Baseline Prevalence of Trachoma in 13 Local Government Areas of Borno State, Nigeria.

PURPOSE: We set out to determine the baseline prevalence of trachoma in 13 Local Government Areas (LGAs) of Borno State, Nigeria. METHODS: A population-based cross-sectional survey was conducted in each of 13 LGAs from 2017 to 2019, with the support of Tropical Data (TD). World Health Organization (WHO)-recommended protocols were used. With a probability-proportional-to-size systematic sampling method, 25 villages were selected per LGA in 2017 and 30 villages per LGA in 2019; in each village, 25 households were enrolled for 2017 surveys, while 30 were enrolled for 2019 surveys. All present, consenting residents aged ≥1 year were examined by TD-certified graders for trachomatous inflammation-follicular (TF) and trachomatous trichiasis (TT) using the WHO simplified grading scheme. Additionally, we collected data on household-level access to water, sanitation and hygiene (WASH) facilities. RESULTS: One LGA (Magumeri) had TF prevalence in 1-9-year-olds ≥10%; two other LGAs (Monguno and Kaga) had TF prevalence between 5.0% and 9.9%. The prevalence of TT unknown to the health system was ≥0.2% in six LGAs. The proportion of households with access to improved water sources ranged from 30% (Kwaya Kusar) to 95% (Monguno); household-level access to improved latrines was lowest in Shani (7%) and highest in Maiduguri (95%). CONCLUSION: Active TT case finding and strengthening of TT surgical services are needed in six LGAs. Mass drug administration (MDA) of antibiotics is needed in three LGAs to reduce the prevalence of active trachoma to below elimination thresholds. The trachoma elimination programme should engage WASH agencies to augment access to improved WASH facilities.

Baseline Prevalence of Trachoma in 21 Local Government Areas of Adamawa State, North East Nigeria.

PURPOSE: To determine the prevalence of trachoma in each of the 21 local government areas (LGAs) of Adamawa State, Nigeria. METHODS: A population-based cross-sectional survey was conducted in each of the 21 LGAs of Adamawa State between 2017 and 2019. With the support of Tropical Data (TD), surveys were planned and implemented in accordance with World Health Organization (WHO) recommendations. A two-stage cluster sampling technique was used in each LGA, 25 or 30 clusters were selected with a probability of selection proportionate to cluster size, and in each of these clusters, 25 or 30 households were enrolled for the survey. All residents aged 1 year and older within selected households were examined by TD-certified graders for trachomatous inflammation - follicular (TF) and trachomatous trichiasis (TT) using the WHO simplified grading scheme. Additionally, data were collected on household water and sanitation access. RESULTS: All 21 LGAs had TF prevalence in 1-9-year-olds below 5%. The prevalence of TT unknown to the health system in people aged ≥15 years was ≥0.2% in three of the 21 LGAs. Access to improved water and sanitation facilities was <80% in the majority of the surveyed LGAs. Only 12 of the 21 LGAs had ≥50% household-level improved latrine access, and only Yola North had ≥80% household-level improved latrine access. CONCLUSION: There is no need for mass treatment with antibiotics for trachoma elimination purposes in any of these LGAs. There is a need for active TT case finding and provision of community-based TT surgical services in three LGAs. Furthermore, engagement with water and sanitation agencies is needed to augment access to improved water and sanitation facilities across the State; this will help to avoid the recrudescence of active trachoma in the State.