| Summary: | Trachoma, caused by ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. The World Health Organization elimination strategy includes community mass treatment with oral antibiotics, education regarding hygiene and facial cleanliness and environmental improvements. Population-based trachoma prevalence surveys are essential to determine whether community interventions are required. Knowledge of risk factors associated with trachoma and C. trachomatis infection in a particular setting may help prioritise trachoma elimination activities. We conducted a trachoma prevalence survey to establish the prevalence of active (follicular and/or inflammatory) trachoma and C. trachomatis infection on the Bijagós Archipelago of Guinea Bissau. We also collected household risk factor data from survey participants. Active trachoma prevalence was 11% overall and 22% in children aged 1–9 years. C. trachomatis infection prevalence was 18% overall and 25% in children aged 1–9 years. Active trachoma and the presence of C. trachomatis infection were strongly correlated. Risk factors for disease and infection were similar. In this environment, measures of facial cleanliness (ocular and nasal discharge) and household-level risk factors relating to fly populations, hygiene behaviours and water usage are likely to be important in C. trachomatis transmission. This may have implications in the implementation of trachoma elimination activities.
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