Dézoumbé Djoré, Djada Djibrine-Atim, Harba Tyau-Tyau, Biao Jean-Eudes, Kali Barka, Bernasconi Jérôme, Hiron Doniphan, Bengraïne Karim, D'Souza Susan, Willis Rebecca, Bakhtiari Ana, Resnikoff Serge, Courtright Paul, Solomon Anthony W
a Programme national de lutte contre la cécité , Ministère de la Santé Publique , N'Djamena , Tchad.
b Hôpital Général de Référence , N'Djamena , Tchad.
Ophthalmic Epidemiol. 2018 Dec;25(sup1):143-154. doi: 10.1080/09286586.2018.1546877.
To estimate the prevalence of trachoma in suspected-endemic areas of Chad, and thereby determine whether trachoma is a public health problem requiring intervention.
We divided the suspected-endemic population living in secure districts into 46 evaluation units (EUs), and used the standardized methodologies of the Global Trachoma Mapping Project. A two-stage cluster-sampling procedure was adopted. In each EU, the goal was to examine at least 1019 children aged 1-9 years by recruiting 649 households; all consenting residents aged ≥ 1 year living in those households were examined. Each participant was examined for trachomatous inflammation-follicular (TF), trachomatous inflammation-intense (TI), and trichiasis.
Two EUs had data that could not be validated, and were excluded from the analysis. GPS data for three other pairs of EUs suggested that EU divisions were inaccurate; data for each pair were combined within the pair. In the 41 resulting EUs, 29,924 households in 967 clusters were visited, and 104,584 people were examined. The age-adjusted EU-level prevalence of TF in 1-9-year-olds ranged from 0.0% to 23.3%, and the age- and gender-adjusted EU-level prevalence of trichiasis in ≥ 15-year-olds ranged from 0.02% to 1.3%. TF was above the WHO elimination threshold in 16 EUs (39%) and trichiasis was above the WHO elimination threshold in 29 EUs (71%). Women had a higher prevalence of trichiasis than did men in 31 EUs (76%). A higher ratio of trichiasis prevalence in women to trichiasis prevalence in men was associated (p = 0.03) with a higher prevalence of trichiasis at EU level.
Public health-level interventions against trachoma are needed in Chad. Over 10,000 people need management of their trichiasis; women account for about two-thirds of this total. The association between a higher ratio of trichiasis prevalence in women to that in men with higher overall trichiasis prevalence needs further investigation.
评估乍得疑似沙眼流行地区的沙眼患病率，从而确定沙眼是否为需要干预的公共卫生问题。
我们将居住在安全地区的疑似流行人群划分为46个评估单元（EU），并采用全球沙眼地图绘制项目的标准化方法。采用两阶段整群抽样程序。在每个评估单元中，目标是通过招募649户家庭来检查至少1019名1-9岁儿童；对居住在这些家庭中所有年龄≥1岁且同意检查的居民进行检查。对每位参与者检查沙眼滤泡性炎症（TF）、沙眼重度炎症（TI）和倒睫情况。
两个评估单元的数据无法得到验证，被排除在分析之外。另外三对评估单元的GPS数据表明评估单元划分不准确；每对评估单元内的数据进行了合并。在最终得到的41个评估单元中，走访了967个群组中的29924户家庭，检查了104584人。1-9岁儿童经年龄调整后的评估单元层面TF患病率在0.0%至23.3%之间，15岁及以上人群经年龄和性别调整后的评估单元层面倒睫患病率在0.02%至1.3%之间。16个评估单元（39%）的TF患病率高于世界卫生组织消除阈值，29个评估单元（71%）的倒睫患病率高于世界卫生组织消除阈值。在31个评估单元（76%）中，女性倒睫患病率高于男性。女性倒睫患病率与男性倒睫患病率的较高比值与评估单元层面较高的倒睫患病率相关（p = 0.03）。
乍得需要针对沙眼采取公共卫生层面的干预措施。超过10000人需要接受倒睫治疗；其中约三分之二为女性。女性倒睫患病率与男性倒睫患病率的较高比值与总体较高的倒睫患病率之间的关联需要进一步研究。
