The Carter Center, Trachoma Control Program, 1149 Ponce de Leon, Atlanta GA 30306, USA.
Trans R Soc Trop Med Hyg. 2014 Jan;108(1):42-8. doi: 10.1093/trstmh/trt101. Epub 2013 Nov 25.
The leading cause of preventable blindness worldwide is trachoma, a condition caused by an infection of the inner eyelid. In Niger, a landlocked republic in Western Africa, surveys in 1988-89 identified trachoma as endemic in all but one region and, as a result, there is a National Prevention of Blindness Program plan to eliminate trachoma by 2015.
Thirty-one districts in eastern and western Niger were surveyed for trachoma prevalence from May 2009 to March 2012 as part of routine program impact evaluations. Prevalence surveys were implemented independently in each district using a two-stage cluster random design. Probability proportional to size was used to randomly select villages and 25 households were selected in each cluster. The prevalence of trachoma of clinical grade trachomatous follicular (TF) was estimated in children aged 1-9 years, and the prevalence of blinding trachoma, trachomatous trichiasis (TT), was measured in adults aged ≥15 years.
A total of 14 211 households was surveyed; 58 617 individuals were evaluated for clinical signs of trachoma, of whom 27 087 were children aged 1-9 years. District-wide implementation of the full SAFE strategy is warranted in 16 districts where TF prevalence exceeds 10% and targeted implementation of the SAFE strategy (surgery for trichiasis; antibiotic therapy to control transmission; facial cleanliness for hygiene promotion; environmental change for improvements in access to water and sanitation) is recommended in the remaining 15 districts. The prevalence of TT among adults exceeded 1% in nine districts, suggesting that surgical services to treat TT should be implemented district-wide.
These results establish the need for continued SAFE strategy implementation throughout Niger.
全球可预防性失明的首要原因是沙眼，一种由眼睑内感染引起的疾病。在尼日尔，一个位于西非的内陆共和国，1988-89 年的调查发现，除了一个地区外，其他地区都存在沙眼流行，因此该国制定了一项国家预防失明计划，计划到 2015 年消除沙眼。
2009 年 5 月至 2012 年 3 月，作为常规项目影响评估的一部分，对尼日尔东部和西部的 31 个地区进行了沙眼患病率调查。每个地区都独立采用两阶段聚类随机设计进行患病率调查。采用与大小成正比的概率随机选择村庄，每个集群中选择 25 户。在 1-9 岁的儿童中评估临床分级沙眼滤泡（TF）的沙眼患病率，在≥15 岁的成人中测量致盲性沙眼、沙眼性倒睫（TT）的患病率。
共调查了 14211 户家庭；对 58617 人进行了沙眼临床体征评估，其中 27087 人为 1-9 岁儿童。在 16 个沙眼患病率超过 10%的地区，需要全面实施 SAFE 策略，在其余 15 个地区，建议有针对性地实施 SAFE 策略（倒睫手术；抗生素治疗控制传播；面部清洁促进卫生；改善获得水和卫生设施的环境变化）。九个地区的成人 TT 患病率超过 1%，这表明需要在全区范围内实施治疗 TT 的手术服务。
这些结果表明，尼日尔需要继续实施 SAFE 战略。
