# Prevalence and associations of trachoma before interventions in six departments of the Colombian Amazon and Orinoquía

## TL;DR

This study found that trachoma is a significant public health issue in several regions of Colombia, requiring urgent interventions.

## Contribution

The study provides new prevalence data for trachoma in six Colombian departments and identifies areas needing intervention.

## Key findings

- Trachomatous inflammation—follicular (TF) prevalence exceeded 5% in four departments.
- Trachomatous trichiasis (TT) prevalence was above 0.2% in only one department.
- The study highlights the need for the SAFE strategy in affected regions.

## Abstract

Between 2011 and 2012, trachoma was identified as a public health problem in the department of Vaupés, Amazon region, Colombia. Given the existence of an epidemiological link and shared risk factors, we conducted prevalence surveys in six further departments: Amazonas, Guainía, Guaviare, Putumayo, Caquetá and Vichada in 2015 and 2016.

The objectives of this study were to determine the prevalence of trachomatous inflammation—follicular (TF) in children aged 1–9 years and trachomatous trichiasis (TT) in individuals aged ≥15 years, and to identify factors associated with TF.

In each department, a cross-sectional survey was conducted using a two-stage cluster sampling design. Data entry was undertaken directly into mobile devices, in accordance with the processes of the Global Trachoma Mapping Project (GTMP). Based on the sampling frame obtained from the Colombian political-administrative division (Divipola), a representative sample of the rural areas of the departments was applied, randomly selecting clusters (communities) and households within clusters. In these households, all residents aged ≥1 year were examined for signs of trachoma using the definitions of the World Health Organization (WHO) simplified grading system.

Logistic regression models were used to identify factors associated with presence of TF, and the geospatial distribution of this sign was represented through maps.

The prevalence of TF in children aged 1–9 years exceeded the 5% threshold in four departments (Guainía, Vichada, Amazonas, and Guaviare), and TT prevalence was higher than 0.2% ≥ 15 years old in only one (Guainía) highlighting the need to implement the SAFE (Surgery, Antibiotics, Facial cleanliness, and Environmental improvement) strategy.

Trachoma is a public health problem in several areas of the Colombian Amazon and Orinoquía regions. Our data indicate a need to implement comprehensive interventions in accordance with WHO recommendations.