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  • Title: Trachoma prevalence remains below threshold in five districts after stopping mass drug administration: results of five surveillance surveys within a hyperendemic setting in Amhara, Ethiopia.
    Author: Nash SD, Stewart AEP, Astale T, Sata E, Zerihun M, Gessese D, Melak B, Ayenew G, Ayele Z, Bayissasse B, Chanyalew M, Tadesse Z, Callahan EK.
    Journal: Trans R Soc Trop Med Hyg; 2018 Dec 01; 112(12):538-545. PubMed ID: 30265355.
    Abstract:
    BACKGROUND: The World Health Organization (WHO) recommends conducting trachoma surveillance surveys in districts where the elimination targets have been met and following a minimum 2-year period after cessation of mass drug administration (MDA) in order to determine the sustainability of low trachoma levels. METHODS: In 2015, population-based surveillance surveys were conducted in five districts of Amhara, Ethiopia. All five districts had a prior trachomatous inflammation-follicular (TF) prevalence among children 1-9 y of age of <5% determined by an impact survey and had not received MDA for ≥2 y. Surveys included examinations for trachoma clinical signs and conjunctival swabbing to determine Chlamydia trachomatis infection prevalence. RESULTS: Approximately 1000 children 1-9 y of age were examined for TF and 200 children 1-5 y of age were swabbed per district. All five surveillance districts had a TF prevalence of <5% and infection was only detected in one district. The prevalence of trachomatous trichiasis in adults ≥15 y of age was ≥1% in all districts. CONCLUSIONS: In a trachoma hyperendemic region, a TF prevalence <5% was successfully maintained in five districts for ≥2 years after stopping MDA. MDA is still not warranted for these districts, however, the S, F and E components of the SAFE strategy should continue.
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