title: The Epidemiology of Trachoma in Darfur States and Khartoum State, Sudan: Results of 32 Population-Based Prevalence Surveys.
abstract: To complete the baseline trachoma map of Sudan by estimating the prevalence of trachoma and associated risk factors in the five Darfur States and Khartoum State.
  
  
  
  Using a standardized methodology developed for the Global Trachoma Mapping Project, we undertook a cross sectional, community-based survey in each of 32 evaluation units (EUs) covering all accessible districts.
  
  
  
  We enumerated a total of 84,568 individuals, with 73,489 people (86.9%) examined from 20,242 households in 908 villages. The highest prevalence of trachomatous inflammation - follicular (TF) in children was found in El Fashir district (18.7%), and the lowest in El Malha district (0.0%). Five districts (El Fashir, Zalinji, Azoom, Maleet, and El Koma) were in the three EUs that had TF prevalences above the 10% threshold at which the World Health Organization recommends mass treatment with azithromycin, together with facial clean3liness and environmental improvement interventions, for at least 3 years. The highest trachomatous trichiasis prevalence in adults was found in the EU composed of Forbranga and Habillah (1.2%), and the lowest in the EU composed of As-salam and Belale districts in South Darfur (0.0%). TF in children was independently associated with younger age, unimproved sanitation in the household, having ≥5 children in the household, outside annual maximum temperatures <40°C, and living in an internally displaced persons camp.
  
  
  
  We found a high prevalence of trachoma in some areas of Darfur, but in general the prevalence throughout Darfur and Khartoum was low.
authors.affiliation: a National Program for Prevention of Blindness , Federal Ministry of Health , Khartoum , Sudan.
authors.forename: Balgesa Elkheir
authors.initials: BE
authors.lastname: Elshafie
authors.affiliation: a National Program for Prevention of Blindness , Federal Ministry of Health , Khartoum , Sudan.|b Department of Ophthalmology , Al Neelain University , Khartoum , Sudan.
authors.forename: Kamal Hashim
authors.initials: KH
authors.lastname: Osman
authors.affiliation: c Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.|d Sightsavers, Haywards Heath , UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Macleod
authors.affiliation: e Sightsavers , Khartoum , Sudan.
authors.forename: Awad
authors.initials: A
authors.lastname: Hassan
authors.affiliation: d Sightsavers, Haywards Heath , UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Bush
authors.affiliation: f Michael Dejene Public Health Consultancy Services , Addis Ababa , Ethiopia.
authors.forename: Michael
authors.initials: M
authors.lastname: Dejene
authors.affiliation: g Task Force for Global Health , Decatur , GA , USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Willis
authors.affiliation: g Task Force for Global Health , Decatur , GA , USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Chu
authors.affiliation: h KCCO International, Division of Ophthalmology , University of Cape Town , South Africa.
authors.forename: Paul
authors.initials: P
authors.lastname: Courtright
authors.affiliation: c Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.|i Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland.
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Solomon
mesh_terms: D000293:Adolescent; D017963:Azithromycin / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D013397:Sudan / Q000453:epidemiology; D014141:Trachoma / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D017963:Azithromycin
keywords: Darfur; Global Trachoma Mapping Project; Khartoum; Sudan; prevalence; trachoma; trichiasis