Prevalence and risk factors for trachoma and ocular Chlamydia trachomatis infection in Niger.
OBJECTIVE
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.
Abdou
A
A
Dana Center for Preventive Ophthalmology, Wilmer Room 129, Johns Hopkins Hospital, 600 N Wolfe Street, Baltimore, MD 21205, USA.
Nassirou
B
B
Kadri
B
B
Moussa
F
F
Munoz
B E
BE
Opong
E
E
West
S K
SK
D017677:Age Distribution; D002675:Child, Preschool; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D015818:Eye Infections, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D006920:Hygiene; D007223:Infant; D008297:Male; D009548:Niger / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D017678:Sex Distribution; D014141:Trachoma / Q000453:epidemiology / Q000382:microbiology; D014881:Water Supply