An Impact Evaluation of Two Rounds of Mass Drug Administration on the Prevalence of Trachoma in Plateau and Nasarawa States of Nigeria: A Clustered Cross Sectional Survey Öffentlichkeit

Abstract

Abstract
An Impact Evaluation of Two Rounds of Mass Drug Administration on the Prevalence of Trachoma in Plateau and Nasarawa States of Nigeria: A Clustered Cross Sectional Survey Introduction: Nigeria is one of the major trachoma endemic countries in sub-Saharan Africa. The national program estimates 28 million people live in the 11 Nigerian states known to be trachoma endemic. An impact evaluation survey was carried out in June 2012 after two annual rounds of mass drug administration to assess the impact of MDA on trachoma prevalence and to provide guidance to the trachoma control program for progress to achieve the ultimate intervention goals. Methods: A two- staged cross-sectional clustered sample survey was used for the survey. Results: A total of 1530 children, 808 (53%) boys and 704 (47%) girls, aged l-9 years from 793 households were screened for clinical signs of trachoma. A total of 2138 persons, 1014 (46%) males and 1124 (54%) females, above the age of 14 years were also examined for signs of trachoma. The baseline TF prevalence in Plateau was 13.9% and the baseline TF prevalence in Nasarawa was 12.1%. The follow up TF prevalence in Plateau was 4.85% and the follow up TF prevalence in Nasarawa was 1.6%. This indicates a 65% TF reduction for Plateau state and 86% TF reduction for Nasarawa State (differences in TF (p<0.001); differences in TT (p=0.012)). Household latrine coverage was 21.0% and 29.2% for Plateau State and 21.8% and 15.2% for Nasarawa State at baseline and follow up surveys respectively. Antibiotic coverage was 60.3% and 31.1% for Plateau State at baseline and follow up surveys respectively. Conclusion: A significant reduction in the prevalence of TF has been registered after two annual rounds of MDA and the ultimate intervention goal (UIG) of reducing TF to below the threshold level of 5%has been achieved. The coverage with MDA has been consistently below 80% and latrine ownership has not improved yet deep reductions in TF have been observed. Two rounds of MDA may be as effective as three or more rounds in reducing TF prevalence if the 80% UIG of antibiotic coverage could be achieved in trachoma endemic areas but findings should be replicated in more robustly designed studies.

Table of Contents

TABLE OF CONTENTS

1. Introduction...............................................................................................................1

2. Literature Review........................................................................................................7

3. Study Design, Procedures and Methods........................................................................17

4. Results......................................................................................................................23

5. Discussion and conclusions .........................................................................................30

7. References............................................................................................................... 35

9. Appendix A: Questionnaire..........................................................................................37

10. Appendix B: Clearance forms................................................................................... 44

11. Appendix C: Assigned Cluster Numbers for Enumeration Areas......................................46

12. Appendix D: Number of Segments in Each cluster.......................................................48

13. Appendix E: Informed Consent.................................................................................50
14. Appendix F: Training Schedule of Trachoma screening and Survey Methods.................. 53

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, General Health Sciences, Epidemiology
Stichwort	Impact Mass Drug Administration Trachoma Prevalence
Committee Chair / Thesis Advisor	McFarland, Deborah A, Emory University
Committee Members	Emerson, Paul M, Emory University King, Jonathan, Emory University
Partnering Agencies	International Non-governmental organization (e.g., CARE, Inc.)

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