Trachoma in Northern Ghana: A Need for Further Studies

Abstract

Background: The northern Ghana Upper East Region [UER], Upper West Region [UWR], and Northern Region (NR) lie within the African trachoma belt. The 3 regions share common features of poverty, dryness, dusty environments, and poor environmental hygiene. Trachoma has been identified previously in the NR and the UWR as a disease of public health importance and a control program is underway.

Purpose: To establish baseline prevalence and risk factor parameters in the Upper East for possible control of trachoma in the region.

Methods: Population-based cross-sectional survey using multi-staged cluster sampling techniques was used. In all 26,323 participants from 4,374 households in 160 communities were examined with a 2.5x magnifying binocular loupe for trachoma; 7,763 were children aged 1–9 years and 15,191 were aged 15 years and over.

Results: Only 3 children were identified with active trachoma (trachoma with follicles, TF = 1; trachoma with intense inflammation, TI = 2) giving regional prevalence of 0.01% (Confidence Limits, CL: 0.0–0.1) for TF and 0.03% (CL: 0.0–0.1) for TI. Trachomatous trichiasis was measured at 0.05% (CL: 0.0–0.1) while children with clean faces was measured at 95.5%. Only 3.6% of the examined households in the region had access to a toilet facility.

Conclusion: Trachoma is not a disease of public health importance in the UER of Ghana despite being in a trachoma endemic zone and sharing the necessary risk factors for the disease.

KEYWORDS::

• Conjunctivitis
• Follicles
• Scarring trachoma
• Trichiasis

ACKNOWLEDGMENTS

The authors would like to thank the ophthalmic nurses and other personnel who played different roles in the survey as well as the supporting agencies that provided the funding.

No member of the research team is associated with any finance interest. The survey was designed as a national needs assessment and the intention to publish motivated by the unique findings.

Financial support was provided by The International Trachoma Initiative and the Ghana Health Service.

Declaration of Interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.