Trachoma

Trachoma, a neglected tropical disease (NTD) remains a leading infectious cause of preventable blindness. Risk factors for trachoma include poor hygiene, with lack of water playing a major role. In southern Malawi, the Lower Shire valley is known to be endemic for all the five common preventive chemotherapy (PCT) NTDs which are Schistosomiasis, Onchocerciasis, Lymphatic Filariasis, Soil Transmitted helminthes and Trachoma. Co-infections (poly-parasitism) within the other four NTDs have been reported but there is no information regarding co-infections between trachoma and other NTDs. Whereas trachoma is mainly associated with lack of water, availability of rivers and streams is associated with Onchocerciasis, Schistosomiasis and STH. Lack of knowledge of specific areas where each NTD occurs within a district leads to treating the entire district with MDAs, which can be very expensive and logistically challenging.

This cross sectional study aims to establish rates of co-infections between trachoma and Schistosomiasis.The hypothesis is that in the Lower Shire, though trachoma and Schistosomiasis are both reported to be endemic and are of public health problems, areas where these are endemic do not overlap. The study is using spatial epidemiology to map areas of co-infection and co-intensity between trachoma and Schistosomiasis. Children aged 1-9 years from randomly selected clusters are being examined using standard WHO protocol, for presence or absence of trachoma, Schistosomiasis or both, and risk factors for each of the diseases are being collected.

The expected outcome will be the determination of point prevalence and infection intensities of Schistosomiasis and trachoma infections in children and this may eventually be used to determine where, within a district mass treatment can be given for a specific disease.