Burden of trachoma in five counties of Eastern Equatoria state, South Sudan: Results from population-based surveys

In order to decrease the prevalence of trachoma within the country, the Republic of South Sudan has implemented components of the SAFE strategy in various counties since 2001. Five counties in Eastern Equatoria state were surveyed in order to monitor progress of programmatic interventions and determ...

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Bibliographic Details
Published in:	PLoS neglected tropical diseases Vol. 11; no. 6; p. e0005658
Main Authors:	Sanders, Angelia M, Stewart, Aisha E P, Makoy, Samuel, Chebet, Joy J, Magok, Peter, Kuol, Aja, Blauvelt, Carla, Lako, Richard, Rumunu, John, Callahan, E Kelly, Nash, Scott D
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 14-06-2017 Public Library of Science (PLoS)
Subjects:	Analysis Anti-Bacterial Agents - therapeutic use Antibiotics Azithromycin Azithromycin - therapeutic use Biology and Life Sciences Child Child, Preschool Children Chlamydia trachomatis Communicable Disease Control - methods Confidence intervals Control Countries Cross sections Cross-Sectional Studies Disease Diseases Dosage and administration Drug Therapy - methods Epidemiology Female Health Health Services Research Households Humans Infant Latrines Male Medicine and Health Sciences People and places Polls & surveys Prevalence Sanitation South Sudan - epidemiology Surveys Trachoma Trachoma - drug therapy Trachoma - epidemiology Trachoma - prevention & control Tropical diseases South Sudan Atlanta Georgia United States > US Sudan
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Summary:	In order to decrease the prevalence of trachoma within the country, the Republic of South Sudan has implemented components of the SAFE strategy in various counties since 2001. Five counties in Eastern Equatoria state were surveyed in order to monitor progress of programmatic interventions and determine if additional rounds of Mass Drug Administration with azithromycin were needed. Five counties (Budi, Lafon, Kapoeta East, Kapoeta South and Kapoeta North) were surveyed from April to October 2015. A cross-sectional, multi-stage, cluster-random sampling was used. All present, consenting residents of selected households were examined for all clinical signs of trachoma using the World Health Organization (WHO) simplified grading system. 14,462 individuals from 3,446 households were surveyed. The prevalence of trachomatous inflammation-follicular (TF) in children ages one to nine years ranged from 17.4% (95% Confidence Interval (CI): 11.4%, 25.6%) in Budi county to 47.6%, (95% CI: 42.3%, 53.0%) in Kapoeta East county. Trachomatous trichiasis (TT) was also highly prevalent in those 15 years and older, ranging between 2.6% (95% CI: 1.6%, 4.0%) in Kapoeta South to 3.9% (95% CI: 2.4%, 6.1%) in Lafon. The presence of water and sanitation were low in all five counties, including two counties which had a complete absence of latrines in all surveyed clusters. To our knowledge, these were the first trachoma surveys conducted in the Republic of South Sudan since their independence in 2011. The results show that despite years of interventions, four of the five surveyed counties require a minimum of five additional years of SAFE strategy implementation, with the fifth requiring at minimum three more years.
Bibliography:	new_version ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Conceptualization: AMS AEPS SDN EKC.Data curation: AMS SDN JJC.Formal analysis: AMS SDN.Funding acquisition: AMS CB EKC.Investigation: AMS JJC SM AK CB PM.Methodology: AMS SDN AEPS.Project administration: AMS SDN AEPS JJC PM CB SM AK EKC.Software: SDN AEPS.Supervision: AMS AEPS SM JJC PM AK CB EKC SDN RL JR.Validation: SDN AMS AEPS.Visualization: AMS SDN AEPS EKC.Writing – original draft: AMS SDN.Writing – review & editing: AMS AEPS SM JJC CB EKC SDN RL JR. The authors have declared that no competing interests exist.
ISSN:	1935-2735 1935-2727 1935-2735
DOI:	10.1371/journal.pntd.0005658