Unimproved water sources and open defecation are associated with active trachoma in children in internally displaced persons camps in the Darfur States of Sudan

Trans R Soc Trop Med Hyg. 2019 Oct 11;113(10):599-609. doi: 10.1093/trstmh/trz042.

Abstract

Purpose: To estimate the proportion of children with trachomatous inflammation-follicular (TF) and adults with trachomatous trichiasis (TT) in internally displaced persons (IDP) camps in the Darfur States of Sudan and to evaluate associated risk factors.

Methods: IDP camps were identified from government census data. We conducted a subanalysis of data collected in these camps during 2014-2015 as part of surveys covering 37 districts of the Darfur States within the Global Trachoma Mapping Project. A random-effects hierarchical model was used to evaluate factors associated with TF in children or TT in adults.

Results: Thirty-six IDP camps were represented in the survey data, in which 1926 children aged 1-9 y were examined, of whom 38 (8%) had TF. Poor sanitation, younger age and living in a household that purchased water from a vendor were associated with TF in children aged 1-9 y. Of 2139 individuals examined aged ≥15 y, 16 (0.7%) had TT. TT was strongly independently associated with being older and living alone.

Conclusion: Trachoma is found at low levels in these camps, but still at levels where intervention is needed. Disease elimination in conflict-related settings presents a unique challenge for the trachoma community, and may require an innovative approach. Understanding how best to undertake trachoma elimination interventions in these areas should be prioritized.

Keywords: Darfur; Global Trachoma Mapping Project; Sudan; prevalence; trachoma; trichiasis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Child
  • Child, Preschool
  • Cluster Analysis
  • Female
  • Humans
  • Infant
  • Male
  • Refugee Camps / statistics & numerical data
  • Refugees / statistics & numerical data*
  • Risk Factors
  • Sudan / epidemiology
  • Surveys and Questionnaires
  • Toilet Facilities* / statistics & numerical data
  • Trachoma / epidemiology
  • Trachoma / etiology*
  • Water Supply* / statistics & numerical data
  • Young Adult