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[PMID]:28747198
[Au] Autor:Harding-Esch EM; Kadimpeul J; Sarr B; Sane A; Badji S; Laye M; Sillah A; Burr SE; MacLeod D; Last AR; Holland MJ; Mabey DC; Bailey RL
[Ad] Endereço:Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK. eharding@sgul.ac.uk.
[Ti] Título:Population-based prevalence survey of follicular trachoma and trachomatous trichiasis in the Casamance region of Senegal.
[So] Source:BMC Public Health;18(1):62, 2017 07 26.
[Is] ISSN:1471-2458
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Trachoma, caused by ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. We conducted the first population-based trachoma prevalence survey in the Casamance region of Senegal to enable the Senegalese National Eye Care Programme (NECP) to plan its trachoma control activities. The World Health Organization (WHO) guidelines state that any individual with trachomatous trichiasis (TT) should be offered surgery, but that surgery should be prioritised where the prevalence is >0.1%, and that districts and communities with a trachomatous inflammation, follicular (TF) prevalence of ≥10% in 1-9 year-olds should receive mass antibiotic treatment annually for a minimum of three years, along with hygiene promotion and environmental improvement, before re-assessing the prevalence to determine whether treatment can be discontinued (when TF prevalence in 1-9 year-olds falls <5%). METHODS: Local healthcare workers conducted a population-based household survey in four districts of the Bignona Department of Casamance region to estimate the prevalence of TF in 1-9 year-olds, and TT in ≥15 year-olds. Children's facial cleanliness (ocular and/or nasal discharge, dirt on the face, flies on the face) was measured at time of examination. Risk factor questionnaires were completed at the household level. RESULTS: Sixty communities participated with a total censused population of 5580 individuals. The cluster-, age- and sex-adjusted estimated prevalence of TF in 1-9 year-olds was 2.5% (95% Confidence Interval (CI) 1.8-3.6) (38/1425) at the regional level and <5% in all districts, although the upper 95%CI exceeded 5% in all but one district. The prevalence of TT in those aged ≥15 years was estimated to be 1.4% (95%CI 1.0-1.9) (40/2744) at the regional level and >1% in all districts. CONCLUSION: With a prevalence <5%, TF does not appear to be a significant public health problem in this region. However, TF monitoring and surveillance at sub-district level will be required to ensure that elimination targets are sustained and that TF does not re-emerge as a public health problem. TT surgery remains the priority for trachoma elimination efforts in the region, with an estimated 1819 TT surgeries to conduct.
[Mh] Termos MeSH primário: Tracoma/epidemiologia
Triquíase/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Antibacterianos/uso terapêutico
Criança
Pré-Escolar
Estudos Transversais
Esquema de Medicação
Feminino
Promoção da Saúde
Seres Humanos
Lactente
Recém-Nascido
Masculino
Prevalência
Saúde Pública
Fatores de Risco
Senegal/epidemiologia
Tracoma/tratamento farmacológico
Triquíase/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180304
[Lr] Data última revisão:
180304
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1186/s12889-017-4605-0


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[PMID]:29422758
[Au] Autor:Liu TS; Meskin S
[Ad] Endereço:Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT, USA.
[Ti] Título:Localized Trichiasis Causing Focal Full-Thickness Corneal Edema, Endothelial Cell Loss, and Corneal Scarring Requiring Penetrating Keratoplasty.
[So] Source:Middle East Afr J Ophthalmol;24(4):216-218, 2017 Oct-Dec.
[Is] ISSN:0975-1599
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:The purpose of the study was to report a case of focal trichiasis causing full-thickness corneal edema, scarring, and endothelial cell loss requiring penetrating keratoplasty (PK). A 66-year-old male was referred for trichiasis of the right upper eyelid corresponding to an area of full-thickness corneal edema. No keratic precipitates or guttata was noted. Specular microscopy showed diffuse endothelial cell loss. He was treated with topical steroids and acyclovir with epilation of lashes. Anterior chamber paracentesis was negative for varicella-zoster virus, cytomegalovirus, and herpes simplex virus. The patient developed diffuse stromal scarring with a decrease in vision and ultimately underwent PK with preceding eyelid repair. To the best of our knowledge, we present the first reported case of chronic trichiasis causing full-thickness corneal edema, scarring, and endothelial cell loss requiring PK.
[Mh] Termos MeSH primário: Edema da Córnea/etiologia
Perda de Células Endoteliais da Córnea/etiologia
Lesões da Córnea/etiologia
Ceratoplastia Penetrante
Triquíase/complicações
[Mh] Termos MeSH secundário: Idoso
Edema da Córnea/cirurgia
Perda de Células Endoteliais da Córnea/cirurgia
Lesões da Córnea/cirurgia
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE
[do] DOI:10.4103/meajo.MEAJO_304_16


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[PMID]:29232708
[Au] Autor:Debrah O; Mensah EO; Senyonjo L; de Souza DK; Hervie TE; Agyemang D; Bakajika D; Marfo B; Ahorsu F; Wanye S; Bailey R; Koroma JB; Aboe A; Biritwum NK
[Ad] Endereço:Eye Care, Ghana Health Service, Accra, Ghana.
[Ti] Título:Elimination of trachoma as a public health problem in Ghana: Providing evidence through a pre-validation survey.
[So] Source:PLoS Negl Trop Dis;11(12):e0006099, 2017 12.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In order to achieve elimination of trachoma, a country needs to demonstrate that the elimination prevalence thresholds have been achieved and then sustained for at least a two-year period. Ghana achieved the thresholds in 2008, and since 2011 has been implementing its trachoma surveillance strategy, which includes community and school screening for signs of follicular trachoma and trichiasis, in trachoma-endemic districts. In 2015-2016, the country conducted a district level population-based survey to validate elimination of trachoma as a public health problem. METHODS: As per WHO recommendations, a cross-sectional survey, employing a two-stage cluster random sampling methodology, was used across 18 previously trachoma endemic districts (evaluation units (EUs) in the Upper West and Northern Regions of Ghana. In each EU 24 villages were selected based on probability proportional to estimated size. A minimum of 40 households were targeted per village and all eligible residents were examined for clinical signs of trachoma, using the WHO simplified grading system. The number of trichiasis cases unknown to the health system was determined. Household environmental risk factors for trachoma were also assessed. RESULTS: Data from 45,660 individuals were examined from 11,099 households across 18 EUs, with 27,398 (60.0%) children aged 1-9 years and 16,610 (36.4%) individuals 15 years and above All EUs had shown to have maintained the WHO elimination threshold for Trachomatous inflammation-Follicular (TF) (<5.0% prevalence) in children aged 1-9 years old. The EU TF prevalence in children aged 1-9 years old ranged from between 0.09% to 1.20%. Only one EU (Yendi 0.36%; 95% CI: 0.0-1.01) failed to meet the WHO TT elimination threshold (< 0.2% prevalence in adults aged 15 and above). The EU prevalence of trichiasis (TT) unknown to the health system in adults aged ≥15 years, ranged from 0.00% to 0.36%. In this EU, the estimated TT backlog is 417 All TT patients identified in the study, as well as through on-going surveillance efforts will require further management. A total of 75.9% (95% CI 72.1-79.3, EU range 29.1-92.6) of households defecated in the open but many households had access to an improved water source 75.9% (95%CI: 71.5-79.8, EU range 47.4-90.1%), with 45.5% (95% CI 41.5-49.7%, EU range 28.4-61.8%) making a round trip of water collection < 30 minutes. CONCLUSION: The findings from this survey indicate elimination thresholds have been maintained in Ghana in 17 of the 18 surveyed EUs. Only one EU, Yendi, did not achieve the TT elimination threshold. A scheduled house-by-house TT case search in this EU coupled with surgery to clear the backlog of cases is necessary in order for Ghana to request validation of elimination of trachoma as a public health problem.
[Mh] Termos MeSH primário: Erradicação de Doenças
Doenças Endêmicas/prevenção & controle
Tracoma/prevenção & controle
Triquíase/prevenção & controle
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Estudos Transversais
Demografia
Características da Família
Feminino
Gana/epidemiologia
Inquéritos Epidemiológicos
Seres Humanos
Lactente
Masculino
Prevalência
Tracoma/epidemiologia
Triquíase/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0006099


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[PMID]:27775463
[Au] Autor:Mpyet C; Muhammad N; Adamu MD; Muazu H; Umar MM; Goyol M; Onyebuchi U; Chima I; Idris H; William A; Isiyaku S; Nwobi B; Flueckiger RM; Willis R; Pavluck A; Chu BK; Olobio N; Solomon AW
[Ad] Endereço:a Department of Ophthalmology , University of Jos , Jos , Nigeria.
[Ti] Título:Prevalence of Trachoma in Katsina State, Nigeria: Results of 34 District-Level Surveys.
[So] Source:Ophthalmic Epidemiol;23(sup1):55-62, 2016.
[Is] ISSN:1744-5086
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To determine the local government area (LGA)-level prevalence of trachoma in all 34 LGAs of Katsina State. METHODS: A population-based prevalence survey was conducted in each LGA of Katsina State, using the Global Trachoma Mapping Project methodology. We used a 3-stage cluster random sampling strategy to select 25 households from each of 25 clusters. We examined all residents of selected households aged 1 year and older for the clinical signs of trachomatous inflammation-follicular (TF), trachomatous inflammation-intense and trichiasis, using the World Health Organization (WHO) simplified grading scheme. RESULTS: We examined 129,281 persons. Six LGAs had a TF prevalence ≥10%, and another six LGAs had a TF prevalence between 5% and 9.9%; all 12 require mass drug administration with azithromycin plus other interventions. The prevalence of trichiasis was ≥1.0% in 13 LGAs, and there is a need to perform trichiasis surgery in over 26,000 persons to reach targets set by the WHO for elimination of trichiasis. CONCLUSION: The prevalence of TF is generally low in Katsina state, but urgent steps must be taken to implement the full SAFE strategy (surgery, antibiotics, facial cleanliness, environmental improvement) in at least 12 LGAs while also stepping up efforts to provide community-based trichiasis surgery throughout the whole state, in order to make trachoma elimination by 2020 a reality.
[Mh] Termos MeSH primário: Tracoma/epidemiologia
Triquíase/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Antibacterianos/uso terapêutico
Criança
Pré-Escolar
Estudos Transversais
Feminino
Inquéritos Epidemiológicos
Seres Humanos
Higiene/normas
Lactente
Recém-Nascido
Masculino
Meia-Idade
Nigéria/epidemiologia
Prevalência
Saneamento/normas
Tracoma/prevenção & controle
Abastecimento de Água/normas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1080/09286586.2016.1236975


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[PMID]:27775454
[Au] Autor:Omar FJ; Kabona G; Abdalla KM; Mohamed SJ; Ali SM; Ame SM; Ngwalle A; Mbise C; Rotondo L; Willis R; Flueckiger RM; Massae PA; Bakhtiari A; Solomon AW; Ngondi JM
[Ad] Endereço:a Department of Eye Care , Ministry of Health , Zanzibar , Tanzania.
[Ti] Título:Baseline Trachoma Surveys in Kaskazini A and Micheweni Districts of Zanzibar: Results of Two Population-Based Prevalence Surveys Conducted with the Global Trachoma Mapping Project.
[So] Source:Ophthalmic Epidemiol;23(6):412-417, 2016 12.
[Is] ISSN:1744-5086
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Based on health care records and trachoma rapid assessments, trachoma was suspected to be endemic in Kaskazini A and Micheweni districts of Zanzibar. This study aimed to investigate the prevalence of trachomatous inflammation-follicular (TF), and trachomatous trichiasis (TT) in each of those districts. METHODS: The survey was undertaken in Kaskazini A and Micheweni districts on Unguja and Pemba Islands, respectively. A multi-stage cluster random sampling design was applied, whereby 25 census enumeration areas (clusters) and 30 households per cluster were included. Consenting eligible participants (children aged 1-9 years and people aged 15 years and older) were examined for trachoma using the World Health Organization simplified grading system. RESULTS: A total of 1673 households were surveyed and 6407 participants (98.0% of those enumerated) were examined for trachoma. Examinees included a total of 2825 children aged 1-9 years and 3582 people aged 15 years and older. TF prevalence in 1-9-year-olds was 2.7% (95% confidence interval, CI, 2.7-4.1%) in Kazkazini A and 11.4% (95% CI 6.6-16.5%) in Micheweni. Among people aged 15 years and older, TT prevalence was 0.01% (95% CI 0.00-0.04%) in Kazkazini A and 0.21% (95% CI 0.08-0.39%) in Micheweni. CONCLUSION: Trachoma is a public health problem in Micheweni district, where implementation of all four components of the SAFE strategy (surgery, antibiotics, facial cleanliness, and environmental improvement), including mass drug administration with azithromycin, is required. These findings will facilitate planning for trachoma elimination.
[Mh] Termos MeSH primário: Tracoma/epidemiologia
Triquíase/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Análise por Conglomerados
Estudos Transversais
Feminino
Inquéritos Epidemiológicos
Seres Humanos
Lactente
Masculino
Prevalência
Tanzânia/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:28898240
[Au] Autor:Cama A; Müller A; Taoaba R; Butcher RMR; Itibita I; Migchelsen SJ; Kiauea T; Pickering H; Willis R; Roberts CH; Bakhtiari A; Le Mesurier RT; Alexander NDE; Martin DL; Tekeraoi R; Solomon AW; Global Trachoma Mapping Project
[Ad] Endereço:International Agency for the Prevention of Blindness, Western Pacific Region, Suva, Fiji.
[Ti] Título:Prevalence of signs of trachoma, ocular Chlamydia trachomatis infection and antibodies to Pgp3 in residents of Kiritimati Island, Kiribati.
[So] Source:PLoS Negl Trop Dis;11(9):e0005863, 2017 Sep.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: In some Pacific Island countries, such as Solomon Islands and Fiji, active trachoma is common, but ocular Chlamydia trachomatis (Ct) infection and trachomatous trichiasis (TT) are rare. On Tarawa, the most populous Kiribati island, both the active trachoma sign "trachomatous inflammation-follicular" (TF) and TT are present at prevalences warranting intervention. We sought to estimate prevalences of TF, TT, ocular Ct infection, and anti-Ct antibodies on Kiritimati Island, Kiribati, to assess local relationships between these parameters, and to help determine the need for interventions against trachoma on Kiribati islands other than Tarawa. METHODS: As part of the Global Trachoma Mapping Project (GTMP), on Kiritimati, we examined 406 children aged 1-9 years for active trachoma. We collected conjunctival swabs (for droplet digital PCR against Ct plasmid targets) from 1-9-year-olds with active trachoma, and a systematic selection of 1-9-year-olds without active trachoma. We collected dried blood spots (for anti-Pgp3 ELISA) from all 1-9-year-old children. We also examined 416 adults aged ≥15 years for TT. Prevalence of TF and TT was adjusted for age (TF) or age and gender (TT) in five-year age bands. RESULTS: The age-adjusted prevalence of TF in 1-9-year-olds was 28% (95% confidence interval [CI]: 24-35). The age- and gender-adjusted prevalence of TT in those aged ≥15 years was 0.2% (95% CI: 0.1-0.3%). Twenty-six (13.5%) of 193 swabs from children without active trachoma, and 58 (49.2%) of 118 swabs from children with active trachoma were positive for Ct DNA. Two hundred and ten (53%) of 397 children had anti-Pgp3 antibodies. Both infection (p<0.0001) and seropositivity (p<0.0001) were strongly associated with active trachoma. In 1-9-year-olds, the prevalence of anti-Pgp3 antibodies rose steeply with age. CONCLUSION: Trachoma presents a public health problem on Kiritimati, where the high prevalence of ocular Ct infection and rapid increase in seropositivity with age suggest intense Ct transmission amongst young children. Interventions are required here to prevent future blindness.
[Mh] Termos MeSH primário: Anticorpos Antibacterianos/sangue
Antígenos de Bactérias/imunologia
Proteínas de Bactérias/imunologia
Chlamydia trachomatis
Tracoma/epidemiologia
Tracoma/microbiologia
Triquíase/etiologia
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Ensaio de Imunoadsorção Enzimática
Seres Humanos
Lactente
Micronésia/epidemiologia
Prevalência
Tracoma/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Bacterial); 0 (Antigens, Bacterial); 0 (Bacterial Proteins); 0 (pgp3 protein, Chlamydia)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170913
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0005863


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[PMID]:28819505
[Au] Autor:Karimurio J; Rono H; Njomo D; Sironka J; Kareko C; Gichangi M; Barasa E; Mwangi A; Ronald K; Kiio F
[Ad] Endereço:Department of Ophthalmology, College of Health Sciences, University of Nairobi, Kenya.
[Ti] Título:Use of validated community-based trachoma trichiasis (TT) case finders to measure the total backlog and detect when elimination threshold is achieved: a TT methodology paper.
[So] Source:Pan Afr Med J;27:84, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The World Health Organization recommends TT surveys to be conducted in adults aged 15+ years (TT 15 survey) and certifies elimination of TT as a public health problem when there is less than 1 unknown case per 1,000 people of all ages. There is no standard survey method to accurately confirm this elimination prevalence threshold of 0.1% because rare conditions require large and expensive prevalence survey samples. The aim of this study was to develop an accurate operational research method to measure the total backlog of TT in people of all ages and detect when the elimination threshold is achieved. METHODS: Between July to October 2016, an innovative Community-based, Mapping, Mop-up and Follow-up (CMMF) approach to elimination of TT as a public health problem was developed and tested in Esoit, Siana, Megwara and Naikara sub-locations in Narok County in Kenya. The County had ongoing community-based TT surgical camps and case finders. TT case finders were recruited from existing pool of Community health volunteers (CHV) in the Community Health Strategy Initiative Programme of the Ministry of Health. They were trained, validated and supervised by experienced TT surgeons. A case finder was allocated a population unit with 2 to 3 villages to conduct a de jure pre-survey census, examine all people in the unit and register those with TT (TT all survey). Identified cases were confirmed by TT surgeons prior to surgery. Operated patients were reviewed at 1 day, 2 weeks and 3-6 months. The case finders will also be used to identify and refer new and recurrent cases. People with other eye and medical conditions were treated and referred accordingly. Standardised data collection and computer based data capture tools were used. Case finders kept registers with details of all persons with TT, those operated and those who refused to be operated (refusals). These details informed decision and actions on follow-up and counselling. Progress towards achievement of elimination threshold was assessed by dividing the number of TT cases diagnosed by total population in the population unit multiplied by 1,000. RESULTS: Narok County Government adopted both the CMMF approach and TT all survey method. All persons in 4,784 households in the four sub-locations were enumerated and examined. The total population projection was 29,548 and pre-survey census 22,912 people. Fifty-three cases of TT were diagnosed. The prevalence was 0.23% and this is equivalent to 2.3 cases per thousand population of all ages. Prior to this study, the project required to operate on at least 30 cases (excess cases) to achieve the elimination threshold of 1 case per 1000 population. CONCLUSION: The total backlog of TT was confirmed and the project is now justified to lay claim of having eliminated TT as a public health problem in the study area. TT all method may not be appropriate in settings with high burden of TT. Nomadic migrations affect estimation of population size. Non-trachomatous TT could not be ruled-out.
[Mh] Termos MeSH primário: Programas de Rastreamento/métodos
Saúde Pública
Tracoma/diagnóstico
Triquíase/diagnóstico
[Mh] Termos MeSH secundário: Feminino
Inquéritos Epidemiológicos
Seres Humanos
Quênia/epidemiologia
Masculino
Prevalência
Tracoma/epidemiologia
Triquíase/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.84.11266


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[PMID]:28438414
[Au] Autor:Habtamu E; Wondie T; Aweke S; Tadesse Z; Zerihun M; Gashaw B; Wondimagegn GS; Mengistie HD; Rajak SN; Callahan K; Weiss HA; Burton MJ
[Ad] Endereço:London School of Hygiene and Tropical Medicine, London, United Kingdom; The Carter Center, Addis Ababa, Ethiopia. Electronic address: Esmael.Ali@lshtm.ac.uk.
[Ti] Título:Predictors of Trachomatous Trichiasis Surgery Outcome.
[So] Source:Ophthalmology;124(8):1143-1155, 2017 Aug.
[Is] ISSN:1549-4713
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Unfavorable outcomes after trachomatous trichiasis (TT) surgery are undermining the global trachoma elimination effort. This analysis investigates predictors of postoperative TT (PTT), eyelid contour abnormalities (ECAs), and granuloma in the 2 most common TT surgery procedures: posterior lamellar tarsal rotation (PLTR) and bilamellar tarsal rotation (BLTR). DESIGN: Secondary data analysis from a randomized, controlled, single-masked clinical trial. PARTICIPANTS: A total of 1000 patients with TT, with lashes touching the eye or evidence of epilation, in association with tarsal conjunctival scarring. METHODS: Participants were randomly allocated and received BLTR (n = 501) or PLTR (n = 499) surgery. Disease severity at baseline, surgical incisions, sutures, and corrections were graded during and immediately after surgery. Participants were examined at 6 and 12 months by assessors masked to allocation. MAIN OUTCOME MEASURES: Predictors of PTT, ECA, and granuloma. RESULTS: Data were available for 992 (99.2%) trial participants (496 in each arm). There was strong evidence that performing more peripheral dissection with scissors in PLTR (odd ratio [OR], 0.70; 95% confidence interval [CI], 0.54-0.91; P = 0.008) and BLTR (OR, 0.83; 95% CI, 0.72-0.96; P = 0.01) independently protected against PTT. Baseline major trichiasis and mixed location lashes and immediate postoperative central undercorrection independently predicted PTT in both surgical procedures. Peripheral lashes in PLTR (OR, 5.91; 95% CI, 1.48-23.5; P = 0.01) and external central incision height ≥4 mm in BLTR (OR, 2.89; 95% CI, 1.55-5.41; P = 0.001) were independently associated with PTT. Suture interval asymmetry of >2 mm (OR, 3.18; 95% CI, 1.31-7.70; P = 0.01) in PLTR and baseline conjunctival scarring in BLTR (OR, 1.72; 95% CI, 1.06-2.81; P = 0.03) were independently associated with ECA. Older age was independently associated with ECA in both PLTR (P value for trend < 0.0001) and BLTR (P value for trend = 0.03). There was substantial intersurgeon variability in ECA rates for both PLTR (range, 19.0%-36.2%) and BLTR (range, 6.1%-28.7%) procedures. In PLTR surgery, irregular posterior lamellar incision at the center of the eyelid (OR, 6.72; 95% CI, 1.55-29.04; P = 0.01) and ECA (OR, 3.08; 95% CI, 1.37-6.94; P = 0.007) resulted in granuloma formation. CONCLUSIONS: Poor postoperative outcomes in TT surgery were associated with inadequate peripheral dissection, irregular incision, asymmetric suture position and tension, inadequate correction, and lash location. Addressing these will improve TT surgical outcomes.
[Mh] Termos MeSH primário: Pálpebras/cirurgia
Procedimentos Cirúrgicos Oftalmológicos
Tracoma/cirurgia
Triquíase/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Granuloma/etiologia
Seres Humanos
Complicações Intraoperatórias
Masculino
Meia-Idade
Complicações Pós-Operatórias
Fatores de Risco
Método Simples-Cego
Tracoma/etiologia
Tracoma/fisiopatologia
Resultado do Tratamento
Triquíase/etiologia
Triquíase/fisiopatologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170810
[Lr] Data última revisão:
170810
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170426
[St] Status:MEDLINE


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[PMID]:28288672
[Au] Autor:Pickering H; Burr SE; Derrick T; Makalo P; Joof H; Hayward RD; Holland MJ
[Ad] Endereço:Clinical Research Department, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK. harry.pickering@lshtm.ac.uk.
[Ti] Título:Profiling and validation of individual and patterns of Chlamydia trachomatis-specific antibody responses in trachomatous trichiasis.
[So] Source:Parasit Vectors;10(1):143, 2017 Mar 13.
[Is] ISSN:1756-3305
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ocular Chlamydia trachomatis (Ct) infection causes trachoma, the leading infectious cause of blindness. A Ct D/UW3 proteome microarray and sera from Gambian adults with trachomatous trichiasis (TT) or healthy matched controls previously identified several novel antigens, which suggested differential recognition in adults with TT. METHODS: We re-analysed this serological microarray data using more robust microarray analysis techniques accounting for typical problems associated with highly dimensional data. We examined the Ct-specific antibody profile concerning the overall diversity of responses, antigen expression stage and cellular localisation of antigens. We tested differentially recognised antigens by further serological testing of the screened sera and used larger independent sample sets for validation. RESULTS: Antibody responses identified High-Performance on antigens expressed early and late in the Ct developmental cycle and those secreted or localised to the outer membrane. Eight antigens were preferentially recognised by scarred individuals and one antigen by healthy individuals. Three of these antigens, two associated with scarring (CT667 and CT706) and one healthy-associated (CT442), were not associated with the presence or absence of scarring following specific serological testing of the arrayed sera and sera from larger, independent case-control cohorts. CONCLUSIONS: This study identified focussed Ct-specific antibody profiles targeting proteins expressed during entry and exit from cells and localised to interact with the host. A small panel of antibody responses could discriminate between adults with and without TT in a trachoma-endemic community. Heterogenous responses in the independent validation of these antibody targets highlighted the need for large sample sizes, clearly defined clinical phenotypes and follow-up work.
[Mh] Termos MeSH primário: Anticorpos Antibacterianos/sangue
Anticorpos Antibacterianos/imunologia
Chlamydia trachomatis/imunologia
Tracoma/imunologia
Triquíase/imunologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Cegueira/microbiologia
Criança
Feminino
Gâmbia/epidemiologia
Seres Humanos
Masculino
Meia-Idade
Proteômica/métodos
Tracoma/epidemiologia
Tracoma/microbiologia
Triquíase/epidemiologia
Triquíase/microbiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Antibodies, Bacterial)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170915
[Lr] Data última revisão:
170915
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170315
[St] Status:MEDLINE
[do] DOI:10.1186/s13071-017-2078-8


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[PMID]:28276755
[Au] Autor:Mpyet C; Muhammad N; Adamu MD; Muazu H; Umar MM; Goyol M; Yahaya HB; Onyebuchi U; Ogoshi C; Hussaini T; Isiyaku S; William A; Flueckiger RM; Chu BK; Willis R; Pavluck AL; Olobio N; Phelan S; Macleod C; Solomon AW; Global Trachoma Mapping Project
[Ad] Endereço:a Department of Ophthalmology , University of Jos , Jos , Nigeria.
[Ti] Título:Prevalence of Trachoma in Kano State, Nigeria: Results of 44 Local Government Area-Level Surveys.
[So] Source:Ophthalmic Epidemiol;24(3):195-203, 2017 Jun.
[Is] ISSN:1744-5086
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: We sought to determine the prevalence of trachoma in 44 Local Government Areas (LGAs) of Kano State, Nigeria. METHODS: A population-based prevalence survey was conducted in each Kano LGA. We used a two-stage systematic and quasi-random sampling strategy to select 25 households from each of 25 clusters in each LGA. All consenting household residents aged 1 year and above were examined for trachomatous inflammation-follicular (TF), trachomatous inflammation-intense (TI) and trichiasis. RESULTS: State-wide crude prevalence of TF in persons aged 1-9 years was 3.4% (95% CI 3.3-3.5%), and of trichiasis in those aged ≥15 years was 2.3% (95% CI 2.1-2.4%). LGA-level age- and sex-adjusted trichiasis prevalence in those aged ≥15 years ranged from 0.1% to 2.9%. All but 4 (9%) of 44 LGAs had trichiasis prevalences in adults above the elimination threshold of 0.2%. State-wide prevalence of trichiasis in adult women was significantly higher than in adult men (2.6% vs 1.8%; OR = 1.5, 95% CI 1.3-1.7; p = 0.001). Four of 44 LGAs had TF prevalences in 1-9-year-olds between 10 and 15%, while another six LGAs had TF prevalences between 5 and 9.9%. In 37 LGAs, >80% of households had access to water within 30 minutes round-trip, but household latrine access was >80% in only 19 LGAs. CONCLUSION: Trichiasis is a public health problem in most LGAs in Kano. Surgeons need to be trained and deployed to provide community-based trichiasis surgery, with emphasis on delivery of such services to women. Antibiotics, facial cleanliness and environmental improvement are needed in 10 LGAs.
[Mh] Termos MeSH primário: Tracoma/epidemiologia
Triquíase/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Distribuição por Idade
Idoso
Idoso de 80 Anos ou mais
Cegueira/epidemiologia
Criança
Pré-Escolar
Análise por Conglomerados
Estudos Transversais
Feminino
Seres Humanos
Lactente
Governo Local
Masculino
Meia-Idade
Nigéria/epidemiologia
Prevalência
Fatores de Risco
Distribuição por Sexo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE
[do] DOI:10.1080/09286586.2016.1265657



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