Risk factors for incidence of trachomatous scarring in a cohort of women in low endemic district
Risk factors for incidence of trachomatous scarring in a cohort of women in low endemic district
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DOI：
10.1136/bjophthalmol-2017-311301
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发表时间：
2018-04-01
影响因子：
4.1
通讯作者：
West, Sheila K.
中科院分区：
文献类型：
--
作者：
Karani, Rabia;Wolle, Meraf;West, Sheila K.
背景/目的为了确定坦桑尼亚农村沙眼低流行区妇女瘢痕形成的发生率，并确定终身烹饪火灾暴露和社会经济地位较低的标志物对这些妇女瘢痕形成发生率的影响。方法2013年至2016年在Kongwa的48个村庄进行了为期3. 5年的前瞻性队列研究，在坦桑尼亚，儿童沙眼的基线率为5.2%。随机抽取了2966名年龄在15岁及以上的女性，这些女性有发生瘢痕的风险，有资格接受随访。在基线和随访时收集了人口统计学因素、烹饪火灾暴露和沙眼瘢痕形成的数据。一生中暴露于烹饪火暴露的指数被创建和双变量分析，年龄调整的logistic回归和多变量logistic模型被用来寻找人口统计学因素和烹饪火暴露与沙眼瘢痕形成的关联。瘢痕形成的发生率随着年龄和暴露于较低社会经济地位的标志物而增加。调整混杂因素后的多变量logistic回归模型未发现终生暴露于烹饪火源与瘢痕形成之间的相关性（OR=0.92; 95%CI 0.68 - 1.24，P=0.58）。暴露于烹饪火灾和事故疤痕之间没有关联。需要更多的研究来了解导致这些女性新疤痕的因素。
Background/aims To determine the incidence of scarring in women in a trachoma low endemic district of rural Tanzania and to determine the effects of lifetime cooking fire exposure and markers of lower socioeconomic status on incidence of scarring in these women.Methods A prospective cohort study was conducted over a 3.5-year period from 2013 to 2016 in 48 villages in Kongwa, Tanzania where trachoma at baseline was 5.2% in children. A random sample of 2966 women aged 15 and older who were at risk for incident scarring were eligible for follow-up. Data on demographic factors, cooking fire exposure and trachomatous scarring were gathered at baseline and follow-up. An index of lifetime exposure to cooking fire exposure was created and bivariate analysis, age-adjusted logistic regression and multivariable logistic models were used to look for associations of demographic factors and cooking fire exposure with incident trachomatous scarring.Results The cumulative incidence of scarring was 7.1% or 2.0% per year. Incidence of scarring increased with age and exposure to markers of lower socioeconomic status. A multivariable logistic regression model adjusting for confounding factors did not find an association between lifetime cooking fire exposure and incidence of scarring (OR=0.92; 95%CI 0.68 to 1.24, P=0.58).Conclusions There was still incident scarring in women in Tanzania despite low rates of active trachoma. There was no association between exposure to cooking fires and incident scarring. More research is needed to understand the factors that contribute to new scarring in these women.