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Current trends in trachoma in a previously hyperendemic area. The Trachoma Study Group
Insights
A study in Uttar Pradesh found 8.5% of children aged 1-10 had trachoma. Active infections were high, but antigen presence was lower, suggesting ophthalmologists need better clinical diagnosis training to avoid overdiagnosis.
Area of Science:
- Ophthalmology
- Public Health
- Infectious Diseases
Background:
- Trachoma is a leading cause of preventable blindness globally.
- Reports indicated a high incidence of trachoma in western Uttar Pradesh, India, in late 1995.
Purpose of the Study:
- To investigate the prevalence and characteristics of trachoma in children in affected villages.
- To assess the accuracy of clinical diagnosis in identifying active trachoma cases.
Main Methods:
- Clinical examination of 837 children aged 1-10 years in three high-incidence villages.
- Assessment of clinical signs of trachoma and categorization into active/inactive forms.
- Laboratory confirmation using Chlamydia trachomatis antigen detection via direct specimen kit.
Main Results:
- Overall trachoma prevalence was 8.5% (71 children).
- Prevalence was higher in males than females and increased with age.
- 85.9% of diagnosed cases were active and infectious; antigen detection confirmed 54.9% of these.
Conclusions:
- Ophthalmologists require re-training in clinical diagnosis to reduce overdiagnosis of trachoma.
- Accurate clinical assessment is crucial for effective trachoma control programs.
Abstract:
In response to reports of an excessive number of cases of trachoma at the end of 1995 from the western parts of the North Indian state of Uttar Pradesh, 837 children in the age-group 1-10 years were examined in three villages from where the maximum number of cases hailed. Clinically, the prevalence of trachoma was found to be 8.5% (71). The prevalence was significantly higher in males as compared to females (p < 0.05); and was observed to increase with age. 85.9% (61) of the clinically diagnosed children were active infective cases. 54.9% (39) of the clinically diagnosed cases showed the presence of antigen in the upper tarsal conjunctival scraping from the affected eye, using the Chlamydia trachomatis direct specimen kit (Syva MicroTrak, UK). It was concluded that ophthalmologists must be reoriented to the clinical diagnosis of trachoma to prevent overdiagnosis.