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Prevalence and risk factors for trachoma in Sarlahi district, Nepal
1Department of International Health, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, MD 21205-2103, USA.
Insights
Trachoma affects 23.6% of preschool children in Nepal, with follicular trachoma being common. Risk factors include limited water access and crowding, but severe trachoma and scarring are rare in this age group.
Area of Science:
- Ophthalmology
- Public Health
- Infectious Diseases
Background:
- Trachoma is a leading cause of preventable blindness globally.
- Preschool children are a vulnerable population for trachoma infection.
- Understanding prevalence and risk factors in specific regions is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of active trachoma in preschool children (24-76 months) in Sarlahi district, Nepal.
- To identify key risk factors associated with trachoma in this population.
- To assess the severity of trachoma and the presence of scarring in young children.
Main Methods:
- A stratified random sample of 40 wards was selected.
- A systematic 20% sample of children aged 24-76 months within selected wards were examined.
- The World Health Organization (WHO) grading system was used to assess trachoma presence and severity.
Main Results:
- The overall prevalence of active trachoma was 23.6% (21.9% follicular, 1.7% intense inflammatory).
- Trachoma prevalence varied significantly across wards (0-50%), with higher rates in communities lacking tube wells.
- Risk factors identified include limited water access, crowding, and lower socioeconomic status; cement housing and more household goods were protective.
Conclusions:
- Follicular trachoma is prevalent in preschool children in Sarlahi, but intense inflammatory trachoma and scarring are rare.
- This preschool population may have a lower risk of developing trachoma-related blindness in adulthood.
- Public health strategies should address environmental and socioeconomic factors contributing to trachoma prevalence.
Aims:
To estimate the prevalence of trachoma in preschool children in Sarlahi district, Nepal, and to identify risk factors for the disease.
Methods:
A stratified random sample of 40 wards was selected for participation in a trachoma survey. Within each ward, a systematic 20% sample of children 24-76 months of age was chosen to determine the presence and severity of trachoma using the World Health Organisation grading system.
Results:
A total of 891 children were selected and 836 (93.8%) were examined for trachoma from December 1990 to March 1991. The prevalence of active trachoma was 23.6% (21.9% follicular and 1.7% intense inflammatory). Cicatricial trachoma was not seen in this age group. The prevalence of trachoma ranged from 0 to 50% across wards with certain communities at much higher risk for trachoma than others. Three year old children had the highest prevalence of follicular (25.5%) and intense inflammatory trachoma (4.3%). Males and females had similar prevalence rates. Wards without any tube wells were at higher risk than those with one or more tube wells. Lower rates of trachoma were seen in families who lived in cement houses, had fewer people per room, more servants, more household goods, animals, and land. Hence, less access to water, crowding and lower socioeconomic status were risk factors for trachoma.
Conclusions:
Although follicular trachoma is prevalent, intense inflammatory trachoma is relatively rare and scarring was not observed in this preschool population. Hence, this population may not be at high risk for repeat infections leading to blindness in adulthood.