title: Risk factors for trachomatous trichiasis in children: cross-sectional household surveys in Southern Sudan.
abstract: We have previously documented blinding trachoma to be a serious public health problem in Southern Sudan, with an unusually high prevalence of trachomatous trichiasis (TT) among children. We aimed to investigate risk factors for TT in children in Southern Sudan. Cross-sectional surveys were undertaken in 11 districts between 2001 and 2006, and eligible participants were examined for trachoma signs. Risk factors were assessed through interviews and observations. Using logistic regression, associations between TT in children and potential risk factors were investigated. In total, 11155 children aged 1-14 years from 3950 households were included in the analysis. Overall prevalence of TT was 1.5% (95% CI 1.1-2.1). Factors independently associated with increased odds of TT in children aged 1-14 years were: increasing age (P(trend)<0.001); female gender (odds ratio=1.5; 95% CI 1.1-2.1); increasing proportion of children in the household with trachomatous inflammation-intense (TI) (P(trend)=0.002); and increasing number of adults in the household with TT (P(trend)<0.001). Our study revealed risk factors for TT in children consistent with those previously reported for TT in adults. While the associations of TT in children with TI in siblings and TT in adult relatives merit further investigation, there is an urgent need for trachoma prevention interventions and trichiasis surgery services that are tailored to cater for young children in Southern Sudan.
authors.affiliation: The Carter Center, Atlanta, Georgia, USA. jn250@cam.ac.uk
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Ngondi
authors.forename: Mark H
authors.initials: MH
authors.lastname: Reacher
authors.forename: Fiona E
authors.initials: FE
authors.lastname: Matthews
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
authors.forename: Gideon
authors.initials: G
authors.lastname: Gatpan
authors.forename: Steven
authors.initials: S
authors.lastname: Becknell
authors.forename: Lucia
authors.initials: L
authors.lastname: Kur
authors.forename: Jonathan
authors.initials: J
authors.lastname: King
authors.forename: Kelly
authors.initials: K
authors.lastname: Callahan
authors.forename: Paul M
authors.initials: PM
authors.lastname: Emerson
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D003430:Cross-Sectional Studies; D005140:Eyelashes / Q000382:microbiology*; D005191:Family Characteristics; D005260:Female; D006201:Hair Diseases / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008297:Male; D012307:Risk Factors; D012423:Rural Health; D012959:Socioeconomic Factors; D013397:Sudan / Q000453:epidemiology; D014141:Trachoma / Q000150:complications / Q000453:epidemiology*