02715nas a2200385   4500000000100000008004100001653001300042653003900055653003500094653000900129653001600138653001300154653001700167653001500184100001400199700001400213700001200227700001100239700001500250700001300265700001600278700001400294700001400308700001600322700001300338700001100351700001700362700001200379245010800391856009800499300001300597490000700610520169800617022001402315       2018                            d10aTrachoma10aNeglected tropical diseases (NTDs)10amass drug administration (MDA)10aMali10aElimination10aChildren10aAzithromycin10aPrevalence1 aTraoré L1 aDembele B1 aKeita M1 aReid S1 aDembéle M1 aMariko B1 aCoulibaly F1 aGoldman W1 aTraoré D1 aCoulibaly D1 aGuindo B1 aAmon J1 aKnieriemen M1 aZhang Y00aPrevalence of trachoma in the Kayes region of Mali eight years after stopping mass drug administration.  uhttp://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0006289&type=printable  ae00062890 v123 a<p><strong>BACKGROUND: </strong>In 2009, three years after stopping mass treatment with azithromycin, a trachoma impact survey in four health districts in the Kayes region of Mali found a prevalence of trachomatous inflammation-follicular (TF) among children aged 1 to 9 years of &gt;5% and a trachomatous trichiasis (TT) prevalence within the general population (≥1-year-old) of &lt;1%. As a result, the government's national trachoma program expanded trichiasis surgery and related activities required to achieve trachoma elimination.</p>

<p><strong>METHODOLOGY/PRINCIPAL FINDINGS: </strong>In 2015, to assess progress towards elimination, a follow-up impact survey was conducted in the Kayes, Kéniéba, Nioro and Yélimané health districts. The survey used district level two-stage cluster random sampling methodology with 20 clusters of 30 households in each evaluation unit. Subjects were eligible for examination if they were ≥1 year. TF and TT cases were identified and confirmed by experienced ophthalmologists. In total 14,159 people were enumerated and 11,620 (82%) were examined. TF prevalence (95% confidence interval (CI)) was 0.5% (0.3-1%) in Kayes, 0.8% (0.4-1.7%) in Kéniéba, 0.2% (0-0.9%) in Nioro and 0.3% (0.1-1%) in Yélimané. TT prevalence (95% CI) was 0.04% (0-0.25%) in Kayes, 0.29% (0.11-0.6%) in Kéniéba, 0.04% (0-0.25%) in Nioro and 0.07% (0-0.27%) in Yélimané.</p>

<p><strong>CONCLUSIONS/SIGNIFICANCE: </strong>Eight years after stopping MDA and intensifying trichiasis surgery outreach campaigns, all four districts reached the TF elimination threshold of &lt;5% and three of four districts reached the TT elimination threshold of &lt;0.1%.</p>
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