Search

A study was conducted to evaluate the efficacy of mass distribution of azithromycin for trachoma control among Ethiopian children on mortality in communities. Results indicated that mass distribution of the drug was quite effective in reducing mortality.

The impact of two annual targeted azithromycin treatments on active trachoma and Chlamydia trachomatis infection rates over three years in Vietnam is evaluated. The increasing infection rates have suggested that treatment might interrupt the duration of infection required for developing immunity, increasing the number of individuals susceptible to reinfection and adversely affecting disease prevalence over time.

ABSTRACT Background Trachoma, caused by ocular infection with Chlamydia trachomatis, remains the leading infectious cause of blindness and in 2002 was responsible for 3.6% of total global blindness. Although transmission [...]

Objective We aimed to summarize and map the existing global population-based data on active trachoma and trichiasis. Detailed distribution maps of various infectious diseases have proved a valuable tool in their control. Such maps play an important role in assessing the magnitude of the problem, defining priority areas for control, monitoring changes, and advocacy. Until now, information on trachoma prevalence at within country levels has not been systematically collated, analysed and reported. Methods We gathered the last 18 years&apos; worth of reported data on active trachoma in children aged less than 10 years, and the last 25 years of reported trichiasis in adults aged 15 years and over from 139 population-based surveys in 33 countries. We collated these data into one database using the "district" (second administrative level) as the standard unit of reporting. We used Geographical Information Systems as a database and cartographic tool to generate a global map of the prevalence of trachoma and trichiasis. Findings We obtained data on active trachoma and trichiasis from 18 countries in the WHO African Region, 6 in the Eastern Mediterranean Region, 3 in the South-East Asia Region, 3 in the Western Pacific Region and 2 in the Region of the Americas. In 23 countries suspected of having endemic trachoma no reliable district-level population-based data were available. In China and India, data were limited to a few districts. The data highlighted important regional differences and marked national variations in prevalence of active trachoma and trichiasis. Conclusion This is the first attempt to summarize and map the existing population-based data on active trachoma and trichiasis. The lack of data in many countries remains an important obstacle to trachoma control efforts. Keywords Trachoma/epidemiology; Eyelid diseases/epidemiology; Geographic information systems (source: MeSH, NLM). Objectif Il s&apos;agissait de resumer et de cartographier les donnees mondiales tirees d&apos;etudes en population concernant le trachome evolutif et le trichiasis. Pour la lutte contre differentes maladies infectieuses, des cartes de distribution detaillees se sont revelees des instruments utiles. Elles sont importantes pour evaluer l&apos;ampleur du phenomene et pour definir les zones on il faut prioritairement lutter contre la maladie, suivre les evolutions et sensibiliser l&apos;opinion. Jusqu&apos;ici, les donnees sur la prevalence du trachome dans les differents pays n&apos;ont pas fait l&apos;objet d&apos;une exploitation, d&apos;une analyse et d&apos;une notification systematiques. Methodes On a tire de 139 enquetes en population effectuees dans 33 pays les donnees sur le trachome evolutif relatives aux 18 dernieres annees chez les enfants de moins de dix ans et les donnees sur le trichiasis relatives aux 25 dernieres annees chez les individus de 15 ans et plus. Ces donnees ont ete regroupees dans une meme base de donnees en utilisant comme unite type de notification le "district" (c&apos;est-a-dire le deuxieme niveau administratif). Les systemes d&apos;information geographique ont servi de base de donnees et d&apos;outil cartographique pour etablir une carte mondiale de la prevalence du trachome et du trichiasis. Resultats Des donnees sur le trachome evolutif et le trichiasis ont ete obtenues aupres des pays suivants : 18 pays de la Region africaine de l&apos;OMS, 6 de la Region de la Mediterranee orientale, de 3 de la Region de I&apos;Asie du Sud-est, 3 de la Region du Pacifique occidental et 2 des Ameriques. Dans 23 pays ou le trachome est suppose endemique, on ne dispose d&apos;aucune donnee fiable provenant d&apos;etudes en population a l&apos;echelle du district. Pour la Chine et I&apos;Inde, on disposait de donnees pour quelques districts seulement. Les donnees ont fait ressortir d&apos;importantes differences entre les Regions et des variations notables au niveau national de la prevalence du trachome evolutif et du trichiasis. Conclusion Il s&apos;agit la de la premiere tentative pour recapituler et cartographier les donnees fournies par les etudes en population sur le trachome evolutif et le trichiasis. Le manque de donnees concernant de nombreux pays oppose un frein important aux efforts de lutte contre le trachome. Objetivo Decidimos resumir y cartografiar los datos disponibles basados en la poblacion mundial sobre el tracoma activo y la triquiasis. Los mapas detallados de la distribucion de diversas enfermedades infecciosas han demostrado ser un valioso instrumento para controlarlas. Esos mapas son una importante ayuda para la evaluacion de la magnitud del problema, la definicion de las areas prioritarias de control, la vigilancia de los cambios y la promocion. Hasta la fecha no se han compilado, analizado y notificado sistematicamente los datos sobre la prevalencia del tracoma a nivel intranacional. Metodos Reunimos los datos notificados en los ultimos 18 anos sobre el tracoma activo entre los menores de 10 anos, asi como los datos sobre triquiasis correspondientes a los ultimos 25 anos en la poblacion adulta de 15 o mas anos, a partir de 139 encuestas basadas en la poblacion de 33 paises. Compilamos dicha informacion en una base de datos utilizando el << distrito >> (segundo nivel administrativo) como unidad estandar de notificacion. Empleamos los Sistemas de Informacion Geografica como base de datos e instrumento de cartografia para generar un mapa mundial de la prevalencia del tracoma y la triquiasis. Resultados Obtuvimos datos sobre el tracoma activo y la triquiasis en 18 paises de la Region de Africa de la OMS, 6 de la Region del Mediterraneo Oriental, 3 de la Region de Asia Sudoriental, 3 de la Region del Pacifico Occidental y 2 de las Americas. En 23 paises con posible tracoma endemico no se pudieron conseguir datos fiables basados en la poblacion a nivel de distrito. En China y la India, los datos se limitaron a unos cuantos distritos. Los datos revelaron importantes diferencias regionales y marcadas variaciones nacionales en la prevalencia del tracoma activo y la triquiasis. Conclusion Este trabajo representa el primer intento de resumir y cartografiar los datos poblacionales disponibles sobre el tracoma activo y la triquiasis. La falta de datos en muchos paises sigue siendo un importante obstaculo para las iniciativas de control del tracoma. Mots cles Trachome/epidemiologie; Paupiere, Maladies/epidemiologie; Systemes d&apos;information geographique (source: MeSH, INSERM). Palabras clave Tracoma/epidemiologia; Enfermedades de los parpados/epidemiologia; Sistemas de informacion geografica (fuente: DeCS, BIREME). [TEXT NOT REPRODUCIBLE IN ASCII.], Voir page 917 le resume en francais. En la pagina 918 figura un resumen en espanol. Introduction Trachoma is an eye disease caused by infection with the bacterium Chlamydia trachomatis. [...]

Objective Limited surveys and anecdotal data indicate that trachoma is endemic in the states of Eastern Equatoria and Upper Nile in southern Sudan. However, its magnitude and geographical distribution are largely unknown. We conducted surveys to ascertain the prevalence and geographical distribution of trachoma, and to identify targets for control interventions. Methods Population-based cross-sectional surveys were conducted in nine sites in southern Sudan between September 2001 and June 2004. Two-stage random cluster sampling with probability proportional to size was used to select the sample. Trachoma grading was done using the WHO simplified grading system. Findings A total of 17 016 persons were examined, a response rate of 86.1% of the enumerated population. Prevalence of signs of active trachoma in children aged 1-9 years was: TF = 53.7% (95% confidence interval (CI) = 52.1-55.3); TI = 42.7% (95% CI = 41.2-44.2); TF and/or TI = 64.1% (95% CI = 62.5-65.5). Prevalence of trichiasis (TT) in children aged less than 15 years was 1.2% (95% CI = 0.9-1.4), while TT prevalence in persons aged 15 years and above was 9.2% (95% CI = 8.6-9.9). Women were more likely to have trichiasis compared to men (odds ratio (OR) = 1.57; 95% CI = 1.34-1.84). Tentative extrapolation to the states of Eastern Equatoria and Upper Nile estimates that there is a backlog of 178 250 (lower and upper bounds = 156 027-205 995) persons requiring surgery and the entire population, estimated to be over 3.9 million, is in need of the SAFE strategy to control blinding trachoma. Conclusions Trachoma is a public health problem in all nine of the study sites surveyed. The unusually high prevalence of active trachoma and TT in children points to the severity of the problem. There is urgent need to implement trachoma control interventions in trachoma endemic regions of southern Sudan. Keywords Trachoma/epidemiology; Eyelid diseases/epidemiology; Sudan (source: MeSH, NLM). Objectif Des enquetes limitees et des donnees anecdotiques indiquent que le trachome est endemique dans les Etats de l&apos;Equatoria oriental et du Nil superieur au Soudan meridional. Toutefois, l&apos;ampleur du phenomene et sa distribution geographique sont largement meconnues. Des enquetes ont ete menees pour determiner la prevalence et la distribution geographique du trachome et identifier les cibles des interventions a mettre en oeuvre contre cette maladie. Methodes Des enquetes transversales en population ont ete realisees en neuf sites du Soudan meridional, entre septembre 2001 et juin 2004. La selection des echantillons s&apos;est effectuee par sondage en grappes a deux degres, avec une probabilite proportionnelle a la taille de la population. Le codage de la maladie a ete realise selon le systeme OMS simplifie de codage du trachome. Resultats Au total 17 016 personnes ont ete examinees, ce qui correspondait a un taux de reponses de 86,1% pour l&apos;ensemble de la population recensee. La prevalence des signes du trachome evolutif chez les enfants de 1 a 9 ans s&apos;etablissait de la maniere suivante : trachome inflammatoire folliculaire (TF) = 53,7 % (intervalle de confiance a 95 % (IC) = 52,1-55,3) ; trachome inflammatoire intense (TI) = 42,7 % (IC a 95 % = 41,2-44,2) ; TF et/ou TI = 64,1% (IC a 95 % = 62,5-65,5). Chez l&apos;enfant de moins de 15 ans, la prevalence du trichiasis (TT) etait de 1,2 % (IC a 95 % = 0,9-1,4), alors que chez les personnes de 15 ans et plus, elle atteignait 9,2 % (IC a 95 % = 8,6-9,9). Les femmes etaient plus sujettes au trichiasis que les hommes [odds ratio (OR) = 1,57; IC a 95 % = 1,34-1,84]. Les tentatives pour extrapoler ces chiffres aux Etats de l&apos;Equatoria oriental et du Nil superieur conduisent a une estimation de 178 250 (limites inferieure et superieure = 156 027 et 205 995) pour le nombre de personnes en attente de soins chirurgicaux. D&apos;autre part, l&apos;ensemble de la population, evaluee a plus de 3,9 millions d&apos;habitants, a besoin de la strategie CHANCE, destinee a indiquer le trachome cecitant. Conclusion Le trachome pose un probleme de sante publique pour l&apos;ensemble des neuf sites ayant servi de cadre a l&apos;enquete. La prevalence inhabituellement elevee du trachome evolutif et du TT chez I&apos;enfant denote bien la gravite du probleme. Il est urgent de metre en oeuvre des interventions de lutte contre le trachome dans les regions du Soudan meridional ou cette maladie est endemique. Mots cles Trachome/epidemiologie; Paupiere, Maladies/epidemiologie; Soudan (source: MeSH, INSERM). Objetivo Segun algunos estudios limitados y diversos datos no comprobados, el tracoma es endemico en las regiones de Equatoria oriental y Alto Nilo del sur del Sudan. Sin embargo, se desconocen en gran medida la magnitud del problema y la distribucion geografica de la enfermedad. Realizamos estudios para determinar la prevalencia y la distribucion geografica del tracoma, asi como para identificar objetivos para las intervenciones de control. Metodos Entre septiembre de 2001 y junio de 2004 se llevaron a cabo estudios transversales basados en la poblacion en nueve sitios del sur del Sudan. Se utilizo un metodo de muestreo aleatorio por conglomerados en dos etapas con probabilidad proporcional al tamano. La tipificacion del tracoma se realizo conforme al sistema de clasificacion simplificado de la OMS. Resultados Se exploro a un total de 17 016 personas, con una tasa de respuesta del 86,1% de la poblacion considerada. La prevalencia de signos de tracoma activo en los ninos de 1 a 9 anos era la siguiente: TF (inflamacion folicular) = 53,7% (intervalo de confianza (IC) del 95% = 52,1- 55,3); TI (inflamacion intensa) = 42,7% (IC95% = 41,2 - 44,2); TF y/o TI = 64,1% (IC95% = 62,5 - 65,5). La prevalencia de triquiasis TT) entre los ninos de menos de 15 anos era del 1,2% (IC95% = 0,9 - 1,4), mientras que la prevalencia de TT en las personas de 15 anos y mas era del 9,2%. (IC95% = 8,6 - 9,9). Las mujeres tenian mas probabilidades que los hombres de sufrir triquiasis (razon de posibilidades (OR) = 1,57; IC95% = 1,34 - 1,84). La extrapolacion provisional a las regiones de Equatoria oriental y Alto Nilo arroja un cumulo estimado de 178 250 personas (limites inferior y superior = 156 027 - 205 995) necesitadas de intervencion quirurgica; si se desea controlar el tracoma causante de ceguera, la estrategia SAFE deberia abarcar a toda la poblacion, estimada en mas de 3,9 millones de personas. Conclusion El tracoma constituye un problema de salud publica en los nueve sitios estudiados. La prevalencia excepcionalmente alta de tracoma activo y TT en la poblacion infantil demuestra la gravedad del problema. Hay que aplicar urgentemente intervenciones de control del tracoma en las regiones del sur del Sudan donde la enfermedad es endemica. Palabras clave Tracoma/epidemiologia; Enfermedades de los parpados/epidemiologia; Sudan (fuente: DeCS, BIREME). Bulletin of the World Health Organization 2005;83:904-912. [TEXT NOT REPRODUCIBLE IN ASCII.], Voir page 910 le resume en francais. En la pagina 911 figura un resumen en espanol. Introduction Trachoma, caused by ocular infection with Chlamydia trachomatis, is the most common infectious [...]

Trachoma is disappearing in many parts of the world, even in the absence of specific control programs. Following mass antimicrobial drug treatments for trachoma in western Nepal, the prevalence of [...]

Objective Household willingness to pay for treatment provides important information for programme planning. We tested for relationships between socioeconomic status, risk of trachoma, perceptions of the effects of azithromycin, and the household willingness to pay for future mass treatment with azithromycin. Methods We surveyed 394 households in 6 villages located in central United Republic of Tanzania regarding their willingness to pay for future azithromycin treatment. A random sample of households with children under 8 years of age was selected and interviewed following an initial treatment programme in each village. Data were gathered on risk factors for trachoma, socioeconomic status, and the perceived effect of the initial azithromycin treatment. Ordered probit regression analysis was used to test for statistically significant relationships. Findings 38% of responding households stated that they would not be willing to pay anything for future azithromycin treatment, although they would be willing to participate in the treatment. A proxy for cash availability was positively associated with household willingness to pay for future antibiotic treatment. Cattle ownership (a risk factor) and being a household headed by a female not in a polygamous marriage (lower socioeconomic status) were associated with a lower willingness to pay for future treatment. A perceived benefit from the initial treatment was marginally associated with a willingness to pay a higher amount. Conclusions As those at greatest risk of active trachoma indicated the lowest willingness to pay, imposing a cost recovery fee for azithromycin treatment would likely reduce coverage and could prevent control of the disease at the community level. Keywords Azithromycin/therapeutic use/economics; Trachoma/drug therapy; Fees, Pharmaceutical; Volition; Forecasting; Socioeconomic factors; Risk factors; United Republic of Tanzania (source: MESH, N/M). Mots cles Azithromycine/usage therapeutique/economie; Trachome/chimiotherapie; Tarifs pharmaceutiques; Volition; Facteur socio-economique; Facteur risque; Republique-Unie de Tanzanie (source: MeSH, INSERM). Palabras clave Azitromicina/uso terapeutico/economia; Tracoma/quimioterapia; Honorarios farmaceuticos; Volicion; Prediccion; Factores socioeconomicos; Factores de riesgo; Republica Unida de Tanzania (fuente: DeCS, BIREME). Bulletin of the World Health Organization 2003;81:101-107., Voir page 106 le resume en francais. En la pagina 106 figura un resumen en espanol. Introduction Trachoma is an important cause of blindness worldwide, with estimates of 5-7 million [...]

The common wisdom is that a trachoma program cannot eliminate ocular chlamydia from a community, just reduce infection to a level where blindness would be minimal. We describe the success [...]

Trachoma is estimated to cause 15% of global blindness, and mass treatment with antibiotics is now advocated in endemic areas. In a randomised trial comparing oral azithromycin and topical tetracycline [...]