The Burden of and Risk Factors for Trachoma in Selected Districts of Zimbabwe: Results of 16 Population-Based Prevalence Surveys

Phiri, Isaac; Manangazira, Portia; Macleod, Colin; Mduluza, Takafira; Dhobbie, Tinashe; Chaora, Shorai Grace; Chigwena, Chriswell T; Katiyo, Joshua; Willis, Rebecca; Bakhtiari, Ana; Bare, Peter; Courtright, Paul; Macheka, Boniface; Midzi, Nicholas; Solomon, Anthony W.; Mapping, Global Trachoma

doi:10.1080/09286586.2017.1298823

Cited by 15 publications

(15 citation statements)

References 18 publications

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“…Baseline trachoma mapping was completed for a total of 1,629 districts (993 EUs) in 32 countries [ 15 – 40 ]. Global support expenditures cover only districts which were mapped using standardised GTMP methodologies: 1,546 districts (905 EUs) in 29 countries.…”

Section: Resultsmentioning

confidence: 99%

The cost of mapping trachoma: Data from the Global Trachoma Mapping Project

et al. 2017

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BackgroundThe Global Trachoma Mapping Project (GTMP) was implemented with the aim of completing the baseline map of trachoma globally. Over 2.6 million people were examined in 1,546 districts across 29 countries between December 2012 and January 2016. The aim of the analysis was to estimate the unit cost and to identify the key cost drivers of trachoma prevalence surveys conducted as part of GTMP.Methodology and principal findingsIn-country and global support costs were obtained using GTMP financial records. In-country expenditure was analysed for 1,164 districts across 17 countries. The mean survey cost was $13,113 per district [median: $11,675; IQR = $8,365-$14,618], $17,566 per evaluation unit [median: $15,839; IQR = $10,773-$19,915], $692 per cluster [median: $625; IQR = $452-$847] and $6.0 per person screened [median: $4.9; IQR = $3.7-$7.9]. Survey unit costs varied substantially across settings, and were driven by parameters such as geographic location, demographic characteristics, seasonal effects, and local operational constraints. Analysis by activities showed that fieldwork constituted the largest share of in-country survey costs (74%), followed by training of survey teams (11%). The main drivers of in-country survey costs were personnel (49%) and transportation (44%). Global support expenditure for all surveyed districts amounted to $5.1m, which included grant management, epidemiological support, and data stewardship.ConclusionThis study provides the most extensive analysis of the cost of conducting trachoma prevalence surveys to date. The findings can aid planning and budgeting for future trachoma surveys required to measure the impact of trachoma elimination activities. Furthermore, the results of this study can also be used as a cost basis for other disease mapping programmes, where disease or context-specific survey cost data are not available.

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Section: Resultsmentioning

confidence: 99%

The cost of mapping trachoma: Data from the Global Trachoma Mapping Project

et al. 2017

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“…In this study, we employed the momentum, 18,27 systems 19,28 and funding 29 of the GTMP to investigate whether trachoma was a public health problem in an area felt to be the most at-risk part of the Republic of the Congo, a hitherto-unsurveyed country. This survey was set up as the epidemiological equivalent of a canary in the mine, with the understanding that finding trachoma at levels indicative of a public health problem here would prompt further trachoma surveys in surrounding health districts, 3,4 and potentially further afield. We did not find trachoma at levels indicative of a public health problem, and (following the example of similar trachoma mapping exercises in Kogi and Kwara states of Nigeria 30,31 ) do not now believe that such further mapping is justified (though refugee populations here may still need to be separately considered).…”

Section: Discussionmentioning

confidence: 99%

“…(An analogous approach was also undertaken in Democratic Republic of the Congo and Zimbabwe. 3,4 ) The districts identified for mapping were Mokéko and Ouesso of Sangha Department, and Impfondo, Epéna, Dongou, Betou and Enyelle of Likouala Department (Figure 1). These seven districts were grouped as a single evaluation unit (EU) with an estimated combined population of 189,656.…”

Section: Introductionmentioning

confidence: 99%

A Population-Based Trachoma Prevalence Survey Covering Seven Districts of Sangha and Likouala Departments, Republic of the Congo

Missamou

Marlhand

Dzabatou-Babeaux

et al. 2018

Ophthalmic Epidemiology

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Purpose : We set out to estimate the prevalence of trachoma and access to water and sanitation in seven suspected-trachoma-endemic districts of northern Congo, surveyed as a single evaluation unit. Methods : From a complete list of rural villages in the seven districts, we systematically selected 22 with probability proportional to village size. In selected villages, we included all households where there were fewer than 25 in total, or used compact segment sampling to select a group of approximately 20 households by random draw. In each selected household, all consenting residents aged ≥1 year were examined by Global Trachoma Mapping Project-certified trachoma graders, and data collected on household-level access to water and sanitation. Results : In November and December 2015, 466 households were visited in 22 villages, and 2081 (88%) of 2377 residents of those households were examined. No examined individual had trichiasis. The age-adjusted prevalence of the active trachoma sign trachomatous inflammation—follicular (TF) in 1–9-year-olds was 2.5% (95%CI 0.9–4.5%). Only 39% (95%CI 35–44%) of households had access to an improved source of drinking water. Only 10% (95%CI 7–13%) of households had access to an improved sanitation facility. Conclusion : Trachoma is not a public health problem in this part of Congo. Access to water and sanitation is inadequate.

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“…In 2011 and 2012, baseline surveys were conducted in 25 LGAs of Sokoto and Kebbi. 16 In total, baseline surveys were conducted in 49 LGAs of Kebbi, Sokoto and Zamfara during the period 2004-2012. Based on LGA-level prevalence estimates of TF in children aged 1-9 years, 20…”

Section: Settingmentioning

confidence: 99%

“…Based on the prevalence of trichiasis in persons aged ≥15 years, 40 LGAs surveyed required community-based trichiasis surgery to reach the trichiasis elimination threshold. The decision was made to implement various aspects of the SAFE strategy in 49 LGAs found to have trachoma of public health significance (27 LGAs with TF prevalence ≥10% and 40 LGAs with trichiasis prevalence ≥0.2%, of which 22 LGAs required public-health-level trichiasis interventions [S], 9…”

Section: Settingmentioning

confidence: 99%

Impact Survey Results after SAFE Strategy Implementation in 15 Local Government Areas of Kebbi, Sokoto and Zamfara States, Nigeria

Mpyet

Muhammad

Adamu

et al. 2018

Ophthalmic Epidemiology

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Purpose: To determine prevalence of trachoma after interventions in 15 local government areas (LGAs) of Kebbi, Sokoto and Zamfara States, Nigeria. Methods: A population-based impact survey was conducted in each LGA using Global Trachoma Mapping Project (GTMP) protocols. In each LGA, 25 villages were selected, except in Arewa LGA, where we selected 25 villages from each of four subunits to obtain finer-resolution prevalence information. Villages were selected with probability proportional to size. In each village, 25 households were enrolled and all consenting residents aged ≥1 year were examined by GTMP-certified graders for trachomatous inflammation-follicular (TF) and trachomatous trichiasis (TT). Information on sources of household water and types of sanitation facilities used was collected through questioning and direct observation. Results: The number of households enrolled per LGA ranged from 623 (Kware and Tangaza) to 2488 (Arewa). There have been marked reductions in the prevalence of TF and TT since baseline surveys were conducted in all 15 LGAs. Eight of the 15 LGAs have attained TF prevalences <5% in children, while 10 LGAs have attained TT prevalences <0.2% in persons aged ≥15 years. Between 49% and 96% of households had access to water for hygiene purposes within 1 km of the household, while only 10-59% had access to improved sanitation facilities. Conclusion: Progress towards elimination of trachoma has been made in these 15 LGAs. Collaboration with water and sanitation agencies and community-based trichiasis surgery are still needed in order to eliminate trachoma by the year 2020.

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The Burden of and Risk Factors for Trachoma in Selected Districts of Zimbabwe: Results of 16 Population-Based Prevalence Surveys

Abstract: Implementation of the SAFE strategy is needed in parts of Zimbabwe. In addition, Zimbabwe needs to conduct more baseline trachoma mapping in districts adjacent to those identified here as having a public health problem from the disease.

Cited by 15 publications

References 18 publications

The cost of mapping trachoma: Data from the Global Trachoma Mapping Project

The cost of mapping trachoma: Data from the Global Trachoma Mapping Project

A Population-Based Trachoma Prevalence Survey Covering Seven Districts of Sangha and Likouala Departments, Republic of the Congo

Impact Survey Results after SAFE Strategy Implementation in 15 Local Government Areas of Kebbi, Sokoto and Zamfara States, Nigeria

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