PT  - JOURNAL ARTICLE
AU  - Rebecca M Flueckiger
AU  - Paul Courtright
AU  - Mariamo Abdala
AU  - Amza Abdou
AU  - Zaid Abdulnafea
AU  - Tawfik K Al-Khatib
AU  - Khaled Amer
AU  - Olga Nelson Amiel
AU  - Sossinou Awoussi
AU  - Ana Bakhtiari
AU  - Wilfried Batcho
AU  - Assumpta Lucienne Bella
AU  - Kamal Hashim Bennawi
AU  - Simon J Brooker
AU  - Brian K Chu
AU  - Michael Dejene
AU  - Djore Dezoumbe
AU  - Balgesa Elkheir Elshafie
AU  - Aba Ange Elvis
AU  - Djouma Nembot Fabrice
AU  - Fatma Juma Omar
AU  - Missamou François
AU  - Drabo François
AU  - Jambi Garap
AU  - Michael Gichangi
AU  - André Goepogui
AU  - Jaouad Hammou
AU  - Boubacar Kadri
AU  - George Kabona
AU  - Martin Kabore
AU  - Khumbo Kalua
AU  - Mathias Kamugisha
AU  - Biruck Kebede
AU  - Kaba Keita
AU  - Asad Aslam Khan
AU  - Genet Kiflu
AU  - Garae Mackline
AU  - Colin Macleod
AU  - Portia Manangazira
AU  - Michael P Masika
AU  - Marilia Massangaie
AU  - Taka Fira Mduluza
AU  - Nabicassa Meno
AU  - Nicholas Midzi
AU  - Abdallahi Ould Minnih
AU  - Sailesh Mishra
AU  - Caleb Mpyet
AU  - Nicholas Muraguri
AU  - Upendo Mwingira
AU  - Beido Nassirou
AU  - Jean Ndjemba
AU  - Cece Nieba
AU  - Jeremiah Ngondi
AU  - Nicholas Olobio
AU  - Alex Pavluck
AU  - Isaac Phiri
AU  - Rachel Pullan
AU  - Babar Qureshi
AU  - Boubacar Sarr
AU  - Do Seiha
AU  - Gloria Marina Serrano Chávez
AU  - Shekhar Sharma
AU  - Siphetthavong Sisaleumsak
AU  - Khamphoua Southisombath
AU  - Gretchen Stevens
AU  - Andeberhan Tesfazion Woldendrias
AU  - Lamine Traoré
AU  - Patrick Turyaguma
AU  - Rebecca Willis
AU  - Georges Yaya
AU  - Souleymane Yeo
AU  - Francisco Zambroni
AU  - Jialiang Zhao
AU  - Anthony W Solomon
TI  - The global burden of trichiasis in 2016
AID  - 10.1101/348995
DP  - 2018 Jan 01
TA  - bioRxiv
PG  - 348995
4099  - http://biorxiv.org/content/early/2018/06/22/348995.short
4100  - http://biorxiv.org/content/early/2018/06/22/348995.full
AB  - Background Trichiasis is present when one or more eyelashes touches the eye. Uncorrected, it can cause blindness. Accurate estimates of numbers affected, and their geographical distribution, help guide resource allocation.Methods We obtained district-level trichiasis prevalence estimates for 44 endemic and previously-endemic countries. We used (1) the most recent data for a district, if more than one estimate was available; (2) age- and sex-standardized corrections of historic estimates, where raw data were available; (3) historic estimates adjusted using a mean adjustment factor for districts where raw data were unavailable; and (4) expert assessment of available data for districts for which no prevalence estimates were available.Findings Internally age- and sex-standardized data represented 1,355 districts and contributed 662 thousand cases (95% confidence interval [CI] 324 thousand-1.1 million) to the global total. age- and sex-standardized district-level prevalence estimates differed from raw estimates by a mean factor of 0.45 (range 0.03-2.28). Previously non-standardized estimates for 398 districts, adjusted by ×0.45, contributed a further 411 thousand cases (95% CI 283-557 thousand). Eight countries retained previous estimates, contributing 848 thousand cases (95% CI 225 thousand-1.7 million). New expert assessments in 14 countries contributed 862 thousand cases (95% CI 228 thousand-1.7 million). The global trichiasis burden in 2016 was 2.8 million cases (95% CI 1.1-5.2 million).Interpretation The 2016 estimate is lower than previous estimates, probably due to more and better data; scale-up of trichiasis management services; and reductions in incidence due to lower active trachoma prevalence.Author Summary As an individual with trichiasis blinks, the eyelashes abrade the cornea, which can lead to corneal opacity and blindness. Through high quality surgery, which involves correcting the position of the in-turned eyelid, it is possible to reduce the number of people with trichiasis. An accurate estimate of the number of persons with trichiasis and their geographical distribution are needed in order to effectively align resources for surgery and other necessary services. We obtained district-level trichiasis prevalence estimates for 44 endemic and previously-endemic countries. We used the most recently available data and expert assessments to estimate the global burden of trichiasis. We estimated that in 2016 the global burden was 2.8 million cases (95% CI 1.1-5.2 million).The 2016 estimate is lower than previous estimates, probably due to more and better data; scale-up of trichiasis management services; and reductions in incidence due to lower active trachoma prevalence.