Completing Baseline Mapping of Trachoma in Uganda: Results of 14 Population-Based Prevalence Surveys Conducted in 2014 and 2018

Figures & data

Figure 1. Uganda districts surveyed for trachoma from 2006–2012, considered as part of the desk reviews and trachoma rapid assessments described herein (A), and/or surveyed in 2014 or 2018 (B).

TF, trachomatous inflammation—follicular; TRA, trachoma rapid assessment

Table 1. Characteristics of survey population by evaluation unit, trachoma prevalence surveys, Uganda, 2014 and 2018.

						Children aged 1–9 years			Adults aged ≥ 15 years
Region	Evaluation Unit*	Survey year	Estimated Population**	Number of clusters±	Number of households sampled	Number enumerated	Number examined	Proportion male (%)	Number enumerated	Number examined	Proportion male (%)
Central Region	Buikwe	2018	436,406	24	842	1546	1,473	49.0	1893	1,677	35.2
Central Region	Kayunga	2018	370,210	24	842	1713	1,669	51.6	1994	1,791	39.3
Central Region	Kyankwanzi	2018	214,057	24	847	1691	1,668	48.7	1749	1,645	42.6
Eastern Region	Amuria	2014	287,248	28	840	1706	1,675	51.7	2030	1,807	35.3
Eastern Region	Bukedea	2014	200,540	28	838	1466	1,462	50.3	1846	1,711	39.6
Eastern Region	Kaberamaido	2014	226,500	28	841	1332	1,307	49.6	1806	1,618	42.8
Eastern Region	Katakwi	2014	175,738	28	839	1666	1,642	51.6	1959	1,765	36.7
Eastern Region	Ngora	2018	142,487	24	843	1769	1,662	50.4	2389	2,069	36.6
Eastern Region	Serere	2018	283,630	24	845	1909	1,868	50.6	2207	1,906	38.7
Northern Region	Arua 1	2018	400,009	24	844	1626	1,616	51.0	1930	1,767	35.8
Northern Region	Arua 2	2018	385,180	24	845	1702	1,697	50.6	1860	1,722	40.8
Northern Region	Maracha	2018	186,176	24	846	1734	1,716	50.2	1975	1,806	41.4
Western Region	Hoima 1	2018	250,502	24	844	1490	1,464	48.8	1843	1,724	38.6
Western Region	Hoima 2	2018	323,401	24	840	1584	1,546	51.2	1808	1,644	41.6
Total				352	11,796	22934	22,465	50.4	27289	24,652	38.8

*Arua and Hoima districts were each split into two evaluation units.

**Population projections based on the National Population and Housing Census 2014

±Number of clusters in 2014 and 2018 was based on estimated mean number of children aged 1–9 years per household (1.5 and 1.7, respectively).

Table 2. Prevalence of trachoma by evaluation unit, Uganda, 2014 and 2018.

				Adults aged ≥15 years
Region	Evaluation Unit*	Survey year	Prevalence of TF in children aged 1–9 years % (95% CI)^a	Prevalence of trichiasis (95% CI)^b	Prevalence of trichiasis+TS unknown to health system % (95% CI)^b
Central Region	Buikwe	2018	0.3 (0.1–0.7)	0.13 (0.03–0.24)	0.07 (0.01–0.14)
Central Region	Kayunga	2018	1.0 (0.5–1.5)	0.26 (0.08–0.53)	0.20 (0.06–0.4)
Central Region	Kyankwanzi	2018	0.9 (0.3–1.6)	0.06 (0.01–0.15)	0.06 (0–0.14)
Eastern Region	Amuria	2014	1.8 (0.7–3.4)	0.04 (0–0.12)	N/A
Eastern Region	Bukedea	2014	3.2 (1.7–4.9)	0.19 (0.05–0.38)	N/A
Eastern Region	Kaberamaido	2014	3.4 (1.5–6.0)	0.34 (0.16–0.54)	N/A
Eastern Region	Katakwi	2014	3.9 (2.1–5.8)	0.04 (0–0.11)	N/A
Eastern Region	Ngora	2018	0.9 (0.5–1.5)	0.04 (0–0.12)	0.04 (0–0.12)
Eastern Region	Serere	2018	1.3 (0.7–2.1)	0.07 (0–0.16)	0.07 (0–0.15)
Northern Region	Arua 1	2018	1.0 (0.1–2.2)	0.38 (0.09–0.79)	0.35 (0.05–0.76)
Northern Region	Arua 2	2018	1.2 (0.6–2.1)	0.81 (0.35–1.50)	0.65 (0.24–1.33)
Northern Region	Maracha	2018	1.0 (0.4–1.7)	0.13 (0.00–0.27)	0.09 (0–0.19)
Western Region	Hoima 1	2018	0.8 (0.3–1.6)	0.13 (0.02–0.29)	0.02 (0–0.06)
Western Region	Hoima 2	2018	0.7 (0.3–1.2)	0.10 (0–0.28)	0 (0–0)

CI, confidence interval; N/A, not applicable; trichiasis+TS, trichiasis with trachomatous conjunctival scarring

*Arua and Hoima districts were each split into two evaluation units.

^a adjusted for age, in one-year bands based on the National Population and Housing Census 2014

^b adjusted for gender and age, in five-year bands based on the National Population and Housing Census 2014

Figure 2. Prevalence of trachomatous inflammation—follicular (TF) in children aged 1–9 years, and any trichiasis in people aged ≥15 years, Uganda, 2006–2018.

A) TF prevalence in districts mapped in 2006–2012; B) TF prevalence in districts mapped in 2014 or 2018; C) TF prevalence combining all data sources from 2006–2018D) Trichiasis prevalence in districts mapped in 2006–2012; E) Trichiasis prevalence in districts mapped in 2014 or 2018; F) Trichiasis prevalence combining all data sources from 2006–2018

Table 3. Proportion of households with key water, sanitation and hygiene indicators by evaluation unit, trachoma prevalence surveys, Uganda, 2014 and 2018.

			Proportion of households (%)**
Region	Evaluation unit*	Number of households sampled	Using improved drinking water source	With drinking water source in yard/within 1km	With improved sanitation facilities
Central Region	Buikwe	842	79.2	40.6	60.7
Central Region	Kayunga	842	89.6	37.9	40.4
Central Region	Kyankwanzi	847	77.1	22.1	30.1
Eastern Region	Amuria	840	94.3	7.9	10.5
Eastern Region	Bukedea	838	97.5	3.8	20.9
Eastern Region	Kaberamaido	841	91.7	8.1	23.5
Eastern Region	Katakwi	839	98.9	19.3	10.8
Eastern Region	Ngora	843	99.5	24.6	14.5
Eastern Region	Serere	845	84.1	29.0	12.9
Northern Region	Arua 1	844	93.0	28.3	29.4
Northern Region	Arua 2	845	86.3	12.4	17.9
Northern Region	Maracha	846	88.5	24.0	19.5
Western Region	Hoima 1	844	76.1	32.2	29.0
Western Region	Hoima 2	840	77.7	32.3	13.9
Total		11,796	88.1	23.0	23.9

*Arua and Hoima districts were each split into 2 evaluation units.

**WASH data were categorised based on WHO/UNICEF Joint Monitoring Program definitions for improved and unimproved water sources and sanitation facilities (https://www.wssinfo.org/definitions-methods/watsan-categories/).