Prevalence of trachoma in the Kayes region of Mali eight years after stopping mass drug administration

• Published in: PLoS neglected tropical diseases Vol. 12; no. 2; p. e0006289
• Main Authors: Traoré, Lamine, Dembele, Benoit, Keita, Modibo, Reid, Steven D, Dembéle, Mahamadou, Mariko, Bréhima, Coulibaly, Famolo, Goldman, Whitney, Traoré, Dramane, Coulibaly, Daouda, Guindo, Boubacar, Amon, Joseph J, Knieriemen, Marily, Zhang, Yaobi
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 12.02.2018; Public Library of Science (PLoS)
• Subjects: Antibiotics; Azithromycin; Biology and Life Sciences; Causes of; Children; Chlamydia; Chlamydia trachomatis; Confidence intervals; Demographic aspects; Diagnosis; Evaluation; Households; International; Medicine and Health Sciences; Methods; People and Places; Prevalence studies (Epidemiology); Random sampling; Statistical sampling; Surgery; Surveying; Surveys; Systematic review; Trachoma; Tropical diseases; Mali
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0006289

In 2009, three years after stopping mass treatment with azithromycin, a trachoma impact survey in four health districts in the Kayes region of Mali found a prevalence of trachomatous inflammation-follicular (TF) among children aged 1 to 9 years of >5% and a trachomatous trichiasis (TT) prevalence within the general population (≥1-year-old) of <1%. As a result, the government's national trachoma program expanded trichiasis surgery and related activities required to achieve trachoma elimination. In 2015, to assess progress towards elimination, a follow-up impact survey was conducted in the Kayes, Kéniéba, Nioro and Yélimané health districts. The survey used district level two-stage cluster random sampling methodology with 20 clusters of 30 households in each evaluation unit. Subjects were eligible for examination if they were ≥1 year. TF and TT cases were identified and confirmed by experienced ophthalmologists. In total 14,159 people were enumerated and 11,620 (82%) were examined. TF prevalence (95% confidence interval (CI)) was 0.5% (0.3-1%) in Kayes, 0.8% (0.4-1.7%) in Kéniéba, 0.2% (0-0.9%) in Nioro and 0.3% (0.1-1%) in Yélimané. TT prevalence (95% CI) was 0.04% (0-0.25%) in Kayes, 0.29% (0.11-0.6%) in Kéniéba, 0.04% (0-0.25%) in Nioro and 0.07% (0-0.27%) in Yélimané. Eight years after stopping MDA and intensifying trichiasis surgery outreach campaigns, all four districts reached the TF elimination threshold of <5% and three of four districts reached the TT elimination threshold of <0.1%.