Abstract
Purpose :
To evaluate the relationship between gender and the prevalence, and severity, of trachomatous scarring (TS) in a formerly trachoma hyperendemic district.
Methods :
A cross-sectional study was conducted amongst adults in Kongwa District, Tanzania. Participants underwent ocular examination. The presence and severity of TS was evaluated in photographs of the everted upper eyelid of each eye. The TS severity was graded using the photographic four step severity scale which goes from S0 (none) to S4 (severe). The analysis was done at the person level; for each participant the more severely affected eye was selected. For the analysis TS was dichotomized; S3 and S4 scars (more severe TS) were grouped together and compared to S0, S1, S2 scars (none to mild TS) which were also grouped together. Logistic regression models were used to examine the association between the age, gender, and TS severity.
Results :
A total of 3701 participants were included in this study. We report on a subset of these individuals, 2271 participants. The participants’ mean age was 35.8 years (range: 15-94, SD 17.2) and 61% were female. Males and females had similar prevalence of minimal (S1) and mild (S2) TS; females had an increased prevalence of more severe TS. Figure 1 shows the prevalence of more severe TS (S3 and S4 scars) by age and gender. Age was associated with more severe TS; for every year increase in age, there was a 6.6% increase in the odds of having more severe TS (95% CI: 5.8%, 7.4%). More severe TS was seen in females; females were 2.61 times more likely to have more severe TS compared to males (95% CI: 1.95, 3.50).
Conclusions :
Gender and age are positively associated with more severe trachomatous scarring. The significantly increased odds of more severe trachomatous scarring in females in this study suggests that focusing on reasons why women develop more severe scarring could yield a pathway by which to reduce the risk of developing downstream potentially blinding trachoma sequalae.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.