Scaling up of trachoma mapping in Salima District, Central Malawi

Abstract

Background: A number of suspected en demic districts with Trachoma have not been mapped in Malawi, and this contributes to delays for scaling up trachoma control activities. Objectives: To determine the prevalence of trachoma and associated risk factors in one of the sus pected endemic districts (Salima District) in central Malawi and to generate information to guide policy decisions. Methods: A population- based survey conducted in randomly selected clusters in Salima District (population 418,672), centralMalawi. Children aged 1-9 years and adults aged 15 and above were assessed for clinical signs of trachoma. Results: In total, 884 households were enumerated within 36 clusters. A total of 2765 persons were examined for ocular signs of trachoma. The prevalence of tracho matous inflammation, follicular (TF) among child ren aged 1-9 years was 17.1% (95% CI 14.9-19.4). The prevalence of trachoma trichiasis (TT) in women aged 15 years and above was 1.3% (CI 0.7-2.3), while the prevalence in men was zero. The presence of a dirty face and lack of sanitation were significantly associated with trachoma follicular (P < 0.001). Conclusion: Prevalence rate of trachoma follicles (TF) in Central Malawi exceeds the WHO guidelines for the intervention with mass antibiotic distribution (TF > 10%), and warrants the trachoma SAFE (Surgery, Antibiotics, Face washing and Environmental hygiene) control strategy to be undertaken in Salima District.