Vashist Praveen, Manna Souvik, Senjam Suraj Singh, Gupta Vivek, Gupta Noopur, Wadhwani Meenakshi, Grover Sumit, Bhardwaj Amit
Community Ophthalmology, AIIMS, New Delhi, India.
Department of Ophthalmology, Dr. R. P. Centre, AIIMS, New Delhi, India.
Ophthalmic Epidemiol. 2024 Dec;31(6):553-560. doi: 10.1080/09286586.2023.2232036. Epub 2023 Jul 5.
To determine the burden of trachoma and its related risk factors among the underserved population of sixteen states/union territories (UTs) in India.
Trachoma rapid assessment (TRA) was conducted in seventeen Enumeration Units (EUs) spanning sixteen states/UTs in India according to standard WHO guidelines. A total of ten clusters were selected in each EU and 50 children aged 1-9 years were assessed clinically for signs of active trachoma and facial cleanliness in each cluster. Additionally, all adults aged 15 years and above in the same households were examined for evidence of trachomatous trichiasis (TT) and corneal opacity. Environmental risk factors contributing to trachoma were also noted in all households.
Out of 766 districts in India, seventeen EUs were selected for TRA depending on evidence of socio-developmental indicators like poverty and suboptimal access to water, sanitation, and healthcare facilities. The total population of the selected clusters was 21,774 in the 17 EUs. Overall, 104 of 8807 children (1.2%; CI: 0.9-1.4) had evidence of follicular or inflammatory stages of trachoma. Nearly 16.6% (CI:15.8-17.4) children were noted to have unclean faces in the 170 clusters. Trichiasis was noted in 19 adults (2.1 per 1000; CI:1.2-3.2 per 1000). Environmental sanitation was found to be unsatisfactory in two-thirds (67.8%) of the surveyed households in the clusters mainly due to improper garbage disposal.
Active trachoma was not a public health problem in any of the EUs surveyed. However, burden of TT among adults was found to be above 0.2% in two EUs; hence, further public health interventions like trichiasis surgery were recommended.
确定印度16个邦/联邦属地（UTs）中服务不足人群的沙眼负担及其相关风险因素。
根据世界卫生组织标准指南，在印度16个邦/UTs的17个普查单位（EUs）中进行沙眼快速评估（TRA）。每个EU共选择10个群组，对每个群组中50名1 - 9岁儿童进行临床检查，以确定活动性沙眼迹象和面部清洁情况。此外，对同一家庭中所有15岁及以上的成年人进行检查，以确定是否有沙眼性倒睫（TT）和角膜混浊迹象。还记录了所有家庭中导致沙眼的环境风险因素。
在印度的766个区中，根据贫困以及获得水、卫生设施和医疗保健设施不足等社会发展指标的证据，选择了17个EUs进行TRA。17个EUs中选定群组的总人口为21,774人。总体而言，8807名儿童中有104名（1.2%；置信区间：0.9 - 1.4）有沙眼滤泡期或炎症期迹象。在170个群组中，近16.6%（置信区间：15.8 - 17.4）的儿童面部不清洁。在19名成年人中发现有倒睫（每1000人中有2.1人；置信区间：每1000人中有1.2 - 3.2人）。在群组中，三分之二（67.8%）的受访家庭环境卫生状况不佳，主要原因是垃圾处理不当。
在所调查的任何一个EUs中，活动性沙眼都不是公共卫生问题。然而，在两个EUs中发现成年人的TT负担高于0.2%；因此，建议采取进一步的公共卫生干预措施，如倒睫手术。
