Abebe Bejiga

Prevalence of trachoma and its determinants in Dalocha District, Central Ethiopia

AIM. This community-based cross-sectional study was conducted to determine the prevalence of trachoma in Dalocha District, Central Ethiopia. METHODS. A multistage sampling method was used to identify the peasant associations and households included in the study. The WHO clinical grading method for trachoma was used. RESULTS. Of the 619 sampled persons, 302 (48.8%) males and 317 (51.2%) females, 564 people were available for examination, yielding a response rate of 91.1%. More than half (51.1%) of the children aged 10 years or less had active trachoma (trachomatous inflammation, TI, in 16.5% and trachomatous follicles, TF, in 34.6%). On the other hand, active trachoma and trachomatous trichiasis (TT) were each found in 5.5% of individuals older than 10 years of age. CONCLUSIONS. According to the WHO, the findings of TI and TF in more than 5% and 20%, respectively, of children aged 10 years or less and TT in more than 1% of older individuals indicate that trachoma is a major public health problem in Dalocha community.

Modified grading system for upper eyelid trachomatous trichiasis.

Aim This study was conducted to determine the level of inter-observer agreement in the modified grading scheme for trichiasis of the upper eyelid. Methods A grading system that covers the entire spectrum of trachomatous trichiasis, extending from the simple to the severe forms, was initially developed by the first and second authors and field-tested. The grading scheme recognizes three levels of severity, based on deviation of the lid margin (TT1, TT2 and TT3); and four anatomical locations indicating where the eyelashes touch the globe in TT1 (nasal, central, temporal, or combined). The grading of trichiasis patients was then conducted on the basis of the modified grading scheme. Results The inter-observer agreement between the grades of simple trichiasis (TT1) and entropion (TT2) using Cronbachs alpha was 0.84, and the agreement within each sub-grade was 0.86. The weighted Kappa value was 0.68 (95% CI 0.57–0.79) for the main grades and 0.49 (95% CI 0.23–0.79) for the sub-grades. Conclusions The inter-observer agreement was very reliable and could easily be attained by all levels of ophthalmic professionals. As the grading follows the natural progression of trichiasis from the simple to the severe forms in relation to the anatomical site involved, it helps to determine the degree of correction and how far to extend the surgical incision.

Active trachoma two years after three rounds of azithromycin mass treatment in Cheha district Gurage zone, Southern Ethiopia

BackgroundAzithromycin mass distribution was given to residents of Gurage zone Cheha district in 2004, 2005 and 2006 for three consecutive years with more than 90% coverage. The effect of treatment in the study community was not yet determined. The present study was therefore designed to assess the effect of azithromycin on the prevalence of active trachoma two years after three rounds of mass treatment of the community at Cheha district, Gurage zone.MethodsA multistage stratified cluster random survey was employed to determine the prevalence of active trachoma among children aged 1 to 9. Selected children were examined for trachoma using the simplified WHO grading system and their households were assessed for trachoma risk factors.ResultsThis survey demonstrated that the prevalence of active trachoma in the study community was 22.8% (95% CI 18.24% - 27.36%) that was lower than that of Southern Nations, Nationalities, and Peoples Regional prevalence (33.2%) in 2006. Only 27.6% (95% CI 25.7% - 30.1%) of the study population had a safe and clean water supply, whereas 42.7% (95% CI 39.8% - 46.2%) of the visited households had simple pit latrines.ConclusionThis survey demonstrated that despite repeated mass oral azithromycin distributions, the prevalence of active trachoma was still high. Therefore, the other components of the SAFE strategy such as fly control program, improving the water sources, measures to improve face washing and construction of utilizable latrines that are being implemented through the health extension package have to be integrated with mass azithromycin treatment to eliminate active trachoma in the district.