The Carter Center Niger

Niamey, Niger

The Carter Center Niger

Niamey, Niger
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Cromwell E.A.,The Carter Center | Amza A.,National Blindness Prevention Program | Kadri B.,National Blindness Prevention Program | Beidou N.,National Blindness Prevention Program | And 6 more authors.
Transactions of the Royal Society of Tropical Medicine and Hygiene | Year: 2014

Background: The leading cause of preventable blindness worldwide is trachoma, a condition caused by an infection of the inner eyelid. In Niger, a landlocked republic in Western Africa, surveys in 1988-89 identified trachoma as endemic in all but one region and, as a result, there is a National Prevention of Blindness Program plan to eliminate trachoma by 2015. Methods: Thirty-one districts in eastern and western Niger were surveyed for trachoma prevalence from May 2009 to March 2012 as part of routine program impact evaluations. Prevalence surveys were implemented independently in each district using a two-stage cluster random design. Probability proportional to size was used to randomly select villages and 25 households were selected in each cluster. The prevalence of trachoma of clinical grade trachomatous follicular (TF) was estimated in children aged 1-9 years, and the prevalence of blinding trachoma, trachomatous trichiasis (TT), was measured in adults aged ≥15 years. Results: A total of 14 211 households was surveyed; 58 617 individuals were evaluated for clinical signs of trachoma, of whom 27 087 were children aged 1-9 years. District-wide implementation of the full SAFE strategy is warranted in 16 districts where TF prevalence exceeds 10% and targeted implementation of the SAFE strategy (surgery for trichiasis; antibiotic therapy to control transmission; facial cleanliness for hygiene promotion; environmental change for improvements in access to water and sanitation) is recommended in the remaining 15 districts. The prevalence of TTamong adults exceeded 1% in nine districts, suggesting that surgical services to treat TT should be implemented district-wide. Conclusions: These results establish the need for continued SAFE strategy implementation throughout Niger. © The Author 2013. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved.


Palmer S.L.,The Carter Center | Palmer S.L.,Emory University | Winskell K.,Emory University | Patterson A.E.,The Carter Center | And 11 more authors.
International Health | Year: 2014

Background: Prior to blindness, trachoma is thought to profoundly affect women's abilities to lead normal lives, but supporting evidence is lacking. To better understand the effects of trichiasis, we asked women to define quality of life, how trichiasis affects this idea and their perceptions of eyelid surgery. Methods: Operated and unoperated women were purposively selected for in-depth interviews. These were audio-recorded and transcribed, and codes were identified and applied to the transcripts. Overarching themes, commonalities and differences were identified and matched to quotations. Results: Twenty-three women were interviewed. Quality of life was defined as health, security, family, social status and religious participation. Trichiasis caused severe pain and loss of health, leading to loss of security. This affected social, economic and religious activities and caused burden on their families. Surgery improved quality of life, even in cases of surgical failure or recurrent disease. Conclusions: Trichiasis disables most women, even those reporting fewer or less-severe symptoms. While women in rural Niger often live in extreme poverty, trichiasis exacerbates the situation, making women unable to work and undermining their social status. It adds to family burden, as women lose the ability to meaningfully contribute to the household and require additional family resources for their care. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved.


PubMed | Programme Nationale de la Sante Oculaire, Bill and Melinda Gates Foundation, Agnes Scott College, Emory University and 3 more.
Type: Journal Article | Journal: International health | Year: 2014

Prior to blindness, trachoma is thought to profoundly affect womens abilities to lead normal lives, but supporting evidence is lacking. To better understand the effects of trichiasis, we asked women to define quality of life, how trichiasis affects this idea and their perceptions of eyelid surgery.Operated and unoperated women were purposively selected for in-depth interviews. These were audio-recorded and transcribed, and codes were identified and applied to the transcripts. Overarching themes, commonalities and differences were identified and matched to quotations.Twenty-three women were interviewed. Quality of life was defined as health, security, family, social status and religious participation. Trichiasis caused severe pain and loss of health, leading to loss of security. This affected social, economic and religious activities and caused burden on their families. Surgery improved quality of life, even in cases of surgical failure or recurrent disease.Trichiasis disables most women, even those reporting fewer or less-severe symptoms. While women in rural Niger often live in extreme poverty, trichiasis exacerbates the situation, making women unable to work and undermining their social status. It adds to family burden, as women lose the ability to meaningfully contribute to the household and require additional family resources for their care.

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