An impact evaluation of two rounds of mass drug administration on the prevalence of active trachoma: A clustered cross sectional survey

• Type of Material: Article
• Authors: Asrat Genet Amnie, The City University of New York; Paul Emerson, Emory University; Deborah McFarland, Emory University; Jonathon King, The Carter Center; Emmanuel Miri, Nigeria London School of Hygiene and Tropical Medicine; Lisa Dickman, The Carter Center
• Language: English
• Date: 2019-09-16
• Publisher: Public Library Science
• Publication Version: Final Published Version
• Copyright Statement: © 2018 Amnie et al
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0222660
• Title of Journal or Parent Work: Public Library of Science One
• Volume: 14
• Issue: 9
• Start Page: e0201911
• End Page: e0201911
• Grant/Funding Information: The authors received no specific funding for this work.
• Keywords: Science & Technology; Science & Technology - Other Topics; Multidisciplinary Sciences
• Research Categories: Health Sciences, Public Health

Abstract

INTRODUCTION: We investigated the impact of two round of mass drug administration on trachoma prevalence in Plateau and Nasarawa States of Nigeria. The mass drug administration was conducted as a component of the SAFE Strategy, a combination of interventions recommended for the global elimination of blinding trachoma. METHODS: The study consisted of a two-stage cross-sectional clustered sample survey in which 3990 people from 793 households were screened for clinical signs of trachoma. RESULTS: Of the total 3990 people examined, 1530 were children, of which 808 (53%) were boys and 704 (47%) were girls. The impact of intervention as measured by the changes in overall prevalence of follicular trachoma were as follows: At baseline the overall prevalence of follicular trachoma among children 1-9 years of age was 6.4%, 95% CI [5.8, 7.0]; the overall prevalence of trachomatous trichiasis in the total population was 0.20%, 95% CI [0.16, 0.25]. At follow up, the overall prevalence of follicular trachoma among children 1-9 years of age was 3.4%, 95% CI [1.9, 4.9]; the overall prevalence of trachomatous trichiasis in the total population was 0.20%, 95% CI [0.00, 0.05]. The highest statistically significant reduction (96%) in follicular trachoma prevalence was observed in Doma Local Government Area of Nasarawa State from baseline prevalence of 13.6%, 95% CI [9.7, 17.5] to follow-up prevalence of 0.5%, 95% CI [0.0, 1.5] and the lowest reduction (58%) in follicular trachoma prevalence was observed in Langtang North Local Government Area of Plateau State from baseline prevalence of 15.8%, 95% CI [9.3, 22.3] to 6.6%, 95% CI [1.6, 11.6], (p<0.05). CONCLUSION: A significant reduction in the overall prevalence of follicular trachoma was achieved after two rounds of mass drug administration. In the absence of significant activities pertaining to facial cleanliness and environmental sanitation components of the SAFE strategy in the intervention areas, the observed deep reductions in prevalence could mainly be attributed to mass drug administration. Therefore, two rounds of mass azithromycin administration may be as effective as guideline-recommended three or more rounds in reducing active trachoma prevalence but findings should be replicated in more robustly designed studies.