ArticleTransactions of the Royal Society of Tropical Medicine and Hygiene2023
Photographic grading for trachoma diagnosis within trachoma impact surveys in Amhara region, Ethiopia.
Article in Transactions of the Royal Society of Tropical Medicine and Hygiene, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 4 citations in OpenAlex.
- Comparison of Methods for Assessing Chlamydia trachomatis Transmission Intensity: A Systematic Review.The American journal of tropical medicine and hygiene · 2026Article
- Training Data Recorders with a Manual to Take High-Quality Trachoma Photographs in South Sudan.The American journal of tropical medicine and hygiene · 2026Article
- Identifying Borderline Trachoma Grades Using a Three-Latent Class Model.The American journal of tropical medicine and hygiene · 2025Article
- Trichiasis with and without tarsal conjunctival scarring: A multi-country observational study.PLOS global public health · 2025Article
- Severity of Trachomatous Scarring among Adults in Trachoma-Endemic Amhara Region of Ethiopia.The American journal of tropical medicine and hygiene · 2024Article
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Authors and funding
25 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAs countries reach the trachoma elimination threshold and cases of trachomatous inflammation follicular (TF) become rare, it becomes difficult to train survey graders to recognize clinical signs. We assess the use of photography as a grading tool, the efficiency of an in-country grading center and the comparability of field and photographic grading.
methodsDuring January-February 2017 surveys in Amhara, Ethiopia, field graders assessed TF, trachomatous inflammation intense (TI) and trachomatous scarring (TS). Photographs were taken from each conjunctiva and later graded at the Gondar Grading Center (GGC) at the University of Gondar in Amhara. Two trained ophthalmology residents graded each set of photographs and a third grader provided an adjudicating grade when needed.
resultsA total of 4953 photographs of 2477 conjunctivae from 1241 participants in 10 communities were graded over 5 d at the GGC. Six examined participants were not photographed. Agreement between field and photographic grades were for TF: percent agreement (PA) 96.7%, κ=0.70 (95% confidence interval [CI] 0.64 to 0.77; for TI: PA 94.7%, κ=0.32 (95% CI 0.20 to 0.43); and for TS: PA 83.5%, κ=0.22 (95% CI 0.15 to 0.29).
conclusionsConjunctival photography may be a solution for programs near the elimination threshold where there are few available community cases for training field graders.
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