The global burden of trichiasis in 2016.

Flueckiger, RMORCID logo; Courtright, PORCID logo; Abdala, M; Abdou, A; Abdulnafea, Z; Al-Khatib, TK; Amer, K; Amiel, ON; Awoussi, S; Bakhtiari, A; +65 more...Batcho, W; Bella, AL; Bennawi, KH; Brooker, SJ; Chu, BK; Dejene, M; Dezoumbe, D; Elshafie, BE; Elvis, AA; Fabrice, DN; Omar, FJ; François, M; François, D; Garap, J; Gichangi, M; Goepogui, A; Hammou, J; Kadri, B; Kabona, G; Kabore, M; Kalua, K; Kamugisha, M; Kebede, B; Keita, K; Khan, AA; Kiflu, G; Yibi, M; Mackline, G; Macleod, C; Manangazira, P; Masika, MP; Massangaie, M; Mduluza, T; Meno, N; Midzi, N; Minnih, AO; Mishra, S; Mpyet, C; Muraguri, N; Mwingira, U; Nassirou, B; Ndjemba, J; Nieba, C; Ngondi, JORCID logo; Olobio, N; Pavluck, A; Phiri, I; Pullan, RORCID logo; Qureshi, B; Sarr, B; Seiha, D; Chávez, GMS; Sharma, S; Sisaleumsak, S; Southisombath, K; Stevens, G; Woldendrias, AT; Traoré, L; Turyaguma, P; Willis, R; Yaya, G; Yeo, S; Zambroni, F; Zhao, J; Solomon, AW and (2019) The global burden of trichiasis in 2016. PLOS NEGLECTED TROPICAL DISEASES, 13 (11). e0007835-. ISSN 1935-2735 DOI: 10.1371/journal.pntd.0007835
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BACKGROUND: Trichiasis is present when one or more eyelashes touches the eye. Uncorrected, it can cause blindness. Accurate estimates of numbers affected, and their geographical distribution, help guide resource allocation. METHODS: We obtained district-level trichiasis prevalence estimates in adults for 44 endemic and previously-endemic countries. We used (1) the most recent data for a district, if more than one estimate was available; (2) age- and sex-standardized corrections of historic estimates, where raw data were available; (3) historic estimates adjusted using a mean adjustment factor for districts where raw data were unavailable; and (4) expert assessment of available data for districts for which no prevalence estimates were available. FINDINGS: Internally age- and sex-standardized data represented 1,355 districts and contributed 662 thousand cases (95% confidence interval [CI] 324 thousand-1.1 million) to the global total. Age- and sex-standardized district-level prevalence estimates differed from raw estimates by a mean factor of 0.45 (range 0.03-2.28). Previously non- stratified estimates for 398 districts, adjusted by ×0.45, contributed a further 411 thousand cases (95% CI 283-557 thousand). Eight countries retained previous estimates, contributing 848 thousand cases (95% CI 225 thousand-1.7 million). New expert assessments in 14 countries contributed 862 thousand cases (95% CI 228 thousand-1.7 million). The global trichiasis burden in 2016 was 2.8 million cases (95% CI 1.1-5.2 million). INTERPRETATION: The 2016 estimate is lower than previous estimates, probably due to more and better data; scale-up of trichiasis management services; and reductions in incidence due to lower active trachoma prevalence.


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