Prevalence Of Active Trachoma Research Articles

Progress towards the elimination of trachoma in Nigeria.

Trachoma is targeted for elimination as a public health problem worldwide by 2030. In Nigeria, elimination activities are implemented at the local government area (LGA) level. They started in 2002 by conducting baseline population-based prevalence surveys (PBPSs), which continued in a systematic manner with engagement from the Global Trachoma Mapping Project in 2013, and subsequently Tropical Data. The results led to the development of Nigeria's first trachoma action plan and its subsequent revision with additional information. Following 449 baseline PBPSs, 122 LGAs had an active trachoma prevalence above the elimination threshold, requiring interventions, while 231 LGAs required community-based interventions for trichiasis management. By 2021, >34 million antibiotic treatments had been provided in 104 LGAs, with 89 LGAs eliminating active trachoma. Nationally, water and sanitation coverages increased by 3% and 18%, respectively, in 7y. Systematic trichiasis case finding and management were carried out in 231 LGAs, resulting in the management of 102527 people. Fifty-four LGAs decreased trichiasis prevalence unknown to the health system to <0.2% in persons ≥15y of age. Where this elimination prevalence threshold was reached, trichiasis services were transitioned to routine eye/healthcare systems. Such progress relied on strong leadership and coordination from the national trachoma program and tremendous support provided by partners. Attaining elimination of trachoma as a public health problem in Nigeria by 2030 is feasible if funding support is sustained.

High prevalence of active trachoma and associated factors among school-aged children in Southwest Ethiopia.

Active trachoma is a highly contagious ongoing stage of trachoma that predominantly occurs during childhood in an endemic area. This study assessed the prevalence and factors associated with active trachoma among school-aged children. A community-based analytical cross-sectional study was done from March 1st to June 30th, 2021, in Southwest Ethiopia's people's regional state. A total of 1292 school-aged children were surveyed. The quantitative data were collected using a pre-tested, structured interview-based questionnaire and observation check list. The World health organization (WHO) simplified trachoma grading system was used to assess stages of trachoma. In this study, the prevalence of active trachoma was 570(44.1%), 95% CI (41.4, 46.9). Also, age group 6-10; being female; flies at household (HH), flies on child's face, improved water source, improved sanitation, presence of ocular discharge, presence of nasal discharge, and unclean faces of the child were significantly associated with active trachoma. The very high prevalence of active trachoma in the study area is significantly associated with; age group 6-10, female gender, presence of flies in household and on child's face, presence of ocular and nasal discharge, unclean faces, improved water source, improved sanitation in the household. Thus, environmental sanitation and facial cleans trachoma elimination strategy should be intensified in the study area.

Baseline Prevalence of Trachoma in 13 Local Government Areas of Borno State, Nigeria

ABSTRACT Purpose We set out to determine the baseline prevalence of trachoma in 13 Local Government Areas (LGAs) of Borno State, Nigeria. Methods A population-based cross-sectional survey was conducted in each of 13 LGAs from 2017 to 2019, with the support of Tropical Data (TD). World Health Organization (WHO)-recommended protocols were used. With a probability-proportional-to-size systematic sampling method, 25 villages were selected per LGA in 2017 and 30 villages per LGA in 2019; in each village, 25 households were enrolled for 2017 surveys, while 30 were enrolled for 2019 surveys. All present, consenting residents aged ≥1 year were examined by TD-certified graders for trachomatous inflammation—follicular (TF) and trachomatous trichiasis (TT) using the WHO simplified grading scheme. Additionally, we collected data on household-level access to water, sanitation and hygiene (WASH) facilities. Results One LGA (Magumeri) had TF prevalence in 1–9-year-olds ≥10%; two other LGAs (Monguno and Kaga) had TF prevalence between 5.0% and 9.9%. The prevalence of TT unknown to the health system was ≥0.2% in six LGAs. The proportion of households with access to improved water sources ranged from 30% (Kwaya Kusar) to 95% (Monguno); household-level access to improved latrines was lowest in Shani (7%) and highest in Maiduguri (95%). Conclusion Active TT case finding and strengthening of TT surgical services are needed in six LGAs. Mass drug administration (MDA) of antibiotics is needed in three LGAs to reduce the prevalence of active trachoma to below elimination thresholds. The trachoma elimination programme should engage WASH agencies to augment access to improved WASH facilities.

Ten Years After Mass Treatment with Two Doses of Azithromycin for Trachoma Elimination in Rombo District – Kilimanjaro: Is Trachoma Still Eliminated? A Case Study of Kahe Mpya Sub-Village

Purpose: This study aimed at evaluating the long term impact of mass distribution of azithromycin in a community which had high prevalence of trachoma and documenting the current prevalence of trachoma. Material and Methods: All residents of Kahe Mpya were given chance to participate in this study, in turn 575 residents participated. The conjunctiva of each consenting resident was examined for clinical signs of trachoma using WHO trachoma grading scheme. Results: The overall prevalence of active trachoma was 4.7% versus 8.1% found 10 years back after the second dose of azithromycin and 3.4% during the elimination period in 2005. In children &lt; 10 years of age the prevalence of active trachoma was 3.3% versus 16.3% found after the second dose of azithromycin and 2.6% during elimination. Children &lt; 10 years of age carry the majority (70%) of the active disease. TS, TT and CO were 109(19%) cases, 7(1.2%) cases and 2(0.3%) cases respectively, and almost all of these cases were in the age group older than 30 years. Conclusion: The prevalence of trachoma fell dramatically during the interventions period and continued to be low ten years after mass azithromycin distribution. Trachoma is still eliminated in this community. Complications of trachoma (TT and TS) still continue to develop.

Prevalence and associated factors of active trachoma among 1-9 years of age children in Andabet district, northwest Ethiopia, 2023: A multi-level mixed-effect analysis.

Trachoma is the chief cause of preventable blindness worldwide and has been earmarked for elimination as a public health problem by 2030. Despite the five-year Surgery, Antibiotics, Facial cleanliness, and Environmental improvement (SAFE)-based interventions in the Andabet district, the prevalence of trachomatous follicular (TF) was 37%. With such a high prevalence of TF, the determinant factors were not revealed. Besides, there were no reports on the overall prevalence of active trachoma (i.e.TF and or trachomatous intense (TI)). To determine the prevalence and associated factors of active trachoma among 1-9 years of age children in the Andabet district. A community-based cross-sectional study was conducted among children aged under nine years from March 1-30, 2023 in Andabet district, Northwest Ethiopia. Multi-stage systematic random sampling was employed to reach 540 children. A multilevel mixed-effect logistic regression analysis was employed to assess factors associated with active trachoma. We fitted both random effect and fixed effect analysis. Finally, variables with p<0.05 in the multivariable multilevel analysis were claimed to be significantly associated with active trachoma. In this study, the overall prevalence of active trachoma was 35.37% (95% CI: 31.32%, 39.41%). The prevalence of TF and TI was 31.3% and 4.07% respectively. In the multilevel logistic regression analysis ocular discharge, fly-eye contact, latrine utilization, and source of water were significantly associated with the prevalence of active trachoma. In this study, the prevalence of active trachoma was much higher than the World Health Organization (WHO) threshold prevalence. Ocular discharge, fly-eye contact, latrine utilization, and source of water were independent determinants of active trachoma among children (1-9 years). Therefore, paying special attention to these high-risk groups could decrease the prevalence of a neglected hyperendemic disease, active trachoma.

Behavioral Responses for Face Cleanliness Message to Prevent Trachoma Among Mothers Having Children Age 1-9 Years Old, in Fogera District, Northwest Ethiopia: An Application of Extended Parallel Process Model.

Trachoma is an eye disease caused by bacteria called Chlamydia trachomatis. This infection causes papillary and/or follicular inflammation of the tarsal conjunctiva referred to as active trachoma. Active trachoma prevalence among 1 to 9 years old children is 27.2% in Fogera district (study area). Many people still require the implementation of the face cleanliness components of the SAFE strategy. Even if face cleanness is an important component to prevent trachoma, there is limited research done on this area. Therefore, the purpose of this study is to assess behavioral responses to face cleanliness messages to prevent trachoma among mothers having children aged 1 to 9 years old. A community-based cross-sectional study was conducted with the guidance of an extended parallel process model in Fogera District from December 01 to December 30, 2022. A multi-stage sampling technique was used to select 611 study participants. Interviewer administered questionnaire was used to collect the data. Bivariable and multivariable logistic regression analysis was done to identify predictors of behavioral responses using SPSS V.23 significant variables were declared by AOR at a 95% confidence interval and a p-value <0.05. Among the total participants, 292 (47.8%) were in danger control. Residence [AOR = 2.91; 95% CI: (1.44-3.86)], marital status [AOR = 0.79; 95% CI: (0.667-0.939)], level of education [AOR = 2.74; 95% CI: (1.546-3.65)], family size [AOR = 0.57; 95% CI: (0.453-0.867)], round trip to collect water [AOR = 0.79; 95% CI: (0.423-0.878)], having information about face washing [AOR = 3.79; 95% CI: (2.661-5.952)], Source of an information health facility [AOR = 2.76; 95% CI: (1.645-4.965)], school [AOR = 3.68; 95% CI: (1.648-7.530)], health extension workers [AOR = 3.96; 95% CI: (2.928-6.752)], Women development army [AOR = 2.809; 95% CI: (1.681-4.962)], knowledge [AOR = 2.065; 95% CI: (1.325-4.427)] self-esteem [AOR = 1.013; 95% CI: (1.001-1.025)], self-control [AOR = 1.132; 95%CI: (1.04-1.24)], and future orientation [AOR = 2.16; 95% CI: (1.345-4.524)] were found to be statistically significant predictors of behavioral response. Less than half of the participants were in the danger control response. Residence, marital status, level of education, family size, face-washing information, source of information, knowledge, self-esteem, self-control, and future orientation were independent predictors of face cleanliness. Strategies of face cleanliness messages should give high attention to perceived efficacy with consideration of perceived threat.

Active Trachoma Prevalence and Related Variables among Children in a Pastoralist Community in Southern Ethiopia in 2021: A Community-Based Cross-Sectional Study.

An estimated 30% of trachoma burden is borne by Ethiopia. Data on the prevalence of active trachoma and related factors in a pastoralist population are currently lacking. Additionally, no research has been conducted in the Oromia, Guji Zone of the Liben District. A community-based cross-sectional study was conducted among 538 children 1-9 years old in the pastoralist community of the Liben District from March 1 to April 30, 2021. A multistage systematic sampling method was applied to choose the sample. A structured questionnaire and WHO's trachoma grading scheme were used to identify active trachoma. Bivariate and multivariable logistic regression models were fitted to determine associated factors. An adjusted odds ratio with 95% confidence interval was calculated to decide the level of significance: 157 (29.2%) (95% CI: 24.9, 33.1) of children had clinical signs of active trachoma, 103 (66%) had trachomatous follicles, 41 (26%) had trachomatous intense, and 13 (8%) had both. There was an independent relationship between active trachoma and open defecation (adjusted odds ratio [AOR]: 2.75; 95% CI: 1.24, 6.09), defecating outside close to a house (AOR: 2.5; 95% CI: 1.07, 6.08), not having a latrine (AOR: 3.70; 95% CI: 1.60, 8.60), children who did not wash their faces with soap (AOR: 1.85; 95% CI: 1.10, 3.07), and being in a widowed household (AOR: 3.26; 95% CI: 1.57, 6.63). The study's findings revealed that about one-third of the children had clinical signs of trachoma. Research indicates that trachoma is a major concern for children in rural communities. Therefore, attention to trachoma control with antibiotics, facial hygiene, and environmental sanitation is strongly encouraged.

Epidemiology of Trachoma among Children in a War Zone: Prevalence and Risk Factors for Trachoma in Rural Areas During the Siege and War in Yemen

Background and Aims: Trachoma has historical and continuing significance as a major cause of vision loss, with an essentially disproportionate impact on the poorest individuals in the poorest communities as in Yemen now under siege and war especially in rural areas. There is no awareness among local and national governments of this disease as a public health problem of top priority in Yemen. However, there is no evidence or no survey/research data or document regarding the prevalence of trachoma in the distract of Bani Matter, in Sana’a Governorate, Yemen. Therefore, we conducted a study to assess the prevalence of active trachoma and associated factors in this rural area.

To eliminate trachoma: Azithromycin mass drug administration coverage and associated factors among adults in Goro district, Southeast Ethiopia.

Globally, although effective prevention strategies and treatment are available, trachoma remains the major cause of infectious loss of sight. Trachoma is a predominant neglected disease in Ethiopia, and there is a 40.4% prevalence of active trachoma in the Goro district, Southeast Ethiopia. World Health Organization (WHO) recommends azithromycin mass treatment of at least 80% coverage to eliminate trachoma, even though the coverage of azithromycin mass treatment has not been studied yet in depth. Thus, this study aimed to assess the coverage and factors influencing azithromycin mass treatment uptake among adults in Goro district, Southeast Ethiopia. A community-based cross-sectional study was conducted from April 1st to April 30th, 2021 among all adults aged 15 years old and above. The multistage sampling technique was used to select 593 study respondents. A structured interviewer-administered questionnaire was used. Data were entered into Epi-Data version 3.1 and analyzed using SPSS version 23.0 software. Descriptive analysis and binary logistic regression analysis were used to analyze the data. Adjusted odds ratios (AOR) along with a 95% confidence interval (CI) and p-value < 0.05 were used to declare the strength and the significance of association, respectively. Five hundred and seventy eight study participants with a 97% response rate were included. The proportion of azithromycin mass drug administration coverage was found to be 75.80%; 95% CI: (72%-79%) in this study. Having better knowledge about trachoma (AOR = 2.36; 95% CI: 1.19-4.70), having better knowledge about azithromycin mass treatment (AOR = 4.19; 95% CI: 2.19-7.98), being educated (AOR = 7.20; 95% CI: 1.02-51.09), a campaign conducted at the quiet time (off-harvesting/planting season) (AOR = 6.23; 95% CI: 3.23-11.98), heard about the serious adverse effect from others (AOR = 0.25; 95% CI: 0.10-0.59) and being a volunteer to take azithromycin in the next campaign (AOR = 5.46; 95% CI: 2.76-10.79) were significantly associated with azithromycin mass drug administration coverage. The proportion of azithromycin mass treatment coverage of this study was lower than the WHO minimum target coverage. Thus, strengthening awareness, enhancing azithromycin mass trachoma treatment messages, and conducting campaigns off-season outside of harvesting and planting time should be prioritized in the future to meet the 2030 Sustainable Development Goal (SDG) target.

Prevalence of active trachoma and its associated factors among 1-9 years of age children from model and non-model kebeles in Dangila district, northwest Ethiopia.

BackgroundTrachoma is the leading infectious disease that leads to blindness worldwide, especially in developing countries. Though Ethiopia had targeted a trachoma elimination program by 2020, the problem worsens, particularly in the Amhara Region. Even though sustained intervention measures are undertaken across the region, it is unclear why trachoma is still a significant public health problem. So, this study assessed the prevalence of active trachoma and associated factors among 1–9 years of age children from model and non-model kebeles in Dangila district Amhara Region, Northwest Ethiopia.MethodsA community-based comparative cross-sectional study was conducted from 20th September 2019 to 29th October 2019. A multistage stratified random sampling technique was used to reach 704 children from model and non-model kebeles. Samples were allocated proportionally to model and non-model kebeles. A structured and pretested data collection tool and observational checklist was used to manage the necessary data. Data were coded and entered in Epidata version 4.6, and further analysis was done using SPSS version 20 software. Bivariable and multivariable logistic regression analysis was employed to identify factors associated with active trachoma. Adjusted Odds Ratios (AOR), p-value, and respected Confidence Interval (CI) were used to report the findings.ResultsSeven hundred four children were included in this study, with a response rate of 97.8%. The overall prevalence of active trachoma was 6% (95% CI: 4.5, 8.1). The prevalence of active trachoma among non-model and model Kebele was not significantly different. Still, the prevalence of active trachoma among children from model Kebele were [4.5%, (95% CI: 2.4%, 7.1%)] relatively lower compared with non-model kebeles, [7.6%, 95% CI: (4.9%, 10.9%)]. Moreover, not using latrine (AOR = 4.29, 95% CI: 1.96, 9.34), fly-eye contact (AOR = 2.59, 95% CI: 1.11, 6.03), presence of sleep in eyes (AOR = 2.46, 95% CI: 1.10, 5.47), presence of ocular discharge (AOR = 2.79, 95% CI: 1.30, 6.00), presence of nasal discharges (AOR = 2.67, 95% CI: 1.21, 5.90) and washing faces with soap (AOR = 0.22, 95% CI: 0.07, 0.69) were found significantly associated with the prevalence of active trachoma among children 1–9 years old.ConclusionsThe prevalence of active trachoma in the model and non-model kebeles was high and did not show a statistical difference. Attention to be given to latrine utilization, washing face with soap, and other personal hygiene activities.

Prevalence of active trachoma and associated factors among school age children in Debre Tabor Town, Northwest Ethiopia, 2019: a community based cross-sectional study

BackgroundTrachoma is an infectious eye disease caused by Chlamydial trachomatis. It is a major health problem in poor nations, notably in Sub-Saharan Africa. Despite the severity of the problem, there was a scarcity of data on trachoma prevalence and associated factors among school-aged children in Debre Tabor town following SAFE and MDA.ObjectivesThe goal of this study was to determine the prevalence of active trachoma and its associated factors among school-aged children in Debre Tabor, Northwest Ethiopia, in 2019.MethodsA community-based cross-sectional study was used among school-aged children. Structured interview questionnaires, an observational checklist, and a physical examination were used to collect data from study participants who were chosen using a systematic random sampling procedure. IBM SPSS 20 was used to enter data, which was then transferred to IBM SPSS 20 for bivariate and multivariable logistic regression analysis.ResultA total of 394 children aged 5–15 had been screened and took part in the study, with 9.9% (95% CI: 6.9, 12.7) testing positive for active trachoma. Having an unimproved larine type (AOR = 5.18; 95%CI: 1.96, 13.69), improper solid waste disposal (AOR = 3.026; 95%CI: 1.17, 7.8), family size greater than four (AOR = 3.4; 95%CI: 1.22, 9.49), not using soap for face washing (AOR = 4.48; 95%CI: 1.46, 13.72) and an unclean face of the child during examination (AOR = 23.93; 95%CI: 8.25, 69.38) were found to be significant predictors of active trachoma.ConclusionActive trachoma among school-age children was high compared to the WHO’s definition of trachoma as a public health problem. A family size of four, poor solid waste management, an unimproved type of latrine, an unclean child's face, and not using soap when washing one's face were all significant predictors of active trachoma. Promotion of behavioral determinants through health education programs like keeping facial cleanliness by washing their child’s face with soap, managing solid waste properly, and installing improved latrines to reduce active trachoma needs to be in place.

Interventions for Neglected Tropical Diseases Among Children and Adolescents: A Meta-analysis.

Neglected tropical diseases (NTDs) are a group of communicable diseases affecting the poorest populations around the world. To assess the effectiveness of interventions, including mass drug administration (MDA), water, sanitation, and hygiene (WASH), vector control, health education, and micronutrients supplementation, for NTDs among children and adolescents. We conducted a literature search on the Cochrane Controlled Trials Register, Medline, and other databases until December 2020. We included randomized controlled trials and quasi-experimental studies conducted among children and adolescents. Two authors independently screened studies for relevance. Two authors independently extracted data, assessed the risk of bias, performed metaanalysis, and rated the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation. We included 155 studies (231 articles) involving 262 299 participants. For soil-transmitted helminthiasis, MDA may reduce the prevalence of Ascaris, Trichuris, and hookworm by 58%, 36%, and 57%, respectively. We are uncertain of the effect of health education, WASH, and iron supplementation on soil-transmitted helminthiasis prevalence. For Schistosomiasis, health education probably reduces the intensity and prevalence of S. mansoni, whereas micronutrient supplementation may reduce anemia prevalence and the infection intensity of S. hematobium compared with no supplementation. We are uncertain of the effect of MDA and vector control on Schistosomiasis outcomes. For trachoma, health education probably reduces the prevalence of active Trachoma, whereas we are uncertain of the effect of MDA, WASH, and vector control on Trachoma outcomes. There is limited data on the effectiveness of interventions for NTDs targeting children and adolescents. Future studies are needed to evaluate the relative effectiveness and cost-effectiveness of various interventions specifically targeting children and adolescents.

Prevalence of active trachoma and associated factors among children 1-9 years old at Arsi Negele Town, West Arsi Zone, Oromia Regional State, Southern Ethiopia.

Trachoma is a public health issue in more than 50 nations worldwide, mainly in Sub-Saharan Africa, where hundreds of millions of people are considered blind. Ethiopia is projected to have 30% of the global active trachoma burden. The frequency of Trachoma Folliculitis in children aged 1 to 9 years old is 30% in the Oromia Region. Therefore, the aim of this study was to assess the prevalence of active trachoma and associated variables among children aged 1 to 9 years old in Arsi Negele Town, West Arsi Zone, Oromia Regional State, Southern Ethiopia, December 24-26, 2019. A community-based cross-sectional study was conducted in the Arsi Negele town community on December 24-26, 2019. A total of 178 study volunteers were recruited using a single population proportion formula and assigned to families in the town's three kebeles in proportion. A simple random selection procedure was used to choose study participants from the identified households. Madda Walabu University provided ethical approval, and different government structures provided letters of permission. Pre-tested structured questionnaires and binocular loupes X 2.5 were used to collect data from either mothers or fathers of eligible children for eye examination; torches with bottles of alcohol were used to gather data from either mothers or fathers of eligible children for eye examination. For analysis, data was entered into (IBM, SPSS) version 22. To assess factors associated with active trachoma, bivariate and multivariable logistic regressions were used. The crude and adjusted odds ratios with 95% confidence intervals were calculated to investigate the degree of association between the independent variables and active trachoma. Multivariate logistic regression was used to find connections between dependent and independent variables with a p≤ 0.05 confidence levels and a 95% confidence interval. The prevalence of active trachoma was determined to be 21.91% TF among 178 children aged 1 to 9 years. Flies on children's faces (AOR = 3.427; 95 percent CI: 1.432-8.171), unclean children's faces (AOR = 3.99; 95 percent CI: 1.427-11.158), face washing habits (AOR = 3.064; 95 percent CI: 1.273-7.373), and not using soap while face washing (AOR = 4.564; 95 percent CI 1.561-13.342) were found to be statistically significant associated factors with the prevalence of active trachoma. The prevalence of active trachoma was found to be relatively high. Face washing practices and the lack of soap use while washing faces were found as associated factors requiring optimal interventions to prevent trachoma infection among children aged 1-9 years in Arsi Negele town.

Risk factors for the progression of trachomatous scarring in a cohort of women in a trachoma low endemic district in Tanzania.

BackgroundTrachoma, a chronic conjunctivitis caused by Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. Trachoma has been targeted for elimination as a public health problem which includes reducing trachomatous inflammation—follicular prevalence in children and reducing trachomatous trichiasis prevalence in adults. The rate of development of trachomatous trichiasis, the potentially blinding late-stage trachoma sequelae, depends on the rate of trachomatous scarring development and progression. Few studies to date have evaluated the progression of trachomatous scarring in communities that have recently transitioned to a low trachomatous inflammation—follicular prevalence.Methodology/Principal findingsWomen aged 15 and older were randomly selected from households in 48 communities within Kongwa district, Tanzania and followed over 3.5 years for this longitudinal study. Trachomatous inflammation—follicular prevalence was 5% at baseline and at follow-up in children aged 1–9 in Kongwa, Tanzania. 1018 women aged 15 and older had trachomatous scarring at baseline and were at risk for trachomatous scarring progression; 691 (68%) completed follow-up assessments. Photographs of the upper tarsal conjunctiva were obtained at baseline and follow-up and graded for trachomatous scarring using a previously published four-step severity scale. The overall cumulative 3.5-year progression rate of scarring was 35.3% (95% CI 31.6–39.1). The odds of TS progression increased with an increase in age in women younger than 50, (OR 1.03, 95% CI 1.01–1.05, p = 0.005) as well as an increase in the household poverty index (OR 1.29, 95% CI 1.13–1.48, p = 0.0002).Conclusions/SignificanceThe 3.5-year progression of scarring among women in Kongwa, a formerly hyperendemic now turned hypoendemic district in central Tanzania, was high despite a low active trachoma prevalence. This suggests that the drivers of scarring progression are likely not related to on-going trachoma transmission in this district.

Active trachoma prevalence and its associated factors among children aged 1-9 years in rural residents of Lare District, Southwest Ethiopia

To determine the prevalence of active trachoma and its associated factors among children in Lare District, Southwest Ethiopia, 2019. A community-based cross-sectional study was conducted. A total of 620 participants were recruited using a multi-stage sampling technique. A structured questionnaire, torch, and magnifying loupes were used for data collection. The data was entered into epidemiological information and exported to statistical package for social science version 20 for analysis. The bi-variable and multivariable Logistic regression analysis model was fitted to identify factors associated with active trachoma. Odds ratio with a 95%CI was used to show the direction and strength of association between independent and outcome variables. A total of 610 children participated in this study with a response rate of 98.39%. The prevalence of active trachoma was 132 (21.60%; 95%CI: 18.40-24.70). Family size being 6-9 (AOR=2.34; 95%CI: 1.14-5.02), presence of more than two preschool children in a house (AOR=2.04; 95%CI: 1.12-3.70), open field waste disposal system (AOR=2.62; 95%CI: 1.00-6.80) and type of latrine being uncovered (AOR=4.12; 95%CI: 2.00-8.51) were positively associated with active trachoma. On the other side, water consumption being 40-60 liters per day was a protective factor for active trachoma. The prevalence of active trachoma is high among children aged 1-9y in Lare District. Uncovered latrine, open field waste disposal system, family sizes of 6-9, and the presence of more than two preschool children in a house are associated with the occurrence of active trachoma. On the other side, water consumption of 40-60 liters is a protective factor.

Status of active trachoma infection among school children who live in villages of open field defecation: a comparative cross-sectional study

BackgroundAlthough many efforts are made by different stakeholders, magnitude of active trachoma remains high among children in Ethiopia. Open field defecation was found to be the main source of active trachoma. However, comparative information on the effect of open field defecation and non-open field defecation on active trachoma is scarce in Ethiopia.MethodsComparative community based cross-sectional study was conducted from June 1–30, 2019 in Boricha and Dale districts to assess prevalence of active trachoma among primary school children. We have selected four primary schools purposively from two districts in Sidama. Study participants were selected by using simpe random sampling method. Data were collected through face to face interview, direct observation and ophthalmic examination. Logistic regression analysis was conducted to assess factors associated with active trachoma infection among primary school children. Adjusted Odds Ratios with 95% confidence interval and p-value less than 0.05 were computed to determine the level of significance.ResultFrom the total of 746 study participants, only 701 study participants gave full response for interview questions making a response rate of 94%. The overall prevalence of active trachoma infection was 17.5% (95% CI, 14.1–20.8) among primary school students. Specifically, prevalence of active trachoma infection was 67.5% among children who lived in open field defecation villages, but it was 88.5% among school children who live in Non-ODF Kebeles. Factors like: Living in open field defecation Kebeles (AOR = 2.52, 95% CI, 1.5–4.1), having ocular discharge (AOR = 5.715, 95% CI, 3.4–9.4), having nasal discharge (AOR = 1.9, 95% CI, 1.06–3.39), and fly on the face (AOR = 6.47, 95% CI, 3.36–12.44) of children were positively associated with active trachoma infection. However, finger cleanness (AOR = 0.43, 95% CI, 0.21–0.9) was protective factor against active trachoma infection in this study.ConclusionSignificant variation in prevalence of active trachoma infection among school children between open filed and non-open field defecation Kebeles was observed. Surprisingly, the prevalence in open field defecation was significantly lower than non-open field defecation. Hence, this indicates active trachoma infection highly depends on the hand hygiene than environmental sanitation. Educational campaign of hand hygiene should be enhanced in the community for school students.

The impact of access to water supply and sanitation on the prevalence of active trachoma in Ethiopia: A systematic review and meta-analysis.

BackgroundTrachoma is a worldwide infectious disease causing blindness. Trachoma continued as a public health problem in Ethiopia due to a lack of sanitation and inadequate prevention strategies. This study aimed to identify the impact of water supply and sanitation intervention on preventing active trachoma among children.MethodsSystematic literature searches were performed from 4 international databases. The search involved articles published from January 1995 up to March 2019. The Cochran Q and I2 statistical tests were used to check heterogeneity among the studies. A random-effect meta-analysis was employed to determine the pooled estimates with a 95% confidence interval (CI). Data analysis was performed using the CMA V.3 and RevMan 5 software program, and the result of the systematic review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.FindingsOut of 211 studies screened for the analysis, only 29 studies were finally included in this systematic review and meta-analysis. The result revealed factors that are significantly associated with increased odds of active trachoma. Accordingly, households with no access to toilet facilities (odds ratio [OR]: 2.04, 95% CI: 1.75–2.38), no access to improved water (OR: 1.58, 95% CI: 1.27–1.96), and do not practice regular face washing for children (OR: 4.19, 95% CI: 3.02–5.81) have shown increased odds of active trachoma. Besides, the results show a higher prevalence of active trachoma among children who did not wash their faces with soap and frequently.ConclusionsThe study found strong evidence that lack of access to water, sanitation, and hygiene (WASH) was associated with increased prevalence of active trachoma among children. Therefore, a comprehensive and partnership-oriented program is needed to tackle the problem, but further study will be required to strengthen its implementation.

Prevalence and Factors Associated with Active Trachoma among Children 1-9 years of Age in the Catchment Population of Tora Primary Hospital, Silte zone, Southern Ethiopia, 2020

Background: Trachoma is the foremost cause of wide-reaching, preventable blindness. According to the World Health Organization report, nearly 1.3 million human beings are sightless due to trachoma, whereas about eighty-four million are hurt from active trachoma. A survey revealed that the countrywide prevalence of active trachoma among children aged 1–9 years in Ethiopia was 40.1%. Limited data are present regarding the study area; therefore, the aim of this study was to determine the magnitude and factors associated with active trachoma among 1-9 years of children in the catchment population of Tora Primary Hospital, South Ethiopia. Methods: A community-based cross-sectional study was performed on 589 children in a study place from February 15 to March 13, 2020. We used Epi data program version 3.1 and SPSS version 20 for data entry and analysis, respectively. Results: The overall occurrence of active trachoma in the catchment was 29.4% [CI=25.7, 33.12]. Of these cases, the trachomatous follicle (TF) 90.9%, TI (4.8%), and combination of TF/TI (4.2%) were found. Households’ educational status, frequency of face washing, knowledge about trachoma, source of water for washing purposes, and garbage disposal system were the independently associated factors of active trachoma. Conclusion: In this study area, the occurrence of active trachoma was high. Hence, it needs instant attention, such as constructing a responsiveness application in the community, inspiring children and parents to try out face washing, improving knowledge about trachoma and appropriate excreta disposal.

Stopping azithromycin mass drug administration for trachoma: A systematic review.

The World Health Organization (WHO) recommends continuing azithromycin mass drug administration (MDA) for trachoma until endemic regions drop below 5% prevalence of active trachoma in children aged 1–9 years. Azithromycin targets the ocular strains of Chlamydia trachomatis that cause trachoma. Regions with low prevalence of active trachoma may have little if any ocular chlamydia, and, thus, may not benefit from azithromycin treatment. Understanding what happens to active trachoma and ocular chlamydia prevalence after stopping azithromycin MDA may improve future treatment decisions. We systematically reviewed published evidence for community prevalence of both active trachoma and ocular chlamydia after cessation of azithromycin distribution. We searched electronic databases for all peer-reviewed studies published before May 2020 that included at least 2 post-MDA surveillance surveys of ocular chlamydia and/or the active trachoma marker, trachomatous inflammation–follicular (TF) prevalence. We assessed trends in the prevalence of both indicators over time after stopping azithromycin MDA. Of 140 identified studies, 21 met inclusion criteria and were used for qualitative synthesis. Post-MDA, we found a gradual increase in ocular chlamydia infection prevalence over time, while TF prevalence generally gradually declined. Ocular chlamydia infection may be a better measurement tool compared to TF for detecting trachoma recrudescence in communities after stopping azithromycin MDA. These findings may guide future trachoma treatment and surveillance efforts.

Low prevalence of active trachoma and associated factors among children aged 1\u20139\u2009years in rural communities of Metema District, Northwest Ethiopia: a community based cross-sectional study

BackgroundTrachoma is an infectious disease of the eye caused by Chlamydia trachomatis and transmitted via contact with eye discharge from infected persons and leading to blindness worldwide. Children less than 9 years of age affected more seriously. The disease is common where access to water and sanitation are limited.ObjectiveTo determine the prevalence of active trachoma and associated factors among children aged 1–9 years in rural communities of Metema District, West Gondar Zone, Northwest Ethiopia.MethodA community based cross-sectional study design was used to collect data from 792 children aged 1–9 years old in Metema district from April to May 2018. Multistage sampling technique was used to select the study participants. Pretested interviewer-administered structured questionnaire and eye examination using binocular loupe to differentiate trachoma cases was the data collection methods and tools. The bivariable and multivariable binary logistic regression model was employed for analysis. P-value < 0.05 was considered to declare statistical significance.ResultsA total of 752 children aged l-9 years were enrolled in this study with response rate of 94.9%. The overall prevalence of active trachoma among the study participants was 11.8% (95% CI, 9.5–13.9). Unprotected source of water (AOR = 4.7; 95% CI: 2.5–8.9), lower household water consumption (AOR = 2.8; 95% CI: 1.3–6.0), improper latrine utilization (AOR = 3.2; 95% CI: 1.5–6.7), and frequency of face washing once per day (AOR = 5.3; 95% CI: 1.2–26.6) were the factors significantly associated with active trachoma.ConclusionThe current study revealed a lower overall prevalence of active trachoma (11.8%) than the WHO threshold prevalence (20%) used to declare it as a severe public health problem. All residents and health professional should collaborate on trachoma prevention by implementing the WHO SAFE strategy- surgery for trichiasis, antibiotics, facial cleanliness and environmental improvement for further trachoma elimination.