Sata Eshetu, Presley Nicholas A, Le Phong, Nute Andrew W, Ayele Zebene, Shiferaw Ayalew, Gessese Demelash, Chernet Ambahun, Melak Berhanu, Gonzalez Tania A, Jensen Kimberly A, Dawed Adisu Abebe, Zeru Taye, Tadesse Zerihun, Callahan Elizabeth Kelly, Nash Scott D
Trachoma Control Program, The Carter Center, Addis Ababa 1169, Ethiopia.
Trachoma Control Program, The Carter Center, Atlanta, GA 30307, USA.
Trop Med Infect Dis. 2024 Dec 5;9(12):298. doi: 10.3390/tropicalmed9120298.
Trachoma recrudescence is a serious concern for trachoma control programs. Programs define recrudescence as the return of trachomatous inflammation-follicular (TF) prevalence above elimination threshold (≥5%) on district-level trachoma surveillance surveys (TSSs). This study aimed to determine potential correlates of trachoma recrudescence within a historically highly endemic region. Between 2015 and 2021, population-based TSSs were conducted in 51 districts of Amhara, Ethiopia. District estimates were calculated accounting for multistage design; logistic regression was used to estimate the association of key correlates with recrudescence at the district level. Among the 51 districts, 17 (33%) were recrudescent. Correlates of recrudescence included indicators of historic trachoma burden, such as higher trachomatous inflammation-intense (TI) prevalence (odds ratio [OR]: 2.6, CI: 1.4-5.3) and higher () infection prevalence (OR: 2.9, CI: 1.1-9.9) at the first recorded impact survey. The increased prevalence of children with clean faces (OR: 0.4, CI: 0.21-1.0) and the increased prevalence of travel time to a water source ≤ 30 min (OR: 0.5, CI: 0.2-1.1) at the TSS were associated with a protective effect from recrudescence. Data on historical trachoma burden as well as current water and sanitation conditions may help programs predict where recrudescence is more likely to occur and thus help programs sustain elimination as a public health problem.
沙眼复发是沙眼控制项目的一个严重问题。项目将复发定义为在地区层面的沙眼监测调查（TSS）中，沙眼性炎症-滤泡型（TF）患病率回升至消除阈值以上（≥5%）。本研究旨在确定一个历史上沙眼高度流行地区内沙眼复发的潜在相关因素。2015年至2021年期间，在埃塞俄比亚阿姆哈拉州的51个地区开展了基于人群的TSS。考虑到多阶段设计计算了地区估计值；采用逻辑回归估计地区层面关键相关因素与复发之间的关联。在这51个地区中，有17个（33%）出现了复发。复发的相关因素包括历史沙眼负担指标，如在首次记录的影响调查中较高的沙眼性炎症-重度（TI）患病率（比值比[OR]：2.6，可信区间[CI]：1.4-5.3）和较高的（）感染患病率（OR：2.9，CI：1.1-9.9）。在TSS中，面部清洁儿童患病率的增加（OR：0.4，CI：0.21-1.0）以及前往水源地的出行时间≤30分钟的患病率增加（OR：0.5，CI：0.2-1.1）与复发的保护作用相关。关于历史沙眼负担以及当前水和卫生条件的数据可能有助于项目预测更可能出现复发的地点，从而帮助项目维持将沙眼作为公共卫生问题予以消除的成果。
