title: Population-Based Trachoma Mapping in Six Evaluation Units of Papua New Guinea.
abstract: We sought to determine the prevalence of trachomatous inflammation - follicular (TF) in children aged 1-9 years, and trachomatous trichiasis (TT) in those aged ≥15 years, in suspected trachoma-endemic areas of Papua New Guinea (PNG).
  
  
  
  We carried out six population-based prevalence surveys using the protocol developed as part of the Global Trachoma Mapping Project.
  
  
  
  A total of 19,013 individuals were sampled for inclusion, with 15,641 (82.3%) consenting to participate. Four evaluation units had prevalences of TF in children ≥10%, above which threshold the World Health Organization (WHO) recommends mass drug administration (MDA) of azithromycin for at least three years; Western Province (South Fly/Daru) 11.2% (95% confidence interval, CI, 6.9-17.0%), Southern Highlands (East) 12.2% (95% CI 9.6-15.0%), Southern Highlands (West) 11.7% (95% CI 8.5-15.3%), and West New Britain 11.4% (95% CI 8.7-13.9%). TF prevalence was 5.0-9.9% in Madang (9.4%, 95% CI 6.1-13.0%) and National Capital District (6.0%. 95% CI 3.2-9.1%) where consideration of a single round of MDA is warranted. Cases of TT were not found outside West New Britain, in which four cases were seen, generating an estimated population-level prevalence of TT in adults of 0.10% (95% CI 0.00-0.40%) for West New Britain, below the WHO elimination threshold of 0.2% of those aged ≥15 years.
  
  
  
  Trachoma is a public health issue in PNG. However, other than in West New Britain, there are few data to support the idea that trachoma is a cause of blindness in PNG. Further research is needed to understand the stimulus for the active trachoma phenotype in these populations.
authors.affiliation: a School of Medicine & Health Sciences , University of Papua New Guinea , Port Moresby , Papua New Guinea.|b National Department of Health, Port Moresby , Papua New Guinea.
authors.forename: Robert
authors.initials: R
authors.lastname: Ko
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: b National Department of Health, Port Moresby , Papua New Guinea.|e Wewak General Hospital , Papua New Guinea.
authors.forename: David
authors.initials: D
authors.lastname: Pahau
authors.affiliation: f Eye Care Department , Ministry of Health , Honiara , The Solomon Islands.
authors.forename: Oliver
authors.initials: O
authors.lastname: Sokana
authors.affiliation: g Brien Holden Vision Institute , Sydney , Australia.
authors.forename: Drew
authors.initials: D
authors.lastname: Keys
authors.affiliation: g Brien Holden Vision Institute , Sydney , Australia.|h School of Optometry and Vision Science , University of New South Wales , Sydney , Australia.
authors.forename: Anthea
authors.initials: A
authors.lastname: Burnett
authors.affiliation: i Task Force for Global Health , Decatur , GA , USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Willis
authors.affiliation: a School of Medicine & Health Sciences , University of Papua New Guinea , Port Moresby , Papua New Guinea.|j CBM, Port Moresby , Papua New Guinea.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Wabulembo
authors.affiliation: a School of Medicine & Health Sciences , University of Papua New Guinea , Port Moresby , Papua New Guinea.|b National Department of Health, Port Moresby , Papua New Guinea.|k PNG Eye Care, Port Moresby , Papua New Guinea.|l National Prevention of Blindness Committee , Papua New Guinea.
authors.forename: Jambi
authors.initials: J
authors.lastname: Garap
authors.affiliation: c Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Solomon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D006920:Hygiene / Q000592:standards; D007223:Infant; D008297:Male; D008875:Middle Aged; D010219:Papua New Guinea / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012499:Sanitation / Q000592:standards; D014141:Trachoma / Q000453:epidemiology*; D058457:Trichiasis / Q000453:epidemiology*; D014881:Water Supply / Q000592:standards; D055815:Young Adult
keywords: Papua New Guinea; prevalence; trachoma; trachomatous inflammation – follicular; trachomatous trichiasis