Kanyi Sarjo, Hydara Abba, Sillah Ansumana, Mpyet Caleb, Harte Anna, Bakhtiari Ana, Willis Rebecca, Jimenez Cristina, Aboe Agatha, Bailey Robin, Harding-Esch Emma M, Solomon Anthony W, Joof Balla Musa
The National Eye Health Programme, Ministry of Health, Banjul, Kanifing, The Gambia.
Sheikh Zayed Regional Eye Care Center, Banjul, Kanifing, The Gambia.
Ophthalmic Epidemiol. 2024 Dec;31(6):534-542. doi: 10.1080/09286586.2023.2213320. Epub 2023 Jul 3.
Trichiasis is present when in-turned eyelashes touch the eyeball. It may result in permanent vision loss. Trachomatous trichiasis (TT) is caused by multiple rounds of inflammation associated with conjunctival Chlamydia trachomatis infection. Surveys have been designed to estimate the prevalence of TT in evaluation units (EUs) of trachoma-endemic countries in order to help develop appropriate programme-level plans. In this study, TT-only surveys were conducted in five EUs of The Gambia to determine whether further intensive programmatic action was required.
Two-stage cluster sampling was used to select 27 villages per EU and ~25 households per village. Graders assessed the TT status of individuals aged ≥15 years in each selected household, including the presence or absence of conjunctival scarring in those with TT.
From February to March 2019, 11595 people aged ≥15 years were examined. A total of 34 cases of TT were identified. All five EUs had an age- and gender-adjusted prevalence of TT unknown to the health system <0.2%. Three of five EUs had a prevalence of 0.0%.
Using these and other previously collected data, in 2021, The Gambia was validated as having achieved national elimination of trachoma as a public health problem. Trachoma is still present in the population, but as its prevalence is low, it is unlikely that today's youth will experience the exposure to C. trachomatis required to precipitate TT. The Gambia demonstrates that with political will and consistent application of human and financial resources, trachoma can be eliminated as a public health problem.
倒睫是指睫毛向内生长触及眼球，可能导致永久性视力丧失。沙眼性倒睫（TT）由与结膜沙眼衣原体感染相关的多轮炎症引起。为了帮助制定适当的项目层面计划，已设计调查以估计沙眼流行国家评估单位（EU）中TT的患病率。在本研究中，在冈比亚的五个评估单位进行了仅针对TT的调查，以确定是否需要进一步的强化项目行动。
采用两阶段整群抽样，每个评估单位选取27个村庄，每个村庄选取约25户家庭。分级人员评估每个选定家庭中年龄≥15岁个体的TT状况，包括患有TT者是否存在结膜瘢痕。
2019年2月至3月，对11595名年龄≥15岁的人进行了检查。共确诊34例TT病例。所有五个评估单位的卫生系统未知的年龄和性别调整后的TT患病率均<0.2%。五个评估单位中有三个患病率为0.0%。
利用这些以及其他先前收集的数据，2021年，冈比亚被确认为已实现将沙眼作为公共卫生问题予以消除。沙眼在人群中仍然存在，但由于其患病率较低，当今的年轻人不太可能经历引发TT所需的沙眼衣原体暴露。冈比亚表明，凭借政治意愿以及持续投入人力和财力资源，沙眼可作为公共卫生问题被消除。
