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1. The global burden of trichiasis in 2016.

Author

Rebecca M Flueckiger, Paul Courtright, Mariamo Abdala, Amza Abdou, Zaid Abdulnafea, Tawfik K Al-Khatib, Khaled Amer, Olga Nelson Amiel, Sossinou Awoussi, Ana Bakhtiari, Wilfried Batcho, Assumpta Lucienne Bella, Kamal Hashim Bennawi, Simon J Brooker, Brian K Chu, Michael Dejene, Djore Dezoumbe, Balgesa Elkheir Elshafie, Aba Ange Elvis, Djouma Nembot Fabrice, Fatma Juma Omar, Missamou François, Drabo François, Jambi Garap, Michael Gichangi, André Goepogui, Jaouad Hammou, Boubacar Kadri, George Kabona, Martin Kabore, Khumbo Kalua, Mathias Kamugisha, Biruck Kebede, Kaba Keita, Asad Aslam Khan, Genet Kiflu, Makoy Yibi, Garae Mackline, Colin Macleod, Portia Manangazira, Michael P Masika, Marilia Massangaie, Takafira Mduluza, Nabicassa Meno, Nicholas Midzi, Abdallahi Ould Minnih, Sailesh Mishra, Caleb Mpyet, Nicholas Muraguri, Upendo Mwingira, Beido Nassirou, Jean Ndjemba, Cece Nieba, Jeremiah Ngondi, Nicholas Olobio, Alex Pavluck, Isaac Phiri, Rachel Pullan, Babar Qureshi, Boubacar Sarr, Do Seiha, Gloria Marina Serrano Chávez, Shekhar Sharma, Siphetthavong Sisaleumsak, Khamphoua Southisombath, Gretchen Stevens, Andeberhan Tesfazion Woldendrias, Lamine Traoré, Patrick Turyaguma, Rebecca Willis, Georges Yaya, Souleymane Yeo, Francisco Zambroni, Jialiang Zhao, and Anthony W Solomon

Subjects
Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

BackgroundTrichiasis is present when one or more eyelashes touches the eye. Uncorrected, it can cause blindness. Accurate estimates of numbers affected, and their geographical distribution, help guide resource allocation.MethodsWe obtained district-level trichiasis prevalence estimates in adults for 44 endemic and previously-endemic countries. We used (1) the most recent data for a district, if more than one estimate was available; (2) age- and sex-standardized corrections of historic estimates, where raw data were available; (3) historic estimates adjusted using a mean adjustment factor for districts where raw data were unavailable; and (4) expert assessment of available data for districts for which no prevalence estimates were available.FindingsInternally age- and sex-standardized data represented 1,355 districts and contributed 662 thousand cases (95% confidence interval [CI] 324 thousand-1.1 million) to the global total. Age- and sex-standardized district-level prevalence estimates differed from raw estimates by a mean factor of 0.45 (range 0.03-2.28). Previously non- stratified estimates for 398 districts, adjusted by ×0.45, contributed a further 411 thousand cases (95% CI 283-557 thousand). Eight countries retained previous estimates, contributing 848 thousand cases (95% CI 225 thousand-1.7 million). New expert assessments in 14 countries contributed 862 thousand cases (95% CI 228 thousand-1.7 million). The global trichiasis burden in 2016 was 2.8 million cases (95% CI 1.1-5.2 million).InterpretationThe 2016 estimate is lower than previous estimates, probably due to more and better data; scale-up of trichiasis management services; and reductions in incidence due to lower active trachoma prevalence.

Published
2019
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2. The global burden of trichiasis in 2016

Author

Alex Pavluck, Nicholas Midzi, Brian Chu, Rebecca Willis, Boubacar Kadri, M.L. Kamugisha, Simon Brooker, Djouma Nembot Fabrice, Aba Ange Elvis, Zaid Abdulnafea, Colin MacLeod, Khumbo Kalua, Andeberhan Tesfazion Woldendrias, Upendo Mwingira, Jeremiah Ngondi, Caleb Mpyet, Gretchen A Stevens, Assumpta Lucienne Bella, Garae Mackline, Kamal Hashim Bennawi, Do Seiha, Ana Bakhtiari, Rebecca M. Flueckiger, Wilfried Batcho, Abdallahi Ould Minnih, Georges Yaya, Khamphoua Southisombath, Isaac K. Phiri, Olga Nelson Amiel, Mariamo Abdala, Fatma Juma Omar, Anthony W. Solomon, Francisco Zambroni, Michael Dejene, Jaouad Hammou, Khaled Amer, Genet Kiflu, Portia Manangazira, Tawfik Al-Khatib, Jambi Garap, Marilia Massangaie, Gloria Marina Serrano Chavez, Biruck Kebede, Amza Abdou, Asad Aslam Khan, Paul Courtright, Nicholas Muraguri, Beido Nassirou, Martin Kabore, Djore Dezoumbe, Michael Gichangi, Jialiang Zhao, Drabo Francois, Rachel L. Pullan, Balgesa Elkheir Elshafie, Missamou François, Kaba Keita, Babar Qureshi, Nicholas Olobio, Taka Fira Mduluza, Cece Nieba, Michael Masika, Souleymane Yeo, Siphetthavong Sisaleumsak, Shekhar Sharma, Makoy S. Yibi, Sailesh Mishra, Jean Ndjemba, Lamine Traoré, André Goepogui, George Kabona, Sossinou Awoussi, Nabicassa Meno, Patrick Turyaguma, and Boubacar Sarr

Subjects
Male, Bacterial Diseases, Eye Diseases, Stratigraphy, RC955-962, Population Dynamics, Prevalence, Social Sciences, Surveys, Global Health, Arctic medicine. Tropical medicine, Medicine and Health Sciences, Global health, Public and Occupational Health, National Security, Data Management, Aged, 80 and over, Incidence (epidemiology), Geology, Middle Aged, Infectious Diseases, Geography, Trachoma, Research Design, Female, Public aspects of medicine, RA1-1270, Raw data, Risk assessment, Research Article, Neglected Tropical Diseases, Adult, Trichiasis, Computer and Information Sciences, Adolescent, Political Science, Research and Analysis Methods, Young Adult, medicine, Humans, Aged, Survey Research, Population Biology, Public Health, Environmental and Occupational Health, Biology and Life Sciences, Tropical Diseases, medicine.disease, Geographic Distribution, Confidence interval, Ophthalmology, Earth Sciences, Demography
Abstract

Background Trichiasis is present when one or more eyelashes touches the eye. Uncorrected, it can cause blindness. Accurate estimates of numbers affected, and their geographical distribution, help guide resource allocation. Methods We obtained district-level trichiasis prevalence estimates in adults for 44 endemic and previously-endemic countries. We used (1) the most recent data for a district, if more than one estimate was available; (2) age- and sex-standardized corrections of historic estimates, where raw data were available; (3) historic estimates adjusted using a mean adjustment factor for districts where raw data were unavailable; and (4) expert assessment of available data for districts for which no prevalence estimates were available. Findings Internally age- and sex-standardized data represented 1,355 districts and contributed 662 thousand cases (95% confidence interval [CI] 324 thousand–1.1 million) to the global total. Age- and sex-standardized district-level prevalence estimates differed from raw estimates by a mean factor of 0.45 (range 0.03–2.28). Previously non- stratified estimates for 398 districts, adjusted by ×0.45, contributed a further 411 thousand cases (95% CI 283–557 thousand). Eight countries retained previous estimates, contributing 848 thousand cases (95% CI 225 thousand-1.7 million). New expert assessments in 14 countries contributed 862 thousand cases (95% CI 228 thousand–1.7 million). The global trichiasis burden in 2016 was 2.8 million cases (95% CI 1.1–5.2 million). Interpretation The 2016 estimate is lower than previous estimates, probably due to more and better data; scale-up of trichiasis management services; and reductions in incidence due to lower active trachoma prevalence., Author summary As an individual with trichiasis blinks, the eyelashes abrade the cornea, which can lead to corneal opacity and blindness. Through high quality surgery, which involves altering the position of the eyelid margin, it is possible to reduce the number of people with trichiasis. Accurate estimates of the number of persons with trichiasis and their geographical distribution are needed in order to effectively align resources for surgery and other necessary services. We obtained district-level trichiasis prevalence estimates for 44 endemic and previously-endemic countries. We used the most recently available data and expert assessments to estimate the global burden of trichiasis. We estimated that in 2016 the global burden was 2.8 million cases (95% CI 1.1–5.2 million). The 2016 estimate is lower than previous estimates, probably due to more and better data; scale-up of trichiasis management services; and reductions in incidence due to lower active trachoma prevalence.

Published
2019

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