Prevalence of trachoma in Yemen: results of population-based prevalence surveys of 42 evaluation units in nine governorates

Figures & data

Table 1. Prevalence of trachomatous inflammation—follicular (TF) in children aged 1–9 years and trichiasis in those aged ≥15 years in 42 evaluation units (EUs) of Yemen, global trachoma mapping project, 2013–2015.

Governorate (EU code)	Districts included in EU	Estimated EU population	Number of 1–9-year-olds examined	TF prevalence in 1–9-year-olds, %^a (95% CI)^c	Number of ≥15-year-olds examined	Trichiasis prevalence in ≥15-year-olds, %^b (95% CI)^c
Adh Dhale’a (569)	Adh Dhale’a, Al Azareq, Al Hosha, Al Husain, Al Shoaeeb	350,966	1399	1.0 (0.5–1.4)	1276	0.0 (0.0–0.0)
Adh Dhale’a (570)	Damt, Jahaf, Joban, Qatabah	301,565	1520	1.3 (0.5–2.1)	1329	0.1 (0.0–0.2)
Al Hodeidah (82)	Al Garrahi, Al Khawkhah, Hays, Jabal Ra’s	23,351	1384	0.8 (0.3–1.6)	1120	0.0 (0.0–0.0)
Al Hodeidah (83)	Al Mansuriyah, At Tuhayat, Bayt al-Faqih, Zabid	141,770	1283	1.4 (0.6–2.6)	837	0.0 (0.0–0.0)
Al Hodeidah (84)	Ad Durayhimi, Al Hali, Al Hawak, As Sukhnah	404,001	1258	0.1 (0.0–0.3)	1008	0.1 (0.0–0.3)
Al Hodeidah (85)	Ad Dahi Al Hajjaylah, Al Marawi’ah, Bajil, Bura	92,040	1401	2.6 (0.9–4.5)	1725	0.3 (0.1–0.6)
Al Hodeidah (86)	Al Mighlaf, Al Munirah, As Salif, Az Zaydiyah	54,279	1330	6.3 (4.3–8.7)	1880	0.1 (0.0–0.1)
Al Hodeidah (87)	Al Qanawis, Alluheyah, Az Zuhrah	43,695	1389	10.3 (6.8–15.1)	1234	0.1 (0.0–0.2)
Al Jawf (88)	Al Humaydat, Az Zahir, Bart Al Anan, Khabb wa ash Sha’af, Kharab Al Marashi, Rajuzah	293,882	907	5.4 (2.7–8.4)	785	0.2 (0.0–0.5)
Al Jawf (89)	Al Ghayl, Al Hazm, Al Khalq, Al Maslub, Al Matammah, Al Maton	65,151	783	8.9 (4.1–12.5)	565	0.0 (0.0–0.0)
Hadramoot (583)	Aldulaiah, Alqaten, Amd, Dawaan, Hajer, Haredah	264,941	1434	1.9 (0.8–3.6)	881	0.0 (0.0–0.1)
Hadramoot (584)	Sayuon, Shebam, Wadi Alaeen,	249,235	1423	0.3 (0.1–0.7)	1250	0.0 (0.0–0.1)
Hadramoot (585)	Alsoom, Khail Ben, Yameen, Sa’ah Tareem	229,593	1491	1.0 (0.4–2.1)	978	0.1 (0.0–0.3)
Hadramoot (586)	Aldees, Alriada Wa Qusiaaer, AlShaher, Broom Mafae, Khail Ba Wazeer	298,644	1338	3.6 (2.0–5.9)	1199	0.1 (0.0–0.2)
Hajjah (587)	Abs	185,595	1429	6.8 (4.5–9.9)	1309	0.1 (0.0–0.3)
Hajjah (588)	Hairan, Haradh, Midi, Mostaba	233,198	1687	4.8 (3.1–6.7)	1065	0.1 (0.0–0.2)
Hajjah (589)	Aslam, Khairan Al Muharaq, Kushar, Qarah, Wash Hah	395,764	1714	3.6 (2.4–5.1)	974	0.0 (0.0–0.1)
Hajjah (590)	Ash Shaghaderah, Bani Qais At Tur, Hajjah, Najrah, Sharis	311,056	1456	2.3 (1.2–3.6)	1134	0.1 (0.0–0.3)
Hajjah (591)	Aflah Alyemen, Aflah Ash Sham, Al Mahabeshah, Kohlan Ash Sharaf	261,495	1610	5.7 (3.1–8.9)	978	0.0 (0.0–0.0)
Hajjah (592)	Al Jamemah, Al Meftah, Ash Shahil, Koaidenah, Qofl Shamr	312,348	1698	3.2 (1.7–4.6)	1067	0.0 (0.0–0.0)
Hajjah (593)	Al Maghrabah, Bani Al Awam, Kohlan Afar, Mabyan	288,087	1685	1.9 (0.7–3.3)	714	0.0 (0.0–0.0)
Ibb (76)	Al Qafr, Hazm Al Udayn, Hubaysh	141,160	1057	1.8 (0.9–2.7)	853	0.4 (0.1–0.8)
Ibb (77)	Al Udayn, Far Al Udayn, Mudhaykhirah	35,812	870	6.3 (1.7–11.2)	686	0.17 (0.0–0.5)
Ibb (78)	As Sabrah, As Sayyani, Dhi As Sufal	98,199	793	12.6 (5.9–19.8)	1359	0.1 (0.0–0.1)
Ibb (79)	Al Dhihar, Al Mashannah, Ba’dan, Jiblah	238,810	1020	0.7 (0.0–1.7)	1408	0.1 (0.0–0.3)
Ibb (80)	Al Makhadir, As Saddah, Yarim	78,439	1022	0.0 (0.0–0.0)	602	0.0 (0.0–0.0)
Ibb (81)	An Nadirah, Ar Radmah, Ash Sha’ir	28,778	838	3.3 (2.3–4.8)	945	1.3 (0.4–2.6)
Lahj (562)	Laboous, Al Haad, AlMaflahi	231,185	1469	2.8 (1.1–4.7)	722	0.0 (0.0–0.0)
Lahj (563)	Al Malah, Habeel Jaber, Halemeen, Radfan, Radfan Alhabeleen, Tuben, Yahar	362,167	1408	0.8 (0.2–1.5)	1179	0.0 (0.0–0.0)
Lahj (564)	Al Hawta, Al Maqaterah, Al Mathareba & Al Arah, Al Musaimeer, Al Qabiata, Tor Albaha	408,847	1352	0.2 (0.0–0.4)	1051	0.0 (0.0–0.0)
Ma’rib (73)	Al Abdiyah, Al Jubah, Bidbadah, Harib, Harib Al Qaramish, Jabal Murad, Mahliyah, Majzar, Ma’rib, Ma’rib City, Medghal, Raghwan, Rahabah, Sirwah	46,541	982	4.5 (2.7–6.3)	25	No estimate^d
Taiz (571)	At Taiziah	274,832	1625	4.4 (2.4–6.5)	1267	0.0 (0.0–0.0)
Taiz (572)	As Selw, Hayfan, Khader, Same’e	387,262	1344	0.9 (0.1–2.1)	1699	0.0 (0.0–0.0)
Taiz (573)	Al Maafer, Al Mawaset, Ash Shamayatain	525,989	1754	2.1 (1.1–3.4)	1015	0.0 (0.0–0.1)
Taiz (574)	Al Mesrakh, Jabal Habashi	305,208	1294	2.2 (1.1–3.0)	2095	0.6 (0.4–0.9)
Taiz (575)	Al Qaherah	202,840	1176	0.5 (0.1–0.8)	1447	0.1 (0.0–0.2)
Taiz (576)	Al Mudhafar	237,589	1557	1.0 (0.3–1.6)	957	0.1 (0.0–0.2)
Taiz (577)	Sharab Ar Rawnah, Sharab As Salam	355,679	1247	0.9 (0.4–1.6)	1642	0.1 (0.0–0.2)
Taiz (578)	Al Makha, Al Wazieah, Dhubab, Mawza’a	148,914	1613	0.8 (0.5–1.2)	1040	0.0 (0.0–0.1)
Taiz (579)	Salah	207,050	1291	1.2 (0.6–1.8)	1405	0.0 (0.0–0.0)
Taiz (580)	Maweah, Saber Al Mawadem	331,872	1587	1.6 (0.9–2.7)	1022	0.0 (0.0–0.0)
Taiz (581)	Maqbanah, Mashrah, Wahdnan	293,319	1409	0.5 (0.1–0.9)	1294	0.0 (0.0–0.1)

^aAdjusted for age in 1-year age bands.

^bAdjusted for gender and age in 5-year age bands.

^c95% confidence intervals from bootstrapped adjusted-cluster-level proportions over 10,000 replicates; upper bound of confidence level for zero count EUs estimated from the exact binomial approximation.

^dOnly 25 adults examined: too few for a reliable trichiasis prevalence estimate.

CI, confidence interval

Figure 1. Evaluation unit-level prevalence of trachomatous inflammation—follicular (TF) in 1–9-year-olds, global trachoma mapping project, Yemen, 2013–2015. Internal boundaries represent districts.

Figure 2. Evaluation unit-level prevalence of trichiasis in ≥15-year-olds, global trachoma mapping project, Yemen, 2013–2015. Internal boundaries represent districts.

Table 2. Univariable analysis of factors associated with trachomatous inflammation—follicular (TF) in 1–9-year-olds, global trachoma mapping project, Yemen, 2013–2015.

	Examined, n	TF cases, n (%)	OR^a	95%CI^b
Individual
Age group 1–4 years (vs. 5–9 years)	23,656	675 (2.9)	0.86	0.76–0.97
Female sex	26,450	758 (2.9)	0.83	0.74–0.93
Household
≥8 people resident in the household	10,403	337 (3.2)	1.16	0.97–1.39
≥5 children aged 1–9 years resident in the household	7,448	336 (4.5)	1.62	1.34–1.97
Latrine type observed at household ^c
Improved	43,269	1024 (2.4)	1
Unimproved	6,966	335 (4.8)	2.04	1.58–2.63
Open defecation, bush or field	6,155	393 (6.4)	2.8	2.14–3.66
Household-reported use of open defecation, bush or field	7,698	461 (6.0)	2.5	1.94–3.21
Unimproved source of drinking water	21,808	730 (3.4)	1.22	0.96–1.57
Time to source of drinking water ≥30 minutes	14,440	610 (4.2)	1.54	1.21–1.98

^aUnivariate odds ratio from multilevel random effects logistic regression accounting for clustering at household- and cluster-level.

^b95% confidence interval; Wald’s test.

^cObserved by data recorders previously trained to identify latrine types linked to the WHO/UNICEF Joint monitoring program definitions

CI, confidence interval; OR, odds ratio

Table 3. Multivariable analysis of factors associated with trachomatous inflammation—follicular (TF) in 1–9-year-olds, global trachoma mapping project, Yemen, 2013–2015.

Variable	OR^a	p-value^b
Age 1–4 years (vs. 5–9 years)	0.86	0.012
Female sex	0.83	0.002
≥5 children aged 1–9 years in household	1.67	<0.0001
Household-reported use of open defecation, bush or field	2.47	<0.0001

^aOdds ratio from multilevel hierarchical logistic regression accounting for clustering at household- and cluster-level.

^bLikelihood ratio test for inclusion of variable in/exclusion of variable from the final model.

OR, odds ratio