Trachoma prevalence and associated risk factors in the gambia and Tanzania: baseline results of a cluster randomised controlled trial.
Trachoma prevalence and associated risk factors in the gambia and Tanzania: baseline results of a cluster randomised controlled trial.
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冈比亚和坦桑尼亚的沙眼患病率和相关危险因素：整群随机对照试验的基线结果。
DOI：
10.1371/journal.pntd.0000861
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发表时间：
2010-11-02
影响因子：
3.8
通讯作者：
West, Sheila K.
中科院分区：
文献类型：
--
作者：
Harding-Esch, Emma M.;Edwards, Tansy;Mkocha, Harran;Munoz, Beatriz;Holland, Martin J.;Burr, Sarah E.;Sillah, Ansumana;Gaydos, Charlotte A.;Stare, Dianne;Mabey, David C. W.;Bailey, Robin L.;West, Sheila K.
由沙眼衣原体眼部感染引起的致盲性沙眼，目标是到2020年在全球消除。了解风险因素有助于采取有针对性的控制措施。作为随机对照试验的一部分，我们评估了活动性沙眼和眼沙眼衣原体的基线患病率和危险因素。在冈比亚48个社区和坦桑尼亚36个社区随机选择的0-5岁儿童中，根据世界卫生组织（WHO）简化的分级系统检查了两个孩子的眼睛，并从每个孩子的右眼取一个眼拭子，通过Amplicor聚合酶链反应进行处理，以检测是否存在C。沙眼DNA冈比亚活动性沙眼的患病率为6.7%（335/5033），坦桑尼亚为32.3%（1008/3122）。这两个国家相应的Amplicor阳性患病率分别为0.8%和21.9%。校正后，两国滤泡性沙眼（TF）的危险因素为眼或鼻分泌物、户主教育水平低和年龄≥1岁。坦桑尼亚的其他风险因素包括儿童脸上的苍蝇、Amplicor阳性和拥挤（每户儿童人数）。在坦桑尼亚，Amplicor阳性的风险因素与TF相似，但不包括苍蝇和拥挤。在冈比亚，只有眼分泌物与Amplicor阳性相关。这些结果表明，尽管两国活动性沙眼和Amplicor阳性的患病率有很大差异，但活动性沙眼的危险因素相似，但Amplicor阳性的危险因素不同。在冈比亚，Amplicor阳性和TF之间缺乏相关性，突出了沙眼临床体征和C。感染沙眼衣原体只有眼部分泌物与C。冈比亚的沙眼DNA，这表明在这种低流行性下，这可能是最重要的风险因素。ClinicalTrials.gov NCT 00792922沙眼由沙眼衣原体引起，是导致失明的主要传染性原因。世界卫生组织（WHO）的控制策略包括对所有社区成员进行抗生素治疗，面部清洁和环境改善。通过确定沙眼的流行程度，可以决定是否需要采取控制措施。了解哪些因素使人们更容易患上沙眼，可以帮助将沙眼控制工作针对那些风险最大的人。我们观察了活动性沙眼和C。冈比亚和坦桑尼亚0-5岁儿童眼睛中的沙眼感染。我们还测量了与活动性沙眼或感染相关的风险因素。冈比亚活动性沙眼和感染的患病率（分别为6.7%和0.8%）低于坦桑尼亚（分别为32.3%和21.9%）。两个国家活动性沙眼的危险因素相似。对于感染，坦桑尼亚的危险因素与TF相似，而在冈比亚，只有眼部分泌物与感染相关。这些结果表明，尽管两国活动性沙眼和感染的患病率有很大差异，但活动性沙眼的危险因素相似，但感染的危险因素不同。
Blinding trachoma, caused by ocular infection with Chlamydia trachomatis, is targeted for global elimination by 2020. Knowledge of risk factors can help target control interventions. As part of a cluster randomised controlled trial, we assessed the baseline prevalence of, and risk factors for, active trachoma and ocular C. trachomatis infection in randomly selected children aged 0–5 years from 48 Gambian and 36 Tanzanian communities. Both children's eyes were examined according to the World Health Organization (WHO) simplified grading system, and an ocular swab was taken from each child's right eye and processed by Amplicor polymerase chain reaction to test for the presence of C. trachomatis DNA. Prevalence of active trachoma was 6.7% (335/5033) in The Gambia and 32.3% (1008/3122) in Tanzania. The countries' corresponding Amplicor positive prevalences were 0.8% and 21.9%. After adjustment, risk factors for follicular trachoma (TF) in both countries were ocular or nasal discharge, a low level of household head education, and being aged ≥1 year. Additional risk factors in Tanzania were flies on the child's face, being Amplicor positive, and crowding (the number of children per household). The risk factors for being Amplicor positive in Tanzania were similar to those for TF, with the exclusion of flies and crowding. In The Gambia, only ocular discharge was associated with being Amplicor positive. These results indicate that although the prevalence of active trachoma and Amplicor positives were very different between the two countries, the risk factors for active trachoma were similar but those for being Amplicor positive were different. The lack of an association between being Amplicor positive and TF in The Gambia highlights the poor correlation between the presence of trachoma clinical signs and evidence of C. trachomatis infection in this setting. Only ocular discharge was associated with evidence of C. trachomatis DNA in The Gambia, suggesting that at this low endemicity, this may be the most important risk factor. ClinicalTrials.gov NCT00792922 Trachoma is caused by Chlamydia trachomatis and is the leading infectious cause of blindness. The World Health Organization's (WHO) control strategy includes antibiotic treatment of all community members, facial cleanliness, and environmental improvements. By determining how prevalent trachoma is, decisions can be made whether control activities need to be put in place. Knowing what factors make people more at risk of having trachoma can help target trachoma control efforts to those most at risk. We looked at the prevalence of active trachoma and C. trachomatis infection in the eyes of children aged 0–5 years in The Gambia and Tanzania. We also measured risk factors associated with having active trachoma or infection. The prevalence of both active trachoma and infection was lower in The Gambia (6.7% and 0.8%, respectively) than in Tanzania (32.3% and 21.9%, respectively). Risk factors for active trachoma were similar in the two countries. For infection, the risk factors in Tanzania were similar to those for TF, whereas in The Gambia, only ocular discharge was associated with infection. These results show that although the prevalence of active trachoma and infection is very different between the two countries, the risk factors for active trachoma are similar but those for infection are different.
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DOI：
10.1016/0035-9203(91)90470-j
发表时间：
1991-11-01
影响因子：
2.2
作者：
BAILEY, R;DOWNES, B;MABEY, D
通讯作者：
MABEY, D
影响因子：
168.9
作者：
BOBO, L;MUNOZ, B;WEST, S
通讯作者：
WEST, S
影响因子：
--
作者：
BRECHNER, RJ;WEST, S;LYNCH, M
通讯作者：
LYNCH, M
影响因子：
168.9
作者：
Emerson, PM;Lindsay, SW;Bailey, RL
通讯作者：
Bailey, RL
影响因子：
4.1
作者：
Fouad, D;Mousa, A;Courtright, P
通讯作者：
Courtright, P