (95% CI: 0.01–0.3) to 2.1% in Dholpur (95% CI: 1.6–2.8) and that of trichiasis ranged from 0.7 per 1000 in Pauri Garhwal (95% CI: 0.01–1.4) to 22.1 per 1000 (95% CI: 15.8–28.4) in Car Nicobar. In four districts (Car Nicobar, Dholpur, Hoshiarpur, Tonk), trichiasis prevalence in adults aged ≥15 years was ≥0.2%. Conclusion: TF was not a public health problem in any of the districts surveyed; thus, antibiotic mass drug administration is not needed. However, TT among adults was found to be above 0.2% in four districts; thus, further trichiasis surgery interventions at the public health level are warranted to achieve elimination. These findings will facilitate planning for elimination of trachoma as a public health problem in India.

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Building on a decade of progress in water, sanitation and hygiene to control, eliminate and eradicate neglected tropical diseases

Cited by 17 publications

References 5 publications

Prevalence of trachoma in Somali region, Ethiopia: results from trachoma impact surveys in 50 woredas

Prevalence of trachoma in Somali region, Ethiopia: results from trachoma impact surveys in 50 woredas

Prevalence of Trachoma in Pre-validation Surveillance Surveys in 11 Evaluation Units (Covering 12 Districts) in Oromia Regional State, Ethiopia: Results from 2018−2020

Current status of trachoma in India: Results from the National Trachoma Prevalence Survey

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