02659nas a2200397   4500000000100000008004100001653001300042653001300055653001600068653002100084653001500105653000900120653002500129653001100154653001400165653001100179653001100190653001800201653002100219653001000240653001700250653002600267653001600293653001000309653001500319100001200334700001200346700001400358700001100372245008300383856007700466300001000543490000700553520168700560022001402247       2009                            d10aTrachoma10aTanzania10aSex Factors10aRural Population10aPrevalence10aMale10aLongitudinal studies10aInfant10aIncidence10aHumans10aFemale10aCohort Effect10aChild, Preschool10aChild10aAzithromycin10aAnti-Bacterial Agents10aAge Factors10aAdult10aAdolescent1 aWolle M1 aMunoz B1 aMkocha HA1 aWest S00aAge, sex, and cohort effects in a longitudinal study of trachomatous scarring.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3820011/pdf/nihms523283.pdf  a592-60 v503 a<p><strong>PURPOSE: </strong>To determine the 5-year incidence rate of scarring, and associated factors, in the population of Maindi, Tanzania.</p>

<p><strong>METHODS: </strong>A census of every resident was obtained at baseline, and ocular examinations for the presence and severity of trachoma were performed. Images of the upper eyelid were taken and graded for the presence and severity of scarring, according to a four-step severity scale based on photographs. Five years after baseline, a second series of images was taken and graded for scarring. Incident scarring was defined as new scars in those without scarring at baseline; progression was defined as those with scars that worsened by one step or more at 5 years.</p>

<p><strong>RESULTS: </strong>The rate of scarring at baseline increased with age, from 1% in the &lt;6-year to 38% in the 41+-year age group. Females at any age had more scarring than did males. The 5-year incidence rate of scarring was 0.20 (95% confidence interval [CI], 0.16-0.25), but varied with age up to 0.43 in the 41+-year group. There was a striking cohort effect, with those aged less than 16 years at baseline having more prevalent scarring and incidence rates comparable to those aged 16 to 40. Progression rates averaged 0.47 (95% CI, 0.36-0.58).</p>

<p><strong>CONCLUSIONS: </strong>In this trachoma-endemic community, incident scarring was high, especially in the younger cohorts. A dramatic increase in risk of trachomatous scarring occurred approximately 15 years ago and appears to be unabated. Trachoma control programs to reduce risk of scarring are urgently needed to avoid blinding complications in this community.</p>
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