@article{33740,
  keywords = {Conflict, Trachoma, Trichiasis, WASH},
  author = {Macleod CK and Binnawi KH and Elshafie BE and Sadig HE and Hassan A and Cocks N and Willis R and Chu BK and Solomon A and Global Trachoma Mapping Project },
  title = {Unimproved water sources and open defecation are associated with active trachoma in children in internally displaced persons camps in the Darfur States of Sudan.},
  abstract = {<p><strong>PURPOSE: </strong>To estimate the proportion of children with trachomatous inflammation-follicular (TF) and adults with trachomatous trichiasis (TT) in internally displaced persons (IDP) camps in the Darfur States of Sudan and to evaluate associated risk factors.</p>

<p><strong>METHODS: </strong>IDP camps were identified from government census data. We conducted a subanalysis of data collected in these camps during 2014-2015 as part of surveys covering 37 districts of the Darfur States within the Global Trachoma Mapping Project. A random-effects hierarchical model was used to evaluate factors associated with TF in children or TT in adults.</p>

<p><strong>RESULTS: </strong>Thirty-six IDP camps were represented in the survey data, in which 1926 children aged 1-9 y were examined, of whom 38 (8%) had TF. Poor sanitation, younger age and living in a household that purchased water from a vendor were associated with TF in children aged 1-9 y. Of 2139 individuals examined aged ≥15 y, 16 (0.7%) had TT. TT was strongly independently associated with being older and living alone.</p>

<p><strong>CONCLUSION: </strong>Trachoma is found at low levels in these camps, but still at levels where intervention is needed. Disease elimination in conflict-related settings presents a unique challenge for the trachoma community, and may require an innovative approach. Understanding how best to undertake trachoma elimination interventions in these areas should be prioritized.</p>
},
  year = {2019},
  journal = {Transactions of the Royal Society of Tropical Medicine and Hygiene},
  volume = {113},
  pages = {599-609},
  issn = {1878-3503},
  url = {https://watermark.silverchair.com/trz042.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAmIwggJeBgkqhkiG9w0BBwagggJPMIICSwIBADCCAkQGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMXBdVtgSfZZ5IBmxaAgEQgIICFViIgR_UMSkzdC-fCHYYDWyp3mkdRWGOb3P3i5eFoEuaLPuU},
  doi = {10.1093/trstmh/trz042},
  language = {eng},
}