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Risk factors for incidence of trachomatous scarring in a cohort of women in low endemic district
  1. Rabia Karani1,
  2. Meraf Wolle1,
  3. Harran Mkocha2,
  4. Beatriz Muñoz1,
  5. Sheila K West1
  1. 1Dana Center for Preventative Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  2. 2Kongwa Trachoma Project, Kongwa, Tanzania
  1. Correspondence to Professor Sheila K West, Dana Center for Preventative Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; shwest{at}jhmi.edu

Abstract

Background/aims To determine the incidence of scarring in women in a trachoma low endemic district of rural Tanzania and to determine the effects of lifetime cooking fire exposure and markers of lower socioeconomic status on incidence of scarring in these women.

Methods A prospective cohort study was conducted over a 3.5-year period from 2013 to 2016 in 48 villages in Kongwa, Tanzania where trachoma at baseline was 5.2% in children. A random sample of 2966 women aged 15 and older who were at risk for incident scarring were eligible for follow-up. Data on demographic factors, cooking fire exposure and trachomatous scarring were gathered at baseline and follow-up. An index of lifetime exposure to cooking fire exposure was created and bivariate analysis, age-adjusted logistic regression and multivariable logistic models were used to look for associations of demographic factors and cooking fire exposure with incident trachomatous scarring.

Results The cumulative incidence of scarring was 7.1% or 2.0% per year. Incidence of scarring increased with age and exposure to markers of lower socioeconomic status. A multivariable logistic regression model adjusting for confounding factors did not find an association between lifetime cooking fire exposure and incidence of scarring (OR=0.92; 95% CI 0.68 to 1.24, P=0.58).

Conclusions There was still incident scarring in women in Tanzania despite low rates of active trachoma. There was no association between exposure to cooking fires and incident scarring. More research is needed to understand the factors that contribute to new scarring in these women.

  • vision
  • ocular surface

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Footnotes

  • Contributors RK contributed to data analysis, original draft preparation, review and editing of the manuscript. MW contributed to data analysis, review and editing of the manuscript. HM contributed to data collection and review of manuscript. BM contributed to data analysis, review and editing. SKW contributed to data collection, data analysis, original draft preparation, review and editing of manuscript.

  • Funding This work was supported by the National Eye Institute (Grant#: EY022584) and the Johns Hopkins Institute for Clinical and Translational Research NIH TL1 Trainee Award (Grant#: TL1 TR001078).

  • Competing interests None declared.

  • Ethics approval This research complied with the tenets of the Declaration of Helsinki and was conducted with approval from the Johns Hopkins University School of Medicine Institutional Review Board and the National Institute of Medical Research of the United Republic of Tanzania.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available on request from Dr Sharon Solomon. Please email request to ssolomo3@jh.edu.

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