Optimizing cluster survey designs for estimating trachomatous inflammation-follicular within trachoma control programs.
Int J Infect Dis
; 116: 101-107, 2022 Mar.
Article
in En
| MEDLINE
| ID: mdl-34965463
ABSTRACT
OBJECTIVES:
The World Health Organization recommends mass drug administration (MDA) with azithromycin to eliminate trachoma as a public health problem. MDA decisions are based on prevalence estimates from two-stage cluster surveys. There is a need to mathematically evaluate current trachoma survey designs. Our study aimed to characterize the effects of the number of units sampled on the precision and cost of trachomatous inflammation-follicular (TF) estimates.METHODS:
A population of 30 districts was simulated to represent the breadth of possible TF distributions in Amhara, Ethiopia. Samples of varying numbers of clusters (14-34) and households (10-60) were selected. Sampling schemes were evaluated based on precision, proportion of incorrect and low MDA decisions made, and estimated cost.RESULTS:
The number of clusters sampled had a greater impact on precision than the number of households. The most efficient scheme depended on the underlying TF prevalence in a district. For lower prevalence areas (< 10%) the most cost-efficient design (providing adequate precision while minimizing cost) was 20 clusters of 20-30 households. For higher prevalence areas (> 10%), the most efficient design was 15-20 clusters of 20-30 households.CONCLUSIONS:
For longer-running programs, using context-specific survey designs would allow for practical precision while reducing survey costs. Sampling 15 clusters of 20-30 households in suspected moderate-to-high prevalence districts and 20 clusters of 20-30 households in districts suspected to be near the 5% threshold appears to be a balanced approach.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Trachoma
Type of study:
Prevalence_studies
/
Risk_factors_studies
Limits:
Humans
/
Infant
Country/Region as subject:
Africa
Language:
En
Journal:
Int J Infect Dis
Journal subject:
DOENCAS TRANSMISSIVEIS
Year:
2022
Document type:
Article
Affiliation country:
Estados Unidos