Prevalence of trachoma in four marakez of Elmenia and Bani Suef Governorates, Egypt

Purpose: In 2015, to determine where interventions are needed to eliminate trachoma as a public health problem from Egypt, we initiated population-based prevalence surveys using the Global Trachoma Mapping Project platform in four suspected-endemic marakez (districts; singular: markaz) of the governorates of Elmenia and Bani Suef. Methods: In each markaz, 30 households were selected in each of 25 villages. Certified graders examined a total of 3682 children aged 1–9 years in 2993 households, noting the presence or absence of trachomatous inflammation—follicular (TF) and trachomatous inflammation—intense (TI) in each eye. A total of 5582 adults aged ≥15 years living in the same households were examined for trachomatous trichiasis (TT). Household-level access to water and sanitation was recorded. Results: Three of four marakez had age-adjusted TF prevalence estimates in 1–9-year olds of >10%; the other markaz had a TF prevalence estimate of 5–9.9%. Estimates of the age- and gender-adjusted prevalence of unmanaged TT in adults ranged from 0.7% to 2.3%. Household-level access to water and sanitation was high. (We did not, however, measure use of water or sanitation facilities.) Conclusions: Each of the four marakez surveyed has trachoma as a public health problem, with a need for implementation of the SAFE (surgery, antibiotics, facial cleanliness, environmental improvement) strategy. Further mapping is also required to determine the need for interventions in other areas of Egypt.