Completing baseline mapping of Trachoma in Nepal: Results of 27 population-based prevalence surveys conducted in 2013 and 2014

Dharmpal Prasad Raman; Katie Ruth Crowley; Lisa Ann Rotondo; Jeremiah James Muriithi Ngondi; Delali Senyo Korbla Bonuedi; Kathryn Crowley; Delali Senyo Korbla Bonuedi; Jeremiah Ngondi; Lisa Ann Rotondo; Dharmpal Prasad Raman; R Henry; Sailesh Mishra; Lionel Nizigama; Aryc Mosher; Rebecca Willis; Anthony W Solomon

Completing baseline mapping of Trachoma in Nepal

Results of 27 population-based prevalence surveys conducted in 2013 and 2014

Crowley, K. R., Bonuedi, D. S. K., Ngondi, J. J. M., Rotondo, L. A., Raman, D. P., Henry, R., Mishra, S., Nizigama, L., Mosher, A., Willis, R., Solomon, A. W., & Global Trachoma Mapping Project (2018). Completing baseline mapping of Trachoma in Nepal: Results of 27 population-based prevalence surveys conducted in 2013 and 2014. Ophthalmic Epidemiology, 25(sup1), 115-120. https://doi.org/10.1080/09286586.2018.1489972

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Abstract

PURPOSE: Trachoma is endemic in parts of Nepal; implementation of the surgery, antibiotics, facial cleanliness, environmental improvement (SAFE) strategy started in 2002. Some suspected-endemic districts had not previously been mapped. We aimed to estimate the prevalences of trachomatous inflammation-follicular (TF) and trichiasis in those districts.

METHODS: Population-based prevalence surveys were undertaken in 27 districts. In each of those districts, two-stage cluster sampling was used to select a sample of 2000 children aged 1-9 years and 4000 adults aged ≥15 years from a total of 40 wards (clusters), drawn evenly from two subdistricts. Consenting eligible participants were examined for trachoma by Global Trachoma Mapping Project (GTMP)-certified graders, using the World Health Organization simplified grading system. Data were analyzed at district level using GTMP methods.

RESULTS: A total of 43,200 households were surveyed, and 162,094 people were examined for trachoma. District-level TF prevalence in 1-9-year-olds ranged from 0% to 4.3% (95% confidence interval [CI] 2.4-6.2). Among adults aged ≥15 years, trichiasis prevalence ranged from 0% to 0.33% (95% CI 0.08-0.65).

CONCLUSION: TF was not a public health problem in any of the 27 districts surveyed; thus, antibiotic mass drug administration is not needed. In two districts (Dhanusa and Gorkha), trichiasis prevalence in adults aged ≥15 years was ≥0.2%; thus, further trichiasis surgery interventions at public health level are warranted to achieve elimination. These findings will facilitate planning for elimination of trachoma as a public health problem in Nepal.