02787nas a2200541   4500000000100000008004100001653001300042653001300055653001500068653001200083653001000095653002300105653000900128653000900137653001100146653001100157653001900168653001100187653001300198653002800211653002100239653002100260653001000281653001100291653001500302100001100317700001500328700001500343700001300358700001300371700001600384700001500400700001400415700001200429700001000441700001200451700001300463700001400476700001400490700001500504700001400519245014500533856006500678300001000743490000600753520147200759022001402231       2013                            d10aTrachoma10aStudents10aPrevalence10aNigeria10aNiger10aNeglected Diseases10aMali10aMale10aInfant10aHumans10aHealth Surveys10aFemale10aEthiopia10aCross-Sectional Studies10aCluster Analysis10aChild, Preschool10aChild10aAfrica10aAdolescent1 aKing J1 aOdermatt P1 aUtzinger J1 aNgondi J1 aBamani S1 aKamissoko Y1 aBoubicar K1 aHassan AS1 aNwobi B1 aJip N1 aAmnie A1 aTeferi T1 aMosher AW1 aStewart A1 aCromwell E1 aEmerson P00aTrachoma among children in community surveys from four African countries and implications of using school surveys for evaluating prevalence.  uhttp://inthealth.oxfordjournals.org/content/5/4/280.full.pdf  a280-70 v53 a<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>
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