Mapping Trachoma in Kaduna State, Nigeria: Results of 23 Local Government Area-Level, Population-Based Prevalence Surveys

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ABSTRACT

Introduction : To prepare for global elimination of trachoma by 2020, the World Health Organization (WHO) recommends mapping of trachoma at district-level to enable planning of elimination activities in affected populations. The aim of our study was to provide data on trachoma for each local government area (LGA) of Kaduna State, Nigeria, as such data were previously unavailable.

Method : As part of the Global Trachoma Mapping Project (GTMP), a population-based cross-sectional trachoma survey was conducted in each of the 23 LGAs of Kaduna State, between May and June 2013. The protocols of the GTMP were used.

Results : The prevalence of trachomatous inflammation – follicular (TF) in children aged 1–9 years was between 0.03% and 8% across the LGAs, with only one LGA (Igabi) having a TF prevalence ≥5%. The LGA-level prevalences of trichiasis in persons aged 15 years and older were between 0.00% and 0.78%. Eleven LGAs had trichiasis prevalences of 0.2% and over in adults; a threshold equivalent to 1 case per 1000 total population. The LGA-level proportion of households with access to improved water sources ranged from 9% to 96%, while household access to latrines ranged from 5% to 99%.

Conclusion : Kaduna State has generally hypoendemic trachoma, but a few trichiasis surgeries are still required to attain the WHO elimination targets. Better access to improved water and sanitation is needed.

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Most cited references 12

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A simple system for the assessment of trachoma and its complications.

B Thylefors, C R Dawson, B Jones … (1987)

A simple grading system for trachoma, based on the presence or absence of five selected "key" signs, has been developed. The method was tested in the field and showed good observer agreement, the most critical point being the identification of severe cases of the disease. It is expected that the system will facilitate the assessment of trachoma and its complications by non-specialist health personnel working at the community level.

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

Anthony W. Solomon, Alexandre L Pavluck, Paul Courtright … (2015)

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.

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Don't spin the pen: two alternative methods for second-stage sampling in urban cluster surveys

Rebecca F. Grais, Angela MC Rose, Jean-Paul Guthmann (2007)

In two-stage cluster surveys, the traditional method used in second-stage sampling (in which the first household in a cluster is selected) is time-consuming and may result in biased estimates of the indicator of interest. Firstly, a random direction from the center of the cluster is selected, usually by spinning a pen. The houses along that direction are then counted out to the boundary of the cluster, and one is then selected at random to be the first household surveyed. This process favors households towards the center of the cluster, but it could easily be improved. During a recent meningitis vaccination coverage survey in Maradi, Niger, we compared this method of first household selection to two alternatives in urban zones: 1) using a superimposed grid on the map of the cluster area and randomly selecting an intersection; and 2) drawing the perimeter of the cluster area using a Global Positioning System (GPS) and randomly selecting one point within the perimeter. Although we only compared a limited number of clusters using each method, we found the sampling grid method to be the fastest and easiest for field survey teams, although it does require a map of the area. Selecting a random GPS point was also found to be a good method, once adequate training can be provided. Spinning the pen and counting households to the boundary was the most complicated and time-consuming. The two methods tested here represent simpler, quicker and potentially more robust alternatives to spinning the pen for cluster surveys in urban areas. However, in rural areas, these alternatives would favor initial household selection from lower density (or even potentially empty) areas. Bearing in mind these limitations, as well as available resources and feasibility, investigators should choose the most appropriate method for their particular survey context.

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Author and article information

Contributors

Anthony W. Solomon: Role: for the Global Trachoma Mapping Project

Journal

Journal ID (nlm-ta): Ophthalmic Epidemiol

Journal ID (iso-abbrev): Ophthalmic Epidemiol

Journal ID (archive): IOPE

Journal ID (publisher-id): iope20

Title: Ophthalmic Epidemiology

Publisher: Taylor & Francis

ISSN (Print): 0928-6586

ISSN (Electronic): 1744-5086

Publication date Collection: 2016

Publication date (Electronic): 05 December 2016

Volume: 23

Issue: sup1 , Trachoma Mapping

Pages: 46-54

Affiliations

[ ^a ] Ophthalmology Unit, Surgery Department, Usmanu Danfodiyo University , Sokoto, Nigeria

[ ^b ] Sightsavers , Kaduna, Nigeria

[ ^c ] Ophthalmology Department, University of Jos , Jos, Nigeria

[ ^d ] National Eye Centre , Kaduna, Nigeria

[ ^e ] Netherlands Leprosy Relief , Nigeria

[ ^f ] Gambo Sawaba Hospital , Zaria, Nigeria

[ ^g ] Federal Ministry of Health , Abuja, Nigeria

[ ^h ] Task Force for Global Health , Decatur, GA, USA

[ ⁱ ] Kaduna State Ministry of Health , Kaduna, Nigeria

[ ^j ] Water Sanitation and Hygiene, Department of Public Health, Social and Environmental Determinants of Health, World Health Organization , Geneva, Switzerland

[ ^k ] Clinical Research Department, London School of Hygiene & Tropical Medicine , London, UK

[ ^l ] London Centre for Neglected Tropical Disease Research , London, UK

Author notes

CONTACT Nasiru Muhammad nasiru69@ 123456yahoo.com Ophthalmology Unit, Surgery Department, Usmanu Danfodiyo University, Sokoto . Nigeria.

[*]

See Appendix

Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/iope.

Article

Publisher ID: 1250918

DOI: 10.1080/09286586.2016.1250918

PMC ID: 5706975

PubMed ID: 27918227

SO-VID: c64d96a8-43a3-4c2c-9a4b-b59d93523832

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.

History

Date received : 31 March 2016

Date accepted : 14 October 2016

Date revision received : 03 September 2016

Page count

Figures: 3, Tables: 3, References: 27, Pages: 9

Funding

Funded by: Global Trachoma Mapping Project

Award ID: ARIES: 203145

This study was principally funded by the Global Trachoma Mapping Project (GTMP) grant from the United Kingdom’s Department for International Development (ARIES: 203145) to Sightsavers, which led a consortium of non-governmental organizations and academic institutions to support ministries of health to complete baseline trachoma mapping worldwide. The GTMP was also funded by the United States Agency for International Development (USAID) through the ENVISION project implemented by RTI International under cooperative agreement number AID-OAA-A-11-00048, and the END in Asia project implemented by FHI360 under cooperative agreement number OAA-A-10-00051. A committee established in March 2012 to examine issues surrounding completion of global trachoma mapping was initially funded by a grant from Pfizer to the International Trachoma Initiative. BAG is an employee of the World Health Organization (WHO); the views expressed in this article are the views of the authors alone and do not necessarily reflect the views or policy of WHO. AWS was a Wellcome Trust Intermediate Clinical Fellow (098521) at the London School of Hygiene & Tropical Medicine. None of the funders had any role in project design, in project implementation or analysis or interpretation of data, in the decisions on where, how or when to publish in the peer-reviewed press, or in the preparation of the manuscript.

Mapping Trachoma in Kaduna State, Nigeria: Results of 23 Local Government Area-Level, Population-Based Prevalence Surveys

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Chinese Journal of School Health

Most cited references 12

A simple system for the assessment of trachoma and its complications.

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

Don't spin the pen: two alternative methods for second-stage sampling in urban cluster surveys

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