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Time trends and heterogeneity in the disease burden of trachoma, 1990–2019: a global analysis
  1. Jingxin He1,
  2. Aiming Chen2,
  3. Minjie Zou1,
  4. Charlotte Aimee Young3,
  5. Ling Jin1,
  6. Danying Zheng1,
  7. Guangming Jin1,
  8. Nathan Congdon1,4,5
  1. 1Sun Yat-sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China
  2. 2Department of Pharmacy, Fifth Affiliated Hospital of Sun Yat- sen University, Zhuhai, China
  3. 3Department of Ophthalmology, Third Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China
  4. 4Centre for Public Health, Queen’s University Belfast, Belfast, UK
  5. 5Orbis International, New York, New York, USA
  1. Correspondence to Dr Guangming Jin, Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, People's Republic of China; guangming27050103{at}; Dr Danying Zheng, Sun Yat-sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, People's Republic of China; zhengdyy{at}


Purpose To evaluate the epidemiological trends and associated risk factors of disease burden due to trachoma.

Methods Data for the country-specific disability-adjusted life year (DALY) number, rate and age-standardised rate of trachoma together with related data of other common eye diseases were acquired from the Global Burden of Disease Study 2019 database. The Socio-Demographic Index (SDI), Human Development Index (HDI), inequality-adjusted HDI and other related indices were obtained from published data or publicly available databases. Regression analyses were conducted to evaluate the associations between potential risk factors and the age-standardised DALY burden of trachoma.

Results The global DALY burden due to trachoma decreased by 37% from 1990 to 2019 and decreased by 69.8% after adjusting for age and population growth, and, in available 1990–2019 data, had the greatest reduction in attributable DALYs of all common eye disease, with the others analysed being cataract, glaucoma, refractive disorders and age-related macular degeneration. Women had higher age-standardised DALY burden due to trachoma than men (p<0.001). The African region (p<0.001) had the heaviest burden among global regions. The age-standardised DALY rate was higher in countries with lower income (p<0.001) and lower SDI (p<0.001). Higher disease burden due to trachoma was associated with lower HDI (β=−48.102, 95% CI −86.888 to −9.316, p=0.016), lower SDI (β=−48.063, 95% CI −83.702 to −12.423, p<0.001) and lower expected years of schooling (β=−2.352, 95% CI −3.756 to −0.948, p=0.002).

Conclusions The global disease burden due to trachoma decreased from 1990 to 2019 and it had the greatest reduction compared with other common eye diseases. Lower HDI, socioeconomic status and educational level were related to a higher national disease burden of trachoma. Our findings could provide necessary information for trachoma control and prevention.

  • epidemiology
  • infection
  • public health

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • JH, AC and MZ are joint first authors.

  • Contributors Conception and design: Guangming Jin, Danying Zheng; Data collection: Jingxin He, Minjie Zou; Analysis and interpretation: Ling Jin, Aiming Chen, Charlotte Aimee Young; Writing of the article: Jingxin He, Aiming Chen, Minjie Zou; Critical revision of the article: Danying Zheng, Nathan Congdon; Administrative, technical or logistical support: Guangming Jin, Danying Zheng, Nathan Congdon.

  • Funding This work was supported by National Natural Science Foundation of China (81873673, 81900841) and the Young Teachers Training Program of Sun Yat-sen University (20ykpy143).

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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