부산대학교 도서관

Background: Trachoma is a chronic conjunctivitis caused by the bacterium Chlamydia trachomatis. Repeated infections lead to trachomatous conjunctival scarring which can progress to potentially blinding trachomatous trichiasis (TT). In trachoma hyperendemic conditions, women compared to men have an increased risk of scarring and TT, which can progress to blinding corneal opacification. This study determined if there were gender differences in scarring prevalence and severity when trachoma prevalence approaches elimination, in a formerly trachoma hyperendemic region. Methodology/Principal findings: A cross-sectional prevalence study was conducted amongst adults age 15 years and older in Kongwa district, Tanzania in 2019. 3168 persons over age 15 years agreed to be examined and had at least one eye with a gradable image. Ocular photographs were graded for scarring according to a published four-step severity scale. Overall, about half of all study participants had scarring. However, more females (52.3%) had any scarring compared to males (47.2%), OR = 1.22 (95% CI = 1.05–1.43). For every year increase in age, there was a 6.5% increase in the odds of having more severe scarring (95% CI: 5.8%, 7.2%). Women were more likely than men to have severe scarring, OR 2.36 (95% CI: 1.84–3.02). Residence in a community with TF≥10% was associated with a 1.6-fold increased odds of any scarring. Conclusions/Significance: Overall scarring prevalence and more severe scarring prevalence was higher in females compared to males, even adjusting for age and community TF prevalence. The data suggest that processes occur that lead to women preferentially progressing towards more severe scarring compared to men. Author summary: Trachoma is a chronic conjunctivitis caused by the bacterium Chlamydia trachomatis. Repeated infections lead to trachomatous conjunctival scarring (TS) which can progress to potentially blinding trachomatous trichiasis (TT). In trachoma hyperendemic conditions, women have an increased risk, scarring and TT. This study determined if there were gender differences in scarring prevalence and severity when trachoma prevalence approaches elimination, in a formerly trachoma hyperendemic region. Overall, about half of all study participants had scarring. Scarring and severity of scarring increased with age. However, compared to males, more females had any scarring and they had more severe scarring. Scarring prevalence and more severe scarring prevalence was higher in communities with higher active trachoma prevalence. Adjusting for age and community active trachoma prevalence, women still had more scarring and severe scarring compared to men. The data suggest that processes occur that lead to women preferentially progressing towards more severe scarring compared to men. Gaining a better understanding of what may be causing this increased progression, could lead to the identification of a potential modifiable risk factor. [ABSTRACT FROM AUTHOR]