Prevalence of Trachoma in Jigawa State, Northwestern Nigeria

Purpose: To determine the magnitude of trachoma and the prevalent forms of the disease, and to provide baseline data for the establishment of a trachoma control program in Jigawa State, northwestern Nigeria. Methods: A population-based cross-sectional survey was conducted in Jigawa State in May 2007 using a 2-stage cluster random sampling technique to select 4598 persons from 40 villages based on probability proportional to size. All participants were examined using a penlight and a 2.5 x binocular loupe for signs of trachoma, and graded using the World Health Organization (WHO) simplified grading system. Results: A total of 4598 people were seen with 99.96% coverage. Of these, 2460 (53.5%) were female and 2138 (46.5%) were male. Mean age was 21.6 years (+/- 19.8 years). The prevalence of follicular trachoma in children aged <= 9 years was 20.5% (95% confidence interval, CI, 18.7-22.4%) with no difference between the sexes. The prevalence of trichiasis in adults aged >= 15 years was 5%, and the prevalence was higher in females than males (odds ratio 2.60, 95% CI 2.06-3.28; p<0.001). Conclusion: Trachoma is a major problem in Jigawa State; there is a need to train trichiasis surgeons and empower them to carry out community-based surgery. District-level prevalence of trachoma needs to be determined to know which aspects of the WHO SAFE strategy (surgery, antibiotics, facial cleanliness and environmental improvements) need to be emphasized in each district.