Blinding trachoma in postconflict southern Sudan

Area of Science:

• Ophthalmology
• Public Health
• Infectious Diseases

Background:

• Trachoma is a leading cause of preventable blindness globally.
• Anecdotal evidence suggested a high burden of blinding trachoma in Mankien payam, southern Sudan.
• Previous data on trachoma prevalence in the region were limited.

Purpose of the Study:

• To estimate the prevalence of trachoma in Mankien payam.
• To determine targets for trachoma interventions.
• To establish a baseline for monitoring and evaluation of control programs.

Main Methods:

• A population-based cross-sectional survey was conducted in May 2005.
• Two-stage cluster random sampling with probability proportional to size was employed.
• Experienced graders used the World Health Organization simplified grading scheme for diagnosis.

Main Results:

• Active trachoma (TF or TI) prevalence in children aged 1-9 years was 63.3%.
• Trachomatous trichiasis prevalence was 9.6% overall, and 19.2% in adults.
• An estimated 5,344 individuals in Mankien payam require trichiasis surgery.

Conclusions:

• Trachoma poses a serious public health threat in Mankien.
• High prevalence of trichiasis, even in children, highlights the severity of the disease.
• The SAFE (Surgery, Antibiotics, Facial cleanliness, Environmental change) strategy should be urgently implemented for trachoma control.