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2. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study

Author

Steinmetz, JD, Bourne, RRA, Briant, PS, Flaxman, S, Taylor, HR, Jonas, JB, Abdoli, A, Abrha, WA, Abualhasan, A, Abu-Gharbieh, E, Adal, TG, Afshin, A, Ahmadieh, H, Alemayehu, W, Alemzadeh, SA, Alfaar, AS, Alipour, V, Androudi, S, Arabloo, J, Arditi, A, Aregawi, BB, Arrigo, A, Ashbaugh, C, Ashrafi, E, Atnafu, DD, Bagli, E, Baig, AA, Barnighausen, TW, Parodi, MB, Beheshti, M, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bijani, A, Bikbov, M, Bottone, M, Braithwaite, T, Bron, AM, Nagaraja, SB, Butt, ZA, dos Santos, FLC, Carneiro, VLA, Casson, RJ, Cheng, C-Y, Choi, J-YJ, Chu, D-T, Cicinelli, MV, Coelho, JM, Congdon, NG, Couto, RAS, Cromwell, EA, Dahlawi, SMA, Dai, X, Dana, R, Dandona, L, Dandona, R, Del Monte, MA, Molla, MD, Dervenis, N, Desta, AA, Deva, JP, Diaz, D, Djalalinia, S, Ehrlich, JR, Elayedath, R, Elhabashy, HR, Ellwein, LB, Emamian, MH, Eskandarieh, S, Farzadfar, F, Fernandes, AG, Fischer, F, Friedman, DS, Furtado, JM, Gaidhane, S, Gazzard, G, Gebremichael, B, George, R, Ghashghaee, A, Gilani, SA, Golechha, M, Hamidi, S, Hammond, BR, Hartnett, MER, Hartono, RK, Hashi, A, Hay, S, Hayat, K, Heidari, G, Ho, HC, Holla, R, Househ, M, Huang, JJ, Ibitoye, SE, Ilic, IM, Ilic, MD, Ingram, AD, Irvani, SSN, Islam, SMS, Itumalla, R, Jayaram, S, Jha, RP, Kahloun, R, Kalhor, R, Kandel, H, Kasa, AS, Kavetskyy, T, Kayode, GA, Kempen, JH, Khairallah, M, Khalilov, R, Khan, EA, Khanna, RC, Khatib, MN, Khoja, TAM, Kim, GR, Kim, JE, Kim, YJ, Kisa, A, Kisa, S, Kosen, S, Koyanagi, A, Bicer, BK, Kulkarni, V, Kurmi, OP, Landires, I, Lansingh, VC, Leasher, JL, LeGrand, KE, Leveziel, N, Limburg, H, Liu, X, Kunjathur, SM, Maleki, S, Manafi, N, Mansouri, K, McAlinden, C, Meles, GG, Mersha, AM, Michalek, IM, Miller, TR, Misra, S, Mohammad, Y, Mohammadi, SF, Mohammed, JA, Mokdad, AH, Moni, MA, Al Montasir, A, Morse, AR, Mulaw, GF, Naderi, M, Naderifar, H, Naidoo, KS, Naimzada, MD, Nangia, V, Swamy, SN, Naveed, M, Negash, H, Huong, LTN, Nunez-Samudio, V, Ogbo, FA, Ogundimu, K, Olagunju, AT, Onwujekwe, OE, Otstavnov, N, Owolabi, MO, Pakshir, K, Panda-Jonas, S, Parekh, U, Park, E-C, Pasovic, M, Pawar, S, Pesudovs, K, Peto, T, Pham, HQ, Pinheiro, M, Podder, V, Rahimi-Movaghar, V, Rahman, MHU, Ramulu, PY, Rathi, P, Rawaf, DL, Rawaf, S, Rawal, L, Reinig, N, Renzaho, AMN, Rezapour, A, Robin, AL, Rossetti, L, Sabour, S, Safi, S, Sahebkar, A, Sahraian, MA, Samy, AM, Sathian, B, Saya, GK, Saylan, M, Shaheen, AA, Shaikh, MA, Shen, TT, Shibuya, K, Shiferaw, WS, Shigematsu, M, Shin, JI, Silva, JC, Silvester, A, Singh, JA, Singhal, D, Sitorus, RS, Skiadaresi, E, Skryabin, VY, Skryabina, AA, Soheili, A, Sorrie, MB, Sousa, RARC, Sreeramareddy, CT, Stambolian, D, Tadesse, EG, Tahhan, N, Tareque, MI, Topouzis, F, Bach, XT, Tsegaye, GW, Tsilimbaris, MK, Varma, R, Virgili, G, Vongpradith, A, Vu, GT, Wang, YX, Wang, N, Weldemariam, AH, West, SK, Wondmeneh, TG, Wong, TY, Yaseri, M, Yonemoto, N, Yu, C, Zastrozhin, MS, Zastrozhina, A, Zhang, Z-J, Zimsen, SRM, Resnikoff, S, Vos, T, Steinmetz, JD, Bourne, RRA, Briant, PS, Flaxman, S, Taylor, HR, Jonas, JB, Abdoli, A, Abrha, WA, Abualhasan, A, Abu-Gharbieh, E, Adal, TG, Afshin, A, Ahmadieh, H, Alemayehu, W, Alemzadeh, SA, Alfaar, AS, Alipour, V, Androudi, S, Arabloo, J, Arditi, A, Aregawi, BB, Arrigo, A, Ashbaugh, C, Ashrafi, E, Atnafu, DD, Bagli, E, Baig, AA, Barnighausen, TW, Parodi, MB, Beheshti, M, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bijani, A, Bikbov, M, Bottone, M, Braithwaite, T, Bron, AM, Nagaraja, SB, Butt, ZA, dos Santos, FLC, Carneiro, VLA, Casson, RJ, Cheng, C-Y, Choi, J-YJ, Chu, D-T, Cicinelli, MV, Coelho, JM, Congdon, NG, Couto, RAS, Cromwell, EA, Dahlawi, SMA, Dai, X, Dana, R, Dandona, L, Dandona, R, Del Monte, MA, Molla, MD, Dervenis, N, Desta, AA, Deva, JP, Diaz, D, Djalalinia, S, Ehrlich, JR, Elayedath, R, Elhabashy, HR, Ellwein, LB, Emamian, MH, Eskandarieh, S, Farzadfar, F, Fernandes, AG, Fischer, F, Friedman, DS, Furtado, JM, Gaidhane, S, Gazzard, G, Gebremichael, B, George, R, Ghashghaee, A, Gilani, SA, Golechha, M, Hamidi, S, Hammond, BR, Hartnett, MER, Hartono, RK, Hashi, A, Hay, S, Hayat, K, Heidari, G, Ho, HC, Holla, R, Househ, M, Huang, JJ, Ibitoye, SE, Ilic, IM, Ilic, MD, Ingram, AD, Irvani, SSN, Islam, SMS, Itumalla, R, Jayaram, S, Jha, RP, Kahloun, R, Kalhor, R, Kandel, H, Kasa, AS, Kavetskyy, T, Kayode, GA, Kempen, JH, Khairallah, M, Khalilov, R, Khan, EA, Khanna, RC, Khatib, MN, Khoja, TAM, Kim, GR, Kim, JE, Kim, YJ, Kisa, A, Kisa, S, Kosen, S, Koyanagi, A, Bicer, BK, Kulkarni, V, Kurmi, OP, Landires, I, Lansingh, VC, Leasher, JL, LeGrand, KE, Leveziel, N, Limburg, H, Liu, X, Kunjathur, SM, Maleki, S, Manafi, N, Mansouri, K, McAlinden, C, Meles, GG, Mersha, AM, Michalek, IM, Miller, TR, Misra, S, Mohammad, Y, Mohammadi, SF, Mohammed, JA, Mokdad, AH, Moni, MA, Al Montasir, A, Morse, AR, Mulaw, GF, Naderi, M, Naderifar, H, Naidoo, KS, Naimzada, MD, Nangia, V, Swamy, SN, Naveed, M, Negash, H, Huong, LTN, Nunez-Samudio, V, Ogbo, FA, Ogundimu, K, Olagunju, AT, Onwujekwe, OE, Otstavnov, N, Owolabi, MO, Pakshir, K, Panda-Jonas, S, Parekh, U, Park, E-C, Pasovic, M, Pawar, S, Pesudovs, K, Peto, T, Pham, HQ, Pinheiro, M, Podder, V, Rahimi-Movaghar, V, Rahman, MHU, Ramulu, PY, Rathi, P, Rawaf, DL, Rawaf, S, Rawal, L, Reinig, N, Renzaho, AMN, Rezapour, A, Robin, AL, Rossetti, L, Sabour, S, Safi, S, Sahebkar, A, Sahraian, MA, Samy, AM, Sathian, B, Saya, GK, Saylan, M, Shaheen, AA, Shaikh, MA, Shen, TT, Shibuya, K, Shiferaw, WS, Shigematsu, M, Shin, JI, Silva, JC, Silvester, A, Singh, JA, Singhal, D, Sitorus, RS, Skiadaresi, E, Skryabin, VY, Skryabina, AA, Soheili, A, Sorrie, MB, Sousa, RARC, Sreeramareddy, CT, Stambolian, D, Tadesse, EG, Tahhan, N, Tareque, MI, Topouzis, F, Bach, XT, Tsegaye, GW, Tsilimbaris, MK, Varma, R, Virgili, G, Vongpradith, A, Vu, GT, Wang, YX, Wang, N, Weldemariam, AH, West, SK, Wondmeneh, TG, Wong, TY, Yaseri, M, Yonemoto, N, Yu, C, Zastrozhin, MS, Zastrozhina, A, Zhang, Z-J, Zimsen, SRM, Resnikoff, S, and Vos, T

Abstract

BACKGROUND: Many causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error. METHODS: We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at younger ages, our analysis focused on adults aged 50 years and older. FINDINGS: Global crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 2010 and 2019 (percentage change -0·2% [95% UI -1·5 to 1·0]; 2019 prevalence 9·58 cases per 1000 people [95% IU 8·51 to 10·8], 2010 prevalence 96·0 cases per 1000 people [86·0 to 107·0]). Age-standardised prevalence of avoidable blindness decreased by -15·4% [-16·8 to -14·3], while avoidable MSVI showed no change (0·5% [-0·8 to 1·6]). However, the number of cases increased for both avoidable blindness (10·8% [8·9 to 12·4]) and MSVI (31·5% [30·0 to 33·1]). The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15·2 million cases [9% IU 12·7-18·0]), followed by glaucoma (3·6 million cases [2·8-4·4]), undercorrected refractive error (2·3 million cases [1·8-2·8]), age-related macular degeneration (1·8 million cases [1·3-2·4]), and diabetic retinopathy (0·86 mill

Published
2021

3. Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study

Author

Bourne, RRA, Steinmetz, JD, Flaxman, S, Briant, PS, Taylor, HR, Resnikoff, S, Casson, RJ, Abdoli, A, Abu-Gharbieh, E, Afshin, A, Ahmadieh, H, Akalu, Y, Alamneh, AA, Alemayehu, W, Alfaar, AS, Alipour, V, Anbesu, EW, Androudi, S, Arabloo, J, Arditi, A, Asaad, M, Bagli, E, Baig, AA, Barnighausen, TW, Parodi, MB, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bijani, A, Bikbov, M, Bottone, M, Braithwaite, T, Bron, AM, Butt, ZA, Cheng, C-Y, Chu, D-T, Cicinelli, MV, Coelho, JM, Dagnew, B, Dai, X, Dana, R, Dandona, L, Dandona, R, Del Monte, MA, Deva, JP, Diaz, D, Djalalinia, S, Dreer, LE, Ehrlich, JR, Ellwein, LB, Emamian, MH, Fernandes, AG, Fischer, F, Friedman, DS, Furtado, JM, Gaidhane, AM, Gaidhane, S, Gazzard, G, Gebremichael, B, George, R, Ghashghaee, A, Golechha, M, Hamidi, S, Hammond, BR, Hartnett, MER, Hartono, RK, Hay, S, Heidari, G, Ho, HC, Chi, LH, Househ, M, Ibitoye, SE, Ilic, IM, Ilic, MD, Ingram, AD, Irvani, SSN, Jha, RP, Kahloun, R, Kandel, H, Kasa, AS, Kempen, JH, Keramati, M, Khairallah, M, Khan, EA, Khanna, RC, Khatib, MN, Kim, JE, Kim, YJ, Kisa, A, Kisa, S, Koyanagi, A, Kurmi, OP, Lansingh, VC, Leasher, JL, Leveziel, N, Limburg, H, Majdan, M, Manafi, N, Mansouri, K, McAlinden, C, Mohammadi, SF, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mokdad, AH, Moosavi, D, Morse, AR, Naderi, M, Naidoo, KS, Nangia, V, Cuong, TN, Huong, LTN, Ogundimu, K, Olagunju, AT, Ostroff, SM, Panda-Jonas, S, Pesudovs, K, Peto, T, Syed, ZQ, Rahman, MHU, Ramulu, PY, Rawaf, DL, Rawaf, S, Reinig, N, Robin, AL, Rossetti, L, Safi, S, Sahebkar, A, Samy, AM, Saxena, D, Serle, JB, Shaikh, MA, Shen, TT, Shibuya, K, Shin, JI, Silva, JC, Silvester, A, Singh, JA, Singhal, D, Sitorus, RS, Skiadaresi, E, Skirbekk, V, Soheili, A, Sousa, RARC, Spurlock, EE, Stambolian, D, Taddele, BW, Tadesse, EG, Tahhan, N, Tareque, MI, Topouzis, F, Bach, XT, Travillian, RS, Tsilimbaris, MK, Varma, R, Virgili, G, Wang, N, Wang, YX, West, SK, Wong, TY, Zaidi, Z, Zewdie, KA, Jonas, JB, Vos, T, Bourne, RRA, Steinmetz, JD, Flaxman, S, Briant, PS, Taylor, HR, Resnikoff, S, Casson, RJ, Abdoli, A, Abu-Gharbieh, E, Afshin, A, Ahmadieh, H, Akalu, Y, Alamneh, AA, Alemayehu, W, Alfaar, AS, Alipour, V, Anbesu, EW, Androudi, S, Arabloo, J, Arditi, A, Asaad, M, Bagli, E, Baig, AA, Barnighausen, TW, Parodi, MB, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bijani, A, Bikbov, M, Bottone, M, Braithwaite, T, Bron, AM, Butt, ZA, Cheng, C-Y, Chu, D-T, Cicinelli, MV, Coelho, JM, Dagnew, B, Dai, X, Dana, R, Dandona, L, Dandona, R, Del Monte, MA, Deva, JP, Diaz, D, Djalalinia, S, Dreer, LE, Ehrlich, JR, Ellwein, LB, Emamian, MH, Fernandes, AG, Fischer, F, Friedman, DS, Furtado, JM, Gaidhane, AM, Gaidhane, S, Gazzard, G, Gebremichael, B, George, R, Ghashghaee, A, Golechha, M, Hamidi, S, Hammond, BR, Hartnett, MER, Hartono, RK, Hay, S, Heidari, G, Ho, HC, Chi, LH, Househ, M, Ibitoye, SE, Ilic, IM, Ilic, MD, Ingram, AD, Irvani, SSN, Jha, RP, Kahloun, R, Kandel, H, Kasa, AS, Kempen, JH, Keramati, M, Khairallah, M, Khan, EA, Khanna, RC, Khatib, MN, Kim, JE, Kim, YJ, Kisa, A, Kisa, S, Koyanagi, A, Kurmi, OP, Lansingh, VC, Leasher, JL, Leveziel, N, Limburg, H, Majdan, M, Manafi, N, Mansouri, K, McAlinden, C, Mohammadi, SF, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mokdad, AH, Moosavi, D, Morse, AR, Naderi, M, Naidoo, KS, Nangia, V, Cuong, TN, Huong, LTN, Ogundimu, K, Olagunju, AT, Ostroff, SM, Panda-Jonas, S, Pesudovs, K, Peto, T, Syed, ZQ, Rahman, MHU, Ramulu, PY, Rawaf, DL, Rawaf, S, Reinig, N, Robin, AL, Rossetti, L, Safi, S, Sahebkar, A, Samy, AM, Saxena, D, Serle, JB, Shaikh, MA, Shen, TT, Shibuya, K, Shin, JI, Silva, JC, Silvester, A, Singh, JA, Singhal, D, Sitorus, RS, Skiadaresi, E, Skirbekk, V, Soheili, A, Sousa, RARC, Spurlock, EE, Stambolian, D, Taddele, BW, Tadesse, EG, Tahhan, N, Tareque, MI, Topouzis, F, Bach, XT, Travillian, RS, Tsilimbaris, MK, Varma, R, Virgili, G, Wang, N, Wang, YX, West, SK, Wong, TY, Zaidi, Z, Zewdie, KA, Jonas, JB, and Vos, T

Abstract

BACKGROUND: To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990-2020, and forecasts for 2050. METHODS: We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. Only studies with samples representative of the population and with clearly defined visual acuity testing protocols were included. We fitted hierarchical models to estimate 2020 prevalence (with 95% uncertainty intervals [UIs]) of mild vision impairment (presenting visual acuity ≥6/18 and <6/12), moderate and severe vision impairment (<6/18 to 3/60), and blindness (<3/60 or less than 10° visual field around central fixation); and vision impairment from uncorrected presbyopia (presenting near vision

Published
2021

4. Progress Towards Elimination of Trachoma as a Public Health Problem in Eritrea: Results of a Systematic Review and Nine Population-based Prevalence Surveys Conducted in 2014

Author

Tesfazion, A, Zecarias, A, Zewengiel, S, Willis, R, Mebrahtu, G, Capa, E, Mpyet, C, Al-Khatib, T, Courtright, P, Solomon, AW, Aboe, A, Adamu, L, Alemayehu, W, Alemu, M, Alexander, NDE, Bakhtiari, A, Bero, B, Boisson, S, Bovill, S, Brooker, SJ, Bush, S, Chu, BK, Dejene, M, Emerson, PM, Flueckiger, RM, Foster, A, Gadisa, S, Gass, K, Gebre, T, Habtamu, Z, Haddad, D, Harvey, E, Haslam, D, Kalua, K, Kello, AB, King, JD, Le Mesurier, R, Lewallen, S, Lietman, TM, MacArthur, C, Macleod, C, Mariotti, SP, Massae, PA, Massey, A, Mathieu, E, McCullagh, S, Mekasha, A, Millar, T, Munoz, B, Ngondi, J, Ogden, S, Pavluck, A, Pearce, J, Resnikoff, S, Sarah, V, Sarr, B, Sisay, A, Smith, JL, Thomson, J, West, SK, Tesfazion, A, Zecarias, A, Zewengiel, S, Willis, R, Mebrahtu, G, Capa, E, Mpyet, C, Al-Khatib, T, Courtright, P, Solomon, AW, Aboe, A, Adamu, L, Alemayehu, W, Alemu, M, Alexander, NDE, Bakhtiari, A, Bero, B, Boisson, S, Bovill, S, Brooker, SJ, Bush, S, Chu, BK, Dejene, M, Emerson, PM, Flueckiger, RM, Foster, A, Gadisa, S, Gass, K, Gebre, T, Habtamu, Z, Haddad, D, Harvey, E, Haslam, D, Kalua, K, Kello, AB, King, JD, Le Mesurier, R, Lewallen, S, Lietman, TM, MacArthur, C, Macleod, C, Mariotti, SP, Massae, PA, Massey, A, Mathieu, E, McCullagh, S, Mekasha, A, Millar, T, Munoz, B, Ngondi, J, Ogden, S, Pavluck, A, Pearce, J, Resnikoff, S, Sarah, V, Sarr, B, Sisay, A, Smith, JL, Thomson, J, and West, SK

Abstract

PURPOSE: To assess Eritrea's progress towards elimination of trachoma as a public health problem, we reviewed and compiled current knowledge on the distribution and burden of trachoma in Eritrea, then undertook further population-based surveys where indicated, with support from the Global Trachoma Mapping Project (GTMP). METHODS: For the systematic review, undertaken in March 2014, we searched (1) PubMed, using the terms ((blind* or trachoma or trichiasis) AND Eritrea); (2) the online database of rapid assessments of avoidable blindness; (3) our own grey literature collections; and (4) the Global Atlas of Trachoma database. In June and July 2014, we conducted nine population-based prevalence surveys, for each of which 30 villages were systematically selected with probability proportional to population size; in each village, 30 households were systematically selected. All consenting residents of selected households aged ≥1 year were examined by GTMP-certified graders for signs of trachoma. Data on household-level access to water and sanitation were also collected. RESULTS: One previous rapid assessment of avoidable blindness, three peer-reviewed publications, and two grey literature reports detailing sets of trachoma prevalence surveys conducted in 2006 and 2011, respectively, were located. Post-intervention impact surveys were needed in seven evaluation units (EUs, framed at sub-Zoba-level: population range 40,000-120,000) of Debub and Northern Red Sea, while baseline surveys were needed in two EUs of Anseba. Four of the seven impact survey EUs and both baseline survey EUs returned trachomatous inflammation-follicular prevalences in 1-9-year-olds of ≥5%; six of the seven impact survey EUs and one of the two baseline survey EUs returned trichiasis prevalences in ≥15-year-olds of ≥0.2%. The prevalence of access to water and sanitation varied widely between EUs. CONCLUSION: Interventions are still required in Eritrea to eliminate trachoma as a public health problem. Da

Published
2018

5. Prevalence of trachoma in four marakez of Elmenia and Bani Suef Governorates, Egypt

Author

Amer, K, Mueller, A, Abdelhafiz, HM, Al-Khatib, T, Bakhtiari, A, Boisson, S, El Arab, GE, Gad, H, Gordon, BA, Madian, A, Mahanna, AT, Mokhtar, S, Safa, OH, Samy, M, Shalaby, M, Taha, ZA, Willis, R, Yacoub, A, Mamdouh, AR, Younis, AK, Zoheir, MBE, Courtright, P, Solomon, AW, Aboe, A, Adamu, L, Alemayehu, W, Alemu, M, Alexander, NDE, Bero, B, Bovill, S, Brooker, SJ, Bush, S, Chu, BK, Dejene, M, Emerson, PM, Flueckiger, RM, Foster, A, Gadisa, S, Gass, K, Gebre, T, Habtamu, Z, Haddad, D, Harvey, E, Haslam, D, Kalua, K, Kello, AB, King, JD, Le Mesurier, R, Lewallen, S, Lietman, TM, MacArthur, C, Macleod, C, Mariotti, SP, Massey, A, Mathieu, E, McCullagh, S, Mekasha, A, Millar, T, Mpyet, C, Munoz, B, Ngondi, J, Ogden, S, Pavluck, A, Pearce, J, Resnikoff, S, Sarah, V, Sarr, B, Sisay, A, Smith, JL, Thomson, J, West, SK, Amer, K, Mueller, A, Abdelhafiz, HM, Al-Khatib, T, Bakhtiari, A, Boisson, S, El Arab, GE, Gad, H, Gordon, BA, Madian, A, Mahanna, AT, Mokhtar, S, Safa, OH, Samy, M, Shalaby, M, Taha, ZA, Willis, R, Yacoub, A, Mamdouh, AR, Younis, AK, Zoheir, MBE, Courtright, P, Solomon, AW, Aboe, A, Adamu, L, Alemayehu, W, Alemu, M, Alexander, NDE, Bero, B, Bovill, S, Brooker, SJ, Bush, S, Chu, BK, Dejene, M, Emerson, PM, Flueckiger, RM, Foster, A, Gadisa, S, Gass, K, Gebre, T, Habtamu, Z, Haddad, D, Harvey, E, Haslam, D, Kalua, K, Kello, AB, King, JD, Le Mesurier, R, Lewallen, S, Lietman, TM, MacArthur, C, Macleod, C, Mariotti, SP, Massey, A, Mathieu, E, McCullagh, S, Mekasha, A, Millar, T, Mpyet, C, Munoz, B, Ngondi, J, Ogden, S, Pavluck, A, Pearce, J, Resnikoff, S, Sarah, V, Sarr, B, Sisay, A, Smith, JL, Thomson, J, and West, SK

Abstract

PURPOSE: In 2015, to determine where interventions are needed to eliminate trachoma as a public health problem from Egypt, we initiated population-based prevalence surveys using the Global Trachoma Mapping Project platform in four suspected-endemic marakez (districts; singular: markaz) of the governorates of Elmenia and Bani Suef. METHODS: In each markaz, 30 households were selected in each of 25 villages. Certified graders examined a total of 3682 children aged 1-9 years in 2993 households, noting the presence or absence of trachomatous inflammation-follicular (TF) and trachomatous inflammation-intense (TI) in each eye. A total of 5582 adults aged ≥15 years living in the same households were examined for trachomatous trichiasis (TT). Household-level access to water and sanitation was recorded. RESULTS: Three of four marakez had age-adjusted TF prevalence estimates in 1-9-year olds of >10%; the other markaz had a TF prevalence estimate of 5-9.9%. Estimates of the age- and gender-adjusted prevalence of unmanaged TT in adults ranged from 0.7% to 2.3%. Household-level access to water and sanitation was high. (We did not, however, measure use of water or sanitation facilities.) Conclusions: Each of the four marakez surveyed has trachoma as a public health problem, with a need for implementation of the SAFE (surgery, antibiotics, facial cleanliness, environmental improvement) strategy. Further mapping is also required to determine the need for interventions in other areas of Egypt.

Published
2018

6. Epidemiology of trachoma and its implications for implementing the 'SAFE' strategy in Somali Region, Ethiopia: results of 14 population-based prevalence surveys

Author

Duale, AB, Ayele, NN, Macleod, CK, Kello, AB, Gezachew, ZE, Binegdie, A, Dejene, M, Alemayehu, W, Flueckiger, RM, Massae, PA, Willis, R, Negash, BK, Solomon, AW, Aboe, A, Adamu, L, Alemu, M, Alexander, NDE, Bero, B, Brooker, SJ, Bush, S, Chu, BK, Courtright, P, Emerson, PM, Foster, A, Gadisa, S, Gass, K, Gebre, T, Habtamu, Z, Kalua, DH, King, JD, Le Mesurier, R, Lewallen, S, Lietman, TM, MacArthur, C, Macleod, C, Mariotti, SP, Massey, A, Mathieu, E, McCullagh, S, Mekasha, A, Millar, T, Mpyet, C, Munoz, B, Ngondi, J, Ogden, S, Pavluck, A, Pearce, J, Resnikoff, S, Sarah, V, Sarr, B, Sisay, A, Smith, JL, Thomson, J, West, SK, Duale, AB, Ayele, NN, Macleod, CK, Kello, AB, Gezachew, ZE, Binegdie, A, Dejene, M, Alemayehu, W, Flueckiger, RM, Massae, PA, Willis, R, Negash, BK, Solomon, AW, Aboe, A, Adamu, L, Alemu, M, Alexander, NDE, Bero, B, Brooker, SJ, Bush, S, Chu, BK, Courtright, P, Emerson, PM, Foster, A, Gadisa, S, Gass, K, Gebre, T, Habtamu, Z, Kalua, DH, King, JD, Le Mesurier, R, Lewallen, S, Lietman, TM, MacArthur, C, Macleod, C, Mariotti, SP, Massey, A, Mathieu, E, McCullagh, S, Mekasha, A, Millar, T, Mpyet, C, Munoz, B, Ngondi, J, Ogden, S, Pavluck, A, Pearce, J, Resnikoff, S, Sarah, V, Sarr, B, Sisay, A, Smith, JL, Thomson, J, and West, SK

Abstract

PURPOSE: Ethiopia is highly trachoma endemic. Baseline mapping was needed in Ethiopia's Somali Region to guide elimination efforts. METHODS: Cross-sectional community-based surveys were conducted in 34 suspected trachoma-endemic woredas, grouped as 14 evaluation units (EUs), using a standardised mapping methodology developed for the Global Trachoma Mapping Project. RESULTS: In total, 53,467 individuals were enumerated. A total of 48,058 (89.9%) were present at the time of survey teams' visits and consented to examination. The prevalence of trachomatous inflammation-follicular (TF) among children aged 1-9 years ranged from 4.1% in the EU covering Danot, Boh, and Geladin woredas in Doolo Subzone to 38.1% in the EU covering Kebribeyah and Hareshen woredas in Fafan Subzone (East). The trichiasis prevalence among adults aged over 15 years varied from 0.1% in the EU covering Afder, Bare, and Dolobay woredas in Afder Subzone (West) to 1.2% in the EU covering Awbere in Fafan Subzone (West). CONCLUSION: Mass drug administration (MDA) with azithromycin is needed in 13 EUs (population 2,845,818). Two EUs (population 667,599) had TF prevalences in 1-9-year-olds of ≥30% and will require at least 5 years of MDA; 5 EUs (population 1,1193,032) had TF prevalences of 10-29.9% and need at least three years of MDA; 6 EUs (population 985,187) had TF prevalences of 5-9.9% and need at least one round of azithromycin distribution before re-survey. In all 13 of these EUs, implementation of facial cleanliness and environmental improvement measures is also needed. Surveys are still needed in the remaining 34 unmapped woredas of Somali Region.

Published
2018

7. Sub-optimal adherence to combination anti-retroviral therapy and its associated factors according to self-report, clinician-recorded and pharmacy-refill assessment methods among HIV-infected adults in Addis Ababa

Author

Mekuria, L.A. (Legese A.), Prins, J.M. (Jan), Yalew, A.W. (Alemayehu W.), Sprangers, M.A.G. (Mirjam), Nieuwkerk, P.T. (Pythia), Mekuria, L.A. (Legese A.), Prins, J.M. (Jan), Yalew, A.W. (Alemayehu W.), Sprangers, M.A.G. (Mirjam), and Nieuwkerk, P.T. (Pythia)

Abstract

Adherence to combination antiretroviral therapy (cART) is generally high in most resource-limited settings. However, sub-optimal adherence occurs in a sizable proportion of patients, and is independently predictive of detectable viremia. We investigated sub-optimal adherence according to self-report, clinician-recorded, and pharmacy-refill assessment methods, and their associated factors among HIV-infected adults receiving cART in Addis Ababa, Ethiopia. Eight-hundred seventy patients who initiated cART between May 2009 and April 2012 were randomly selected, and 664 patients who were alive, had remained in clinical care and were receiving cART for at least six-months were included. Sub-optimal adherence was defined as patients’ response of less than “all-of the time” to the self-report adherence question, or any clinician-recorded poor adherence during the six most recent clinic visits, or a pharmacy-refill of <95% medication possession ratio (MPR). Logistic regression models were fitted to identify factors associated with sub-optimal adherence. The average adherence level to cART, expressed as MPR, was nearly 97%. However, sub-optimal adherence occurred in 12%, 4%, and 27% of patients according to self-report, clinician-recorded, and pharmacy-refill measures, respectively. More satisfaction with social support was significantly associated with less sub-optimal adherence according to self-report and clinician-record. Younger age, lower educational level, and lower CD4 cell count at cART initiation were significantly associated with sub-optimal refill-based adherence. Findings from our large multi-center study suggest that sub-optimal adherence was present in up to a quarter of the patients, despite a high degree of average adherence to cART. Interventions aimed at preventing sub-optimal adherence should focus on improving social support, on younger patients, on patients with lower educational level, and on those who started cART at a lower CD4 cell count.

Published
2017
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8. The Global Trachoma Mapping Project: Methodology of a 34-Country Population-Based Study

Author

Lietman, Thomas, Lietman, Thomas, Solomon, AW, Pavluck, AL, Courtright, P, Aboe, A, Adamu, L, Alemayehu, W, Alemu, M, Alexander, NDE, Kello, AB, Bero, B, Lietman, Thomas, Lietman, Thomas, Solomon, AW, Pavluck, AL, Courtright, P, Aboe, A, Adamu, L, Alemayehu, W, Alemu, M, Alexander, NDE, Kello, AB, and Bero, B

Abstract

© Informa Healthcare USA, Inc.Purpose: To complete the baseline trachoma map worldwide by conducting population-based surveys in an estimated 1238 suspected endemic districts of 34 countries. Methods: A series of national and sub-national projects owned, m

Published
2015

9. Retention in HIV care and predictors of attrition from care among HIV-infected adults receiving combination anti-retroviral therapy in Addis Ababa

Author

Mekuria, L.A. (Legese A.), Prins, J.M. (Jan), Yalew, A.W. (Alemayehu W.), Sprangers, M.A.G. (Mirjam), Nieuwkerk, P.T. (Pythia), Mekuria, L.A. (Legese A.), Prins, J.M. (Jan), Yalew, A.W. (Alemayehu W.), Sprangers, M.A.G. (Mirjam), and Nieuwkerk, P.T. (Pythia)

Abstract

Background: Patient retention in chronic HIV care is a major challenge following the rapid expansion of combination antiretroviral therapy (cART) in Ethiopia. Objective: To describe the proportion of patients who are retained in HIV care and characterize predictors of attrition among HIV-infected adults receiving cART in Addis Ababa. Method: A retrospective analysis was conducted among 836 treatment naïve patients, who started cART between May 2009 and April 2012. Patients were randomly selected from ten healthcare facilities, and their current status in HIV care was determined based on routinely available data in the medical records. Patients lost to follow-up (LTFU) were traced by telephone. Kaplan-Meier technique was used to estimate survival probabilities of retention and Cox proportional hazards regression was performed to identify the predictors of attrition. Results: Based on individual patient data from the medical records, nearly 80% (95%CI: 76.7, 82.1) of the patients were retained in care in the first 3 and half years of antiretroviral therapy. After successfully tracing more than half of the LTFU patients, the updated one year retention in care estimate became 86% (95% CI: 83.41%, 88.17%). In the multivariate Cox regression analyses, severe immune deficiency at enrolment in care/or at cART initiation and 'bed-ridden' or 'ambulatory' functional status at the start of cART predicted attrition. Conclusion: Retention in HIV care in Addis Ababa is comparable with or even better than previous findings from other resource-limited as well as EU/USA settings. However, measures to detect and enroll patients in HIV care as early as possible are still necessary.

Published
2015
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10. The Global Trachoma Mapping Project: Methodology of a 34-Country Population-Based Study

Author

Solomon, AW, Pavluck, AL, Courtright, P, Aboe, A, Adamu, L, Alemayehu, W, Alemu, M, Alexander, NDE, Kello, AB, Bero, B, Brooker, SJ, Chu, BK, Dejene, M, Emerson, PM, Flueckiger, RM, Gadisa, S, Gass, K, Gebre, T, Habtamu, Z, Harvey, E, Haslam, D, King, JD, Le Mesurier, R, Lewallen, S, Lietman, TM, MacArthur, C, Mariotti, SP, Massey, A, Mathieu, E, Mekasha, A, Millar, T, Mpyet, C, Munoz, BE, Ngondi, J, Ogden, S, Pearce, J, Sarah, V, Sisay, A, Smith, JL, Taylor, HR, Thomson, J, West, SK, Willis, R, Bush, S, Haddad, D, Foster, A, Solomon, AW, Pavluck, AL, Courtright, P, Aboe, A, Adamu, L, Alemayehu, W, Alemu, M, Alexander, NDE, Kello, AB, Bero, B, Brooker, SJ, Chu, BK, Dejene, M, Emerson, PM, Flueckiger, RM, Gadisa, S, Gass, K, Gebre, T, Habtamu, Z, Harvey, E, Haslam, D, King, JD, Le Mesurier, R, Lewallen, S, Lietman, TM, MacArthur, C, Mariotti, SP, Massey, A, Mathieu, E, Mekasha, A, Millar, T, Mpyet, C, Munoz, BE, Ngondi, J, Ogden, S, Pearce, J, Sarah, V, Sisay, A, Smith, JL, Taylor, HR, Thomson, J, West, SK, Willis, R, Bush, S, Haddad, D, and Foster, A

Abstract

PURPOSE: To complete the baseline trachoma map worldwide by conducting population-based surveys in an estimated 1238 suspected endemic districts of 34 countries. METHODS: A series of national and sub-national projects owned, managed and staffed by ministries of health, conduct house-to-house cluster random sample surveys in evaluation units, which generally correspond to "health district" size: populations of 100,000-250,000 people. In each evaluation unit, we invite all residents aged 1 year and older from h households in each of c clusters to be examined for clinical signs of trachoma, where h is the number of households that can be seen by 1 team in 1 day, and the product h × c is calculated to facilitate recruitment of 1019 children aged 1-9 years. In addition to individual-level demographic and clinical data, household-level water, sanitation and hygiene data are entered into the purpose-built LINKS application on Android smartphones, transmitted to the Cloud, and cleaned, analyzed and ministry-of-health-approved via a secure web-based portal. The main outcome measures are the evaluation unit-level prevalence of follicular trachoma in children aged 1-9 years, prevalence of trachomatous trichiasis in adults aged 15 + years, percentage of households using safe methods for disposal of human feces, and percentage of households with proximate access to water for personal hygiene purposes. RESULTS: In the first year of fieldwork, 347 field teams commenced work in 21 projects in 7 countries. CONCLUSION: With an approach that is innovative in design and scale, we aim to complete baseline mapping of trachoma throughout the world in 2015.

Published
2015

11. The Global Trachoma Mapping Project: Methodology of a 34-Country Population-Based Study

Author

Lietman, Thomas, Lietman, Thomas, Solomon, AW, Pavluck, AL, Courtright, P, Aboe, A, Adamu, L, Alemayehu, W, Alemu, M, Alexander, NDE, Kello, AB, Bero, B, Lietman, Thomas, Lietman, Thomas, Solomon, AW, Pavluck, AL, Courtright, P, Aboe, A, Adamu, L, Alemayehu, W, Alemu, M, Alexander, NDE, Kello, AB, and Bero, B

Abstract

© Informa Healthcare USA, Inc.Purpose: To complete the baseline trachoma map worldwide by conducting population-based surveys in an estimated 1238 suspected endemic districts of 34 countries. Methods: A series of national and sub-national projects owned, m

Published
2015

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