Browsing by Author "Baayenda, Gilbert"

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    Baseline Prevalence of Trachoma in Refugee Settlements in Uganda: Results of 11 Population-based Surveys.
    (Ophthalmic Epidemiology, 2023-12) Baayenda, Gilbert; Mugume, Francis; Mubangizi, Alfred; Turyaguma, Patrick; Tukahebwa, Edridah M; Byakika, Sarah; Kahwa, Binta; Kusasira, Darlson; Bakhtiari, Ana; Boyd, Sarah; Butcher, Robert; Solomon, Anthony W; Binagwa, Ben; Agunyo, Stella; Osilo, Martin; Crowley, Kathryn; Thuo, Wangeci; French, Mike; Plunkett, Elizabeth; Mosher, Aryc W; Harding-Esch, Emma M; Ngondi, Jeremiah
    There are several settlements in the Northern and Western Regions of Uganda serving refugees from South Sudan and Democratic Republic of Congo (DRC), respectively. Trachoma prevalence surveys were conducted in a number of those settlements with the aim of determining whether interventions for trachoma are required. An evaluation unit (EU) was defined as all refugee settlements in one district. Cross-sectional population-based trachoma prevalence survey methodologies designed to adhere to World Health Organization recommendations were deployed in 11 EUs to assess prevalence of trachomatous inflammation-follicular (TF) in 1-9-year-olds and trachomatous trichiasis (TT) unknown to the health system in ≥15-year-olds. Household-level water, sanitation and hygiene coverage was also assessed in study populations. A total of 40,892 people were examined across 11 EUs between 2018 and 2020. The prevalence of TF in 1-9-year-olds was <5% in all EUs surveyed. The prevalence of trachomatous trichiasis (TT) unknown to the health system in ≥15-year-olds was <0.2% in 5 out of 11 EUs surveyed and ≥0.2% in the remaining 6 EUs. A high proportion of households had improved water sources, but a low proportion had improved latrines or quickly (within a 30-minute return journey) accessible water sources. Implementation of the antibiotic, facial cleanliness and environmental improvement components of the SAFE strategy is not needed for the purposes of trachoma's elimination as a public health problem in these refugee settlements; however, intervention with TT surgery is needed in six EUs. Since instability continues to drive displacement of people from South Sudan and DRC into Uganda, there is likely to be a high rate of new arrivals to the settlements over the coming years. These populations may therefore have trachoma surveillance needs that are distinct from the surrounding non-refugee communities. Implementation of the antibiotic, facial cleanliness and environmental improvement components of the SAFE strategy is not needed for the purposes of trachoma's elimination as a public health problem in these refugee settlements; however, intervention with TT surgery is needed in six EUs. Since instability continues to drive displacement of people from South Sudan and DRC into Uganda, there is likely to be a high rate of new arrivals to the settlements over the coming years. These populations may therefore have trachoma surveillance needs that are distinct from the surrounding non-refugee communities.
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    Completing Baseline Mapping of Trachoma in Uganda: Results of 14 Population-Based Prevalence Surveys Conducted in 2014 and 2018
    (Informa UK Limited, 2018-12-28) Baayenda, Gilbert; Francis Mugume; Turyaguma, Patrick; Tukahebwa, Edridah M.; Binagwa, Ben; Onapa, Ambrose; Agunyo, Stella; Osilo, Martin K.; French, Michael D.; Thuo, Wangeci; Rotondo, Lisa A.; Renneker, Kristen; Willis, Rebecca; Bakhtiari, Ana; Harding-Esch, Emma M.; Solomon, Anthony W.; Ngondi, Jeremiah M.
    Purpose: We aimed to estimate the prevalence of trachomatous inflammation—follicular (TF) in children aged 1–9 years, trichiasis in adults aged ≥15 years, and water and sanitation (WASH) indicators in 12 suspected-endemic districts in Uganda. Methods: Surveys were undertaken in 14 evaluation units (EUs) covering 12 districts. Districts were selected based on a desk review in 2014 (four districts) and trachoma rapid assessments in 2018 (eight districts). We calculated that 1,019 children aged 1–9 years were needed in each EU to estimate TF prevalence with acceptable precision and used three-stage cluster sampling to select 30 households in each of 28 (2014 surveys) or 24 (2018 surveys) villages. Participants living in selected households aged ≥1 year were examined for trachoma; thus enabling estimation of prevalences of TF in 1–9 year-olds and trichiasis in ≥15 year-olds. Household-level WASH access data were also collected. Results: A total of 11,796 households were surveyed; 22,465 children aged 1–9 years and 24,652 people aged ≥15 years were examined. EU-level prevalence of TF ranged from 0.3% (95% confidence interval [CI] 0.1–0.7) to 3.9% (95% CI 2.1–5.8). EU-level trichiasis prevalence ranged from 0.01% (95% CI 0–0.11) to 0.81% (95% CI 0.35–1.50). Overall proportions of households with improved drinking water source, water source in yard or within 1km, and improved sanitation facilities were 88.1%, 23.0% and 23.9%, respectively. Conclusion: TF was not a public health problem in any of the 14 EUs surveyed: antibiotic mass drug administration is not required in these districts. However, in four EUs, trichiasis prevalence was ≥ 0.2%, so public health-level trichiasis surgery interventions are warranted. These findings will facilitate planning for elimination of trachoma in Uganda.