Baseline Prevalence of Trachoma in 21 Local Government Areas of Adamawa State, North East Nigeria

ABSTRACT

Purpose

To determine the prevalence of trachoma in each of the 21 local government areas (LGAs) of Adamawa State, Nigeria.

Methods

A population-based cross-sectional survey was conducted in each of the 21 LGAs of Adamawa State between 2017 and 2019. With the support of Tropical Data (TD), surveys were planned and implemented in accordance with World Health Organization (WHO) recommendations. A two-stage cluster sampling technique was used in each LGA, 25 or 30 clusters were selected with a probability of selection proportionate to cluster size, and in each of these clusters, 25 or 30 households were enrolled for the survey. All residents aged 1 year and older within selected households were examined by TD-certified graders for trachomatous inflammation – follicular (TF) and trachomatous trichiasis (TT) using the WHO simplified grading scheme. Additionally, data were collected on household water and sanitation access.

Results

All 21 LGAs had TF prevalence in 1–9-year-olds below 5%. The prevalence of TT unknown to the health system in people aged ≥15 years was ≥0.2% in three of the 21 LGAs. Access to improved water and sanitation facilities was <80% in the majority of the surveyed LGAs. Only 12 of the 21 LGAs had ≥50% household-level improved latrine access, and only Yola North had ≥80% household-level improved latrine access.

Conclusion

There is no need for mass treatment with antibiotics for trachoma elimination purposes in any of these LGAs. There is a need for active TT case finding and provision of community-based TT surgical services in three LGAs. Furthermore, engagement with water and sanitation agencies is needed to augment access to improved water and sanitation facilities across the State; this will help to avoid the recrudescence of active trachoma in the State.

Keywords:

• Trachoma; Adamawa; Prevalence; WASH; Survey

Acknowledgments

We thank the leadership and staff of the Adamawa State Ministry of Health for their generous and unstinting collaboration; in-country TD trainers; our hard-working field teams; supporting NGDOs; the TD team and the residents of participating communities. We are grateful to Robert Butcher for reviewing the first draft of this manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Disclaimer

The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated, USAID or the United States Government.

Additional information

Funding

Fieldwork for these surveys was funded by the Commonwealth Grant from the United Kingdom to Sightsavers to support the Nigeria National Trachoma Elimination Programme. AWS is a staff member of the World Health Organization.