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Trachoma Impact Survey Results from 31 Woredas in Tigray Region, Ethiopia

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posted on 2024-12-27, 17:00 authored by Gemechis Teferi, Harnet Adane, Evini Cyrille, Aynalem Tefera, Solomon Gadisa, Adugna Amin, Mebratu Tsehaye, Yonas Mitku, Haftamu Assefa, Sharone Backers, Addisu Alemayehu, Belete Mengistu, Fikreab Kebede, Fentahun Tadesse, Nebiyu Negussu, Robert Butcher, Ana Bakhtiari, Rebecca Willis, Sarah Boyd, Cristina Jimenez, Michael Dejene, Anthony W. Solomon, Meheret Deyassa, Mohammed Shafi, Tezera Kifle, Asfaw Tegen, Berihu Mesfin, Tsegay Berihu, Teklay Mariam, Hagos Godefay, Emma M. Harding-Esch, Amanuel Kidane, Ephrem Fisseha

Baseline surveys were conducted in Tigray region, Ethiopia, in 2013. Since then, rounds of azithromycin mass drug administration (MDA) have been delivered in-line with international guidance. The purpose of these surveys was to assess trachomatous inflammation—follicular (TF) prevalence following those treatments to enable the region to plan the next steps towards elimination of trachoma.

All surveys followed WHO recommendations for community-based cross-sectional survey design. Thirty-one woredas in six zones of Tigray region were surveyed. There were two survey series: all 31 woredas were surveyed in the first series, and 11 woredas were resurveyed in the second, due to having a TF prevalence between 5% and 9.9% in the first series.

In the first series of 31 surveys, one woreda had an adjusted TF prevalence in 1−9-year-olds of <5.0%, 13 had a prevalence of 5.0−9.9% and 17 had a prevalence of 10.0−29.9%. In the second series of 11 surveys, the prevalence of TF was <5.0% in seven woredas and 5.0−9.9% in four woredas. The most recent adjusted prevalence of trachomatous trichiasis (TT) unknown to the health system in ≥15-year-olds was ≥.2% in 27 EUs. One-third of households visited had access to an improved drinking water source within a 30-minute return journey of their house, and 11% had an improved latrine.

Eight woredas met the criteria to stop MDA for 2 years before the re-survey. However, further rounds of MDA, additional efforts to improve water and sanitation access and ongoing strengthening of surgical services for TT are needed across Tigray.

Funding

Surveys were funded by the United States Agency for International Development (USAID) Act to End Neglected Tropical Diseases | East program, led by RTI International, the UK Department for International Development and Sightsavers and the Crown Agents. Light for the World funded technical support for publication. RB’s salary was supported by the Fred Hollows Foundation. Core Tropical Data funding was provided by the International Trachoma Initiative; Sightsavers; and RTI International through the United States Agency for International Development (USAID) Act to End NTDs | East program. AWS is a staff member of the World Health Organization. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated, USAID, or the United States Government.

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