02506nas a2200289   4500000000100000008004100001653001300042653001300055653001500068653000900083100001500092700001500107700001600122700001300138700001300151700001200164700001300176700001100189700001400200700003700214245016600251856026000417300001200677490000800689520150500697022001402202       2019                            d10aConflict10aTrachoma10aTrichiasis10aWASH1 aMacleod CK1 aBinnawi KH1 aElshafie BE1 aSadig HE1 aHassan A1 aCocks N1 aWillis R1 aChu BK1 aSolomon A1 aGlobal Trachoma Mapping Project 00aUnimproved water sources and open defecation are associated with active trachoma in children in internally displaced persons camps in the Darfur States of Sudan.  uhttps://watermark.silverchair.com/trz042.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAmIwggJeBgkqhkiG9w0BBwagggJPMIICSwIBADCCAkQGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMXBdVtgSfZZ5IBmxaAgEQgIICFViIgR_UMSkzdC-fCHYYDWyp3mkdRWGOb3P3i5eFoEuaLPuU  a599-6090 v1133 a<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>
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