@article{28393,
  keywords = {Trachoma, Students, Prevalence, Nigeria, Niger, Neglected Diseases, Mali, Male, Infant, Humans, Health Surveys, Female, Ethiopia, Cross-Sectional Studies, Cluster Analysis, Child, Preschool, Child, Africa, Adolescent},
  author = {King J and Odermatt P and Utzinger J and Ngondi J and Bamani S and Kamissoko Y and Boubicar K and Hassan AS and Nwobi B and Jip N and Amnie A and Teferi T and Mosher AW and Stewart A and Cromwell E and Emerson P},
  title = {Trachoma among children in community surveys from four African countries and implications of using school surveys for evaluating prevalence.},
  abstract = {<p><strong>BACKGROUND: </strong>School surveys provide a convenient platform to obtain large child cohorts from multiple communities and are widely used as a proxy to determine community prevalence of neglected tropical diseases. The purpose of this study was to compare trachoma prevalence between preschool- and school-aged children and children who attend and do not attend school.</p>

<p><strong>METHODS: </strong>We analysed data from community-based trachoma surveys conducted from 2008-2011 in Ethiopia, Mali, Niger and Nigeria. The surveys utilised a cross-sectional, randomised cluster design. Individual-level data on school attendance was collected.</p>

<p><strong>RESULTS: </strong>Overall, 75 864 children aged 1-15 years from 2100 communities were included in the analysis. The prevalence of trachomatous inflammation follicular (TF) among these children in surveyed districts was 19.1% (95% CI 17.9-20.2%) in Ethiopia, 6.2% (95% CI 5.4-6.9%) in Niger, 4.6% (95% CI 4.2-4.9%) in Mali and 4.2% (95% CI 3.5-4.9%) in Nigeria. Controlling for age, sex and clustering, the OR of TF for school-attendees compared to non-attendees was 0.64 (95% CI 0.56-0.73) in Ethiopia, 0.67 (95% CI 0.56-0.80) in Mali, 1.03 (95% CI 0.81-1.16) in Niger and 1.06, (95% CI 0.65-1.73) in Nigeria.</p>

<p><strong>CONCLUSION: </strong>Estimating the prevalence of trachoma through examination of only school-going children risks underestimating the true prevalence.</p>
},
  year = {2013},
  journal = {International health},
  volume = {5},
  pages = {280-7},
  issn = {1876-3405},
  url = {http://inthealth.oxfordjournals.org/content/5/4/280.full.pdf},
  doi = {10.1093/inthealth/iht027},
  language = {eng},
}