全球在消除活动性沙眼方面取得的进展：对38个国家的分析
Global progress toward the elimination of active trachoma: an analysis of 38 countries.
作者信息
Renneker Kristen K, Abdala Mariamo, Addy James, Al-Khatib Tawfik, Amer Khaled, Badiane Mouctar Dieng, Batcho Wilfrid, Bella Lucienne, Bougouma Clarisse, Bucumi Victor, Chisenga Tina, Dat Tran Minh, Dézoumbé Djore, Elshafie Balgesa, Garae Mackline, Goepogui André, Hammou Jaouad, Kabona George, Kadri Boubacar, Kalua Khumbo, Kanyi Sarjo, Khan Asad Aslam, Marfo Benjamin, Matendechero Sultani, Meite Aboulaye, Minnih Abdellahi, Mugume Francis, Olobio Nicholas, Omar Fatma Juma, Phiri Isaac, Sanha Salimato, Sharma Shekhar, Seife Fikre, Sokana Oliver, Taoaba Raebwebwe, Tesfazion Andeberhan, Traoré Lamine, Uvon Naomi, Yaya Georges, Logora Makoy Yibi, Hooper P J, Emerson Paul M, Ngondi Jeremiah M
机构信息
International Trachoma Initiative, The Task Force for Global Health, Decatur, GA, USA.
Mozambique Ministry of Health, Maputo, Mozambique.
出版信息
Lancet Glob Health. 2022 Apr;10(4):e491-e500. doi: 10.1016/S2214-109X(22)00050-X.
BACKGROUND
Global elimination of trachoma as a public health problem was targeted for 2020. We reviewed progress towards the elimination of active trachoma by country and geographical group.
METHODS
In this retrospective analysis of national survey and implementation data, all countries ever known to be endemic for trachoma that had either implemented at least one trachoma impact survey shown in the publicly available Trachoma Atlas, or are in Africa were invited to participate in this study. Scale-up was described according to the number of known endemic implementation units and mass drug administration implementation over time. The prevalence of active trachoma-follicular among children aged 1-9 years (TF) from baseline, impact, and surveillance surveys was categorised and used to show programme progress towards reaching the elimination threshold (TF <5%) using dot maps, spaghetti plots, and boxplots.
FINDINGS
We included data until Nov 10, 2021, for 38 countries, representing 2097 ever-endemic implementation units. Of these, 1923 (91·7%) have had mass drug administration. Of 1731 implementation units with a trachoma impact survey, the prevalence of TF had reduced by at least 50% in 1465 (84·6%) implementation units and 1182 (56·4%) of 2097 ever-endemic implementation units had reached the elimination threshold. 2 years after reaching a TF prevalence below 5%, most implementation units sustained this target; however, 58 (56·3%) of 103 implementation units in Ethiopia showed recrudescence.
INTERPRETATION
Global elimination of trachoma as a public health problem by 2020 was not possible, but this finding masks the great progress achieved. Implementation units in high baseline categories and recrudescent TF might prolong the attainment of elimination of active trachoma. Elimination is delayed but, with an understanding of the patterns and timelines to reaching elimination targets and a commitment toward meeting future targets, global elimination can still be achieved by 2030.
FUNDING
None.
背景
全球消除沙眼这一公共卫生问题的目标时间为2020年。我们按国家和地理区域审查了消除活动性沙眼的进展情况。
方法
在这项对国家调查和实施数据的回顾性分析中，所有曾被认定为沙眼流行地区且已实施至少一项沙眼影响调查（可在公开的《沙眼地图集》中查到）的国家，或位于非洲的国家，均受邀参与本研究。根据已知的流行实施单位数量以及大规模药物给药的实施情况随时间的变化来描述扩大规模的情况。对1至9岁儿童基线、影响和监测调查中活动性沙眼滤泡型（TF）的患病率进行分类，并使用点图、意大利面条图和箱线图来展示项目在达到消除阈值（TF<5%）方面的进展。
结果
我们纳入了截至2021年11月10日来自38个国家的数据，代表2097个曾为流行地区的实施单位。其中，1923个（91.7%）实施了大规模药物给药。在1731个有沙眼影响调查的实施单位中，1465个（84.6%）实施单位的TF患病率至少降低了50%，2097个曾为流行地区的实施单位中有1182个（56.4%）达到了消除阈值。在TF患病率降至5%以下2年后，大多数实施单位维持了这一目标；然而，埃塞俄比亚103个实施单位中有58个（56.3%）出现了复发。
解读
到202 0年全球消除沙眼这一公共卫生问题是不可能的，但这一结果掩盖了所取得的巨大进展。高基线类别中的实施单位和复发的TF可能会延长消除活动性沙眼的实现时间。消除工作被推迟了，但是，了解达到消除目标的模式和时间线并致力于实现未来目标，到2030年仍可实现全球消除。
资金来源
无。
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