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Prevalence of Trachoma at Sub-District Level in Ethiopia: Determining When to Stop Mass Azithromycin Distribution
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نویسنده
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king j.d. ,teferi t. ,cromwell e.a. ,zerihun m. ,ngondi j.m. ,damte m. ,ayalew f. ,tadesse z. ,gebre t. ,mulualem a. ,karie a. ,melak b. ,adugna m. ,gessesse d. ,worku a. ,endashaw t. ,admassu ayele f. ,stoller n.e. ,king m.r.a. ,mosher a.w. ,gebregzabher t. ,haileysus g. ,odermatt p. ,utzinger j. ,emerson p.m.
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منبع
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plos neglected tropical diseases - 2014 - دوره : 8 - شماره : 3
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چکیده
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Background:to eliminate blinding trachoma,the world health organization emphasizes implementing the safe strategy,which includes annual mass drug administration (mda) with azithromycin to the whole population of endemic districts. prevalence surveys to assess impact at the district level are recommended after at least 3 years of intervention. the decision to stop mda is based on a prevalence of trachomatous inflammation follicular (tf) among children aged 1-9 years below 5% at the sub-district level,as determined by an additional round of surveys limited within districts where tf prevalence is below 10%. we conducted impact surveys powered to estimate prevalence simultaneously at the sub-district and district in two zones of amhara,ethiopia to determine whether mda could be stopped.methodology:seventy-two separate population-based,sub-district surveys were conducted in 25 districts. in each survey all residents from 10 randomly selected clusters were screened for clinical signs of trachoma. data were weighted according to selection probabilities and adjusted for correlation due to clustering.principal findings:overall,89,735 residents were registered from 21,327 households of whom 72,452 people (80.7%) were examined. the prevalence of tf in children aged 1-9 years was below 5% in six sub-districts and two districts. sub-district level prevalence of tf in children aged 1-9 years ranged from 0.9-76.9% and district-level from 0.9-67.0%. in only one district was the prevalence of trichiasis below 0.1%.conclusions/significance:the experience from these zones in ethiopia demonstrates that impact assessments designed to give a prevalence estimate of tf at sub-district level are possible,although the scale of the work was challenging. given the assessed district-level prevalence of tf,sub-district-level surveys would have been warranted in only five districts. interpretation was not as simple as stopping mda in sub-districts below 5% given programmatic challenges of exempting sub-districts from a highly regarded program and the proximity of hyper-endemic sub-districts. © 2014 king et al.
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آدرس
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the carter center,atlanta,ga,united states,department of epidemiology and public health,swiss tropical and public health institute,basel,switzerland,university of basel,basel, Switzerland, the carter center,addis ababa, Ethiopia, the carter center,atlanta,ga, United States, the carter center,addis ababa, Ethiopia, the carter center,atlanta,ga,united states,department of public health and primary care,institute of public health,university of cambridge,cambridge, United Kingdom, the carter center,addis ababa, Ethiopia, the carter center,addis ababa, Ethiopia, the carter center,addis ababa, Ethiopia, the carter center,addis ababa, Ethiopia, the amhara national regional state health bureau,bahir dar, Ethiopia, the amhara national regional state health bureau,bahir dar, Ethiopia, the carter center,addis ababa, Ethiopia, the carter center,addis ababa, Ethiopia, the carter center,addis ababa, Ethiopia, the amhara national regional state health bureau,bahir dar, Ethiopia, the carter center,addis ababa, Ethiopia, the amhara national regional state health bureau,bahir dar, Ethiopia, francis i. proctor foundation,university of california san francisco,san francisco,ca, United States, the carter center,atlanta,ga, United States, the carter center,atlanta,ga, United States, the carter center,addis ababa, Ethiopia, the carter center,addis ababa, Ethiopia, department of epidemiology and public health,swiss tropical and public health institute,basel,switzerland,university of basel,basel, Switzerland, department of epidemiology and public health,swiss tropical and public health institute,basel,switzerland,university of basel,basel, Switzerland, the carter center,atlanta,ga, United States
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Authors
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