Prevalence and risk factors for trachoma and ocular Chlamydia trachomatis infection in Niger
- 1Programme National de Lutte Contre la Cecité, Niamey, Niger
- 2Dana Center for Preventive Ophthalmology, Johns Hopkins University, Baltimore, Maryland, USA
- 3World Vision, Washington, DC, USA
- Correspondence to: Dr S West Dana Center for Preventive Ophthalmology, Wilmer Room 129, Johns Hopkins Hospital, 600 N Wolfe Street, Baltimore, MD 21205, USA;
- Accepted 6 August 2006
- Published Online First 9 August 2006
Aims: To determine the association of personal and household risk factors for trachoma and ocular Chlamydia trachomatis infection in Niger.
Methods: 12 villages were randomly selected. A census of all households was carried out, and 651 children aged 1–5 years were randomly selected and examined. Household and personal characteristics were determined, trachoma was clinically assessed and a swab for ocular C trachomatis infection was taken.
Results: The prevalence of trachoma was 43% (95% confidence interval (CI) 39% to 47%) and of infection was 21% (95% CI 18% to 24%). Children aged 3–5 years had a stronger association of clinical signs with infection, compared with those aged 1–2 years. Those with unclean faces were three times more likely to have clinical trachoma or ocular C trachomatis infection, compared with those with clean faces (OR 3.1 (95% CI 1.6 to 6.2) and 3.0 (95% CI 1.4 to 6.3), respectively). 75% of compounds were within 30 min of a water source. Flies on the face were a risk factor for trachoma but not for C trachomatis infection.
Conclusions: The different association of clinical signs with infection in younger versus older children may be an age-dependent difference in the duration of clinical disease. In Niger, unclean faces are a major risk factor for trachoma. The ready availability of water for washing suggests that further research on the effect of a strong health education campaign promoting clean children is warranted in this area.
Published Online First 9 August 2006
Funding: This work was supported by a grant from the Conrad F Hilton Foundation.
Competing interests: None declared.