Cornea, Cataract & Refractive Surgery Services, Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Indian J Ophthalmol. 2022 Sep;70(9):3260-3265. doi: 10.4103/ijo.IJO_503_22.
In the mid-twentieth century, trachoma was endemic in the northwestern states of India. We aimed to generate recent estimates of prevalence of trachomatous inflammation, follicular (TF) and trachomatous trichiasis (TT) in ten suspected-endemic districts across seven previously hyper-endemic states and union territories for trachoma in India including Delhi, Rajasthan, Haryana, Punjab, Gujarat, Uttarakhand and the Andaman and Nicobar Islands.
Population-based prevalence surveys were undertaken in 10 districts. In each of those districts, two-stage cluster sampling was used to select a sample of 2000 children aged 1-9 years and all adults aged ≥15 years in the enumerated households from a total of 20 clusters per district. Consenting eligible participants were examined for trachoma by trained ophthalmologists using the World Health Organization's simplified grading system. Data were analyzed at the district level.
A total of 13,802 households were surveyed in which 19,662 children were examined for TF and 44,135 adults aged ≥15 years were examined for TT. District-level TF prevalence in 1-9-year-olds ranged from 0.1% in Bikaner (95% CI: 0.01-0.3) to 2.1% in Dholpur (95% CI: 1.6-2.8) and that of trichiasis ranged from 0.7 per 1000 in Pauri Garhwal (95% CI: 0.01-1.4) to 22.1 per 1000 (95% CI: 15.8-28.4) in Car Nicobar. In four districts (Car Nicobar, Dholpur, Hoshiarpur, Tonk), trichiasis prevalence in adults aged ≥15 years was ≥0.2%.
TF was not a public health problem in any of the districts surveyed; thus, antibiotic mass drug administration is not needed. However, TT among adults was found to be above 0.2% in four districts; thus, further trichiasis surgery interventions at the public health level are warranted to achieve elimination. These findings will facilitate planning for elimination of trachoma as a public health problem in India.
在 20 世纪中叶，沙眼在印度西北部各州流行。我们旨在为印度七个以前高度流行的沙眼州和联邦属地（包括德里、拉贾斯坦邦、哈里亚纳邦、旁遮普邦、古吉拉特邦、北阿坎德邦和安达曼和尼科巴群岛）的十个疑似流行地区估算沙眼性炎症、滤泡性（TF）和沙眼性倒睫（TT）的最近患病率。
在 10 个地区进行了基于人群的患病率调查。在每个地区，采用两阶段聚类抽样方法，从每个地区总共 20 个聚类中选择 2000 名 1-9 岁儿童和所有 15 岁及以上的成年人作为样本。对同意参与的合格参与者进行培训眼科医生使用世界卫生组织简化分级系统进行沙眼检查。数据在地区层面进行分析。
共调查了 13802 户家庭，其中 19662 名儿童接受了 TF 检查，44135 名 15 岁及以上的成年人接受了 TT 检查。1-9 岁儿童中，地区一级 TF 患病率从比卡内尔的 0.1%（95%可信区间：0.01-0.3）到多哈布尔的 2.1%（95%可信区间：1.6-2.8）不等，而 Trichiasis 的患病率从 Pauri Garhwal 的每 1000 人 0.7（95%可信区间：0.01-1.4）到 Car Nicobar 的每 1000 人 22.1（95%可信区间：15.8-28.4）不等。在四个地区（Car Nicobar、Dholpur、Hoshiarpur、Tonk），15 岁及以上成年人的 Trichiasis 患病率≥0.2%。
在所调查的任何地区，TF 都不是一个公共卫生问题，因此不需要进行大规模药物治疗。然而，在四个地区发现，成年人的 TT 患病率高于 0.2%；因此，需要在公共卫生层面进一步进行沙眼手术干预，以实现消除。这些发现将有助于规划在印度消除沙眼这一公共卫生问题。
