June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Incidence and progression of trachomatous scarring in a cohort of children in a formerly hyper-endemic district of Tanzania
Author Affiliations & Notes
  • Michael Saheb Kashaf
    Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Fahd Naufal
    Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Beatriz E Munoz
    Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Harran Mkocha
    Kongwa Trachoma Project, Kongwa, Tanzania, United Republic of
  • Meraf A Wolle
    Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Sheila K West
    Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Michael Saheb Kashaf, None; Fahd Naufal, None; Beatriz Munoz, None; Harran Mkocha, None; Meraf Wolle, None; Sheila West, None
  • Footnotes
    Support  International Trachoma Initiative and the National Eye Institute grant EY022584
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 5221. doi:
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      Michael Saheb Kashaf, Fahd Naufal, Beatriz E Munoz, Harran Mkocha, Meraf A Wolle, Sheila K West; Incidence and progression of trachomatous scarring in a cohort of children in a formerly hyper-endemic district of Tanzania. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5221.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine the incidence and progression of trachomatous scarring in a cohort of children residing in a formerly hyper-endemic district where the prevalence of follicular trachoma (TF) is now <5%.

Methods : A cohort of children, ages 1-9 years, were randomly selected at baseline from 38 villages in Kongwa, Tanzania and followed for 2 years. Images were acquired at baseline and graded for the presence and severity of scarring. At two years, another set of images were obtained and graded independently for presence and severity of scarring. Grading of images at both time points was carried out by two standardized graders using a validated five-point scale ranging between S0-S4. Disparate grades were adjudicated. Children without scarring at baseline were at risk for incident scarring and children with scarring at baseline were at risk for progression. Risks were calculated per year.

Results : Of 1496 children, 1266 were followed up at 2 years (85%). The average age of the cohort at baseline was 5.5 years, and 51% were female. The prevalence of scarring at baseline was 1.7% and no child had grade S4 scarring. Nineteen of the children with scarring at baseline were re-examined at follow-up, with 4/19 (21%) found to have more severe scarring. The cumulative incidence of scarring was 1.6% (~0.8%/year). Girls were more likely to develop scars than boys, with an age-adjusted incidence ratio (IR) of 2.9 (95% confidence interval (CI) (1.1 – 8.06)). There was a suggestion of increased risk of incident scarring in villages with TF prevalence at baseline >5%, with an age-adjusted IR of 2.0 (95% CI (0.8 – 5.0)).

Conclusions : The incidence of new scarring in children aged 1-9 years is very low, although 21% of those who had scarring at baseline progressed in severity over the two-year follow-up period.

This is a 2020 ARVO Annual Meeting abstract.

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