National Trachoma Assessment in the Lao People’s Democratic Republic in 2013–2014

ABSTRACT

Purpose: Population-based prevalence surveys were undertaken to determine whether trachoma is a public health problem in Laos requiring implementation of the SAFE strategy (surgery, antibiotics, facial cleanliness, environmental improvement).

Methods: The country was divided into 19 evaluation units (EUs), each containing a population of roughly 100,000–350,000 people. Of these, 16 were believed most likely to harbor trachoma (based on historical evidence), and were mapped using the Global Trachoma Mapping Project methods. A 2-stage cluster sampling was used to sample approximately 1222 children aged 1–9 years in each EU, as well as all adults aged 15 years and older resident in households with children. The presence or absence of trachomatous inflammation – follicular (TF) and of trichiasis was documented in each subject, and prevalences (adjusted for age and sex) estimated.

Results: The adjusted prevalence of TF in 1–9-year-olds ranged from 0.2% to 2.2% across the 16 EUs. Adjusted all-ages prevalence of trichiasis was 0.00% in 13 EUs, 0.06% in two EUs, and 0.12% in one EU. The trichiasis prevalence in adults in the last EU was 0.19%.

Conclusions: The assessment included all areas of Laos suspected of ever harboring trachoma and most of the rural population of the country. The low prevalence of TF and trichiasis do not warrant any special programs against trachoma at this time.

KEYWORDS:

• Laos
• trachoma
• trichiasis

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Funding

The fieldwork described in this paper was generously supported by the American People through the United States Agency for International Development (USAID) via its END in Asia project, implemented by FHI360 under cooperative agreement number OAA-A-10-00051. The Global Trachoma Mapping Project, which provided logistical, epidemiological and data management support, was funded by a grant from the United Kingdom’s Department for International Development (DFID)(ARIES: 203145) to Sightsavers. A committee established in March 2012 to examine issues surrounding completion of global trachoma mapping was initially supported by a grant from Pfizer to the International Trachoma Initiative. AWS was a Wellcome Trust Intermediate Clinical Fellow (098521) at the London School of Hygiene & Tropical Medicine. None of the funders had any role in project design, project implementation, data analysis or data interpretation, in the decisions on where, how or when to publish in the peer reviewed press, or in preparation of the manuscript. The contents are the responsibility of the Ministry of Health, Cambodia and do not necessarily reflect the views of USAID, DFID or the governments of the United States or the United Kingdom.

Additional information

Funding

The fieldwork described in this paper was generously supported by the American People through the United States Agency for International Development (USAID) via its END in Asia project, implemented by FHI360 under cooperative agreement number OAA-A-10-00051. The Global Trachoma Mapping Project, which provided logistical, epidemiological and data management support, was funded by a grant from the United Kingdom’s Department for International Development (DFID)(ARIES: 203145) to Sightsavers. A committee established in March 2012 to examine issues surrounding completion of global trachoma mapping was initially supported by a grant from Pfizer to the International Trachoma Initiative. AWS was a Wellcome Trust Intermediate Clinical Fellow (098521) at the London School of Hygiene & Tropical Medicine. None of the funders had any role in project design, project implementation, data analysis or data interpretation, in the decisions on where, how or when to publish in the peer reviewed press, or in preparation of the manuscript. The contents are the responsibility of the Ministry of Health, Cambodia and do not necessarily reflect the views of USAID, DFID or the governments of the United States or the United Kingdom.