Prevalence of trachoma in the Kayes region of Mali eight years after stopping mass drug administration

<div><p>Background</p><p>In 2009, three years after stopping mass treatment with azithromycin, a trachoma impact survey in four health districts in the Kayes region of Mali found a prevalence of trachomatous inflammation—follicular (TF) among children aged 1 to 9 years of >5% and a trachomatous trichiasis (TT) prevalence within the general population (≥1-year-old) of <1%. As a result, the government’s national trachoma program expanded trichiasis surgery and related activities required to achieve trachoma elimination.</p><p>Methodology/Principal findings</p><p>In 2015, to assess progress towards elimination, a follow-up impact survey was conducted in the Kayes, Kéniéba, Nioro and Yélimané health districts. The survey used district level two-stage cluster random sampling methodology with 20 clusters of 30 households in each evaluation unit. Subjects were eligible for examination if they were ≥1 year. TF and TT cases were identified and confirmed by experienced ophthalmologists. In total 14,159 people were enumerated and 11,620 (82%) were examined. TF prevalence (95% confidence interval (CI)) was 0.5% (0.3–1%) in Kayes, 0.8% (0.4–1.7%) in Kéniéba, 0.2% (0–0.9%) in Nioro and 0.3% (0.1–1%) in Yélimané. TT prevalence (95% CI) was 0.04% (0–0.25%) in Kayes, 0.29% (0.11–0.6%) in Kéniéba, 0.04% (0–0.25%) in Nioro and 0.07% (0–0.27%) in Yélimané.</p><p>Conclusions/Significance</p><p>Eight years after stopping MDA and intensifying trichiasis surgery outreach campaigns, all four districts reached the TF elimination threshold of <5% and three of four districts reached the TT elimination threshold of <0.1%.</p></div

Comparison of trachoma TF and TT prevalence between 2009 and 2015.

<p>Comparison of trachoma TF and TT prevalence between 2009 and 2015.</p

Prevalence of active trachoma (TF) and trichiasis (TT) in four districts in Kayes region in 2015.

<p>Prevalence of active trachoma (TF) and trichiasis (TT) in four districts in Kayes region in 2015.</p

Clean faces and access to latrines and water sources in the surveyed clusters in Kayes region in 2015.

<p>Clean faces and access to latrines and water sources in the surveyed clusters in Kayes region in 2015.</p