@article{102156, author = {Mwale C and Mboni C and Saasa N and Sikasunge CS and Chelu C and Chisenga T and Sundano L and Kunda NS and Moonga PM and Lombe K and Naluonde T and Boyd S and Bakhtiari A and Jimenez C and Harding-Esch EM and Dejene M and Masaninga F and Bakyaita NN and Kwendakwema D and Solomon AW and Muma KIM}, title = {Assessing trachoma elimination progress in districts with persistent trachoma, Western Province, Zambia}, abstract = {

Background Trachoma is a public health problem in Zambia. We aimed to estimate the prevalence of trachomatous inflammation—follicular (TF) in 1–9-y-olds and of trachomatous trichiasis (TT) in ≥15-y-olds after the implementation of trachoma elimination interventions to determine if the trachoma elimination thresholds had been achieved: <5% for TF in 1–9-y-olds and <0.2% TT for ≥15-y-olds.

Methods Two rounds of impact prevalence surveys in two evaluation units (EUs) comprising four districts of Western Province were conducted; the first in 2018, the second in 2023. All individuals aged ≥1 year from 30 households of 24 clusters in each EU were examined for trachoma. Data were captured electronically.

Results In 2018, TF prevalence in 1–9-y-olds was 13.9% in Kalabo/Sikongo and 17.9% in Shang'ombo/Sioma. Following further interventions, TF prevalence among 1–9-y-olds in 2023 was 7.7% and 12.5%, respectively. TT prevalences in ≥15-y-olds were 0.10% and 0.79% in 2018, and 0.4% and 0.2% in 2023, respectively.

Conclusions These EUs did not attain trachoma elimination thresholds as a public health problem. They fulfilled the WHO definition for persistent trachoma. Therefore, they warrant further investigation, including collection of Chlamydia trachomatis infection data, to inform future programmatic decision-making. Further TT surgical services are also needed.

}, year = {2025}, journal = {International Health}, publisher = {Oxford University Press (OUP)}, issn = {1876-3413, 1876-3405}, url = {https://academic.oup.com/inthealth/advance-article-pdf/doi/10.1093/inthealth/ihaf041/63013245/ihaf041.pdf}, doi = {10.1093/inthealth/ihaf041}, language = {eng}, }