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
Trachoma Control Program, The Carter Center, Atlanta, Georgia, United States of America.
South Sudan Ministry of Health, Government of the Republic of South Sudan, Juba, Republic of South Sudan.
PLoS Negl Trop Dis. 2017 Jun 14;11(6):e0005658. doi: 10.1371/journal.pntd.0005658. eCollection 2017 Jun.
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.
METHODOLOGY/ PRINCIPAL FINDINGS: 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.
CONCLUSIONS/ SIGNIFICANCE: 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.
为降低国内沙眼患病率，南苏丹共和国自2001年起在各县实施了SAFE战略的部分内容。对东赤道州的五个县进行了调查，以监测项目干预措施的进展情况，并确定是否需要额外轮次的阿奇霉素大规模药物给药。
方法/主要发现：2015年4月至10月对五个县（布迪、拉丰、东卡波埃塔、南卡波埃塔和北卡波埃塔）进行了调查。采用横断面、多阶段、整群随机抽样。使用世界卫生组织（WHO）简化分级系统，对选定家庭中所有在场且同意的居民进行沙眼所有临床体征检查。对3446户家庭的14462人进行了调查。1至9岁儿童沙眼性炎症-滤泡型（TF）患病率从布迪县的17.4%（95%置信区间（CI）：11.4%，25.6%）到东卡波埃塔县的47.6%（95%CI：42.3%，53.0%）不等。沙眼性倒睫（TT）在15岁及以上人群中也非常普遍，在南卡波埃塔为2.6%（95%CI：1.6%，4.0%），在拉丰为3.9%（95%CI：2.4%，6.1%）。所有五个县的水和卫生设施状况都很差，包括两个县的所有调查群组中完全没有厕所。
结论/意义：据我们所知，这些是南苏丹共和国自2011年独立以来首次进行的沙眼调查。结果表明，尽管进行了多年干预，但五个被调查县中的四个至少还需要五年实施SAFE战略，第五个县至少还需要三年。
