Risk Factors For Active Trachoma Research Articles

Prevalence and risk factors of active trachoma among primary school children of Amhara Region, Northwest Ethiopia.

Purpose:Trachoma is the leading infectious cause of blindness in the world. It is caused by conjunctival infection with the bacterium Chlamydia trachomatis. The objective of this study was to determine the prevalence and risk factors of active trachoma among primary school children in Amhara region, Ethiopia.Methods:A cross-sectional study was conducted from April to May 2018. Data on sociodemographic and health characteristics of a child were collected using a structured questionnaire and eye examination for this study. Bivariate and multiple logistic regression statistical analyses were used to determine the prevalence and risk factors of active trachoma among primary school children living in Amhara region, Northwest Ethiopia.Results:The prevalence of active trachoma among primary school children living in Amhara region was 10.3% in this study. The results of multiple logistic regression analysis revealed that children who wash their face at least two times per day (AOR = 0.37, 95% CI: 0.14–0.97), children with no flies on their face (AOR = 0.12, 95% CI: 0.10–0.30) had significantly lower risk of being infected by trachoma and children of households who spend 30 min to 1 h to fetch water (AOR = 10.02, 95% CI: 1.10–93.53) had significantly higher risk of being infected by trachoma in the study area.Conclusion:The result of this study showed that risk factors: frequency of face washing per day, presence of flies on child's face during interview, and time required to fetch water for the household were found to be significantly associated with trachoma. Therefore, the study recommends that any concerned bodies directed at prevention and control of trachoma among primary school children living in Amhara region should give special attention to these factors. Implementing the World Health Organization (WHO) endorsed SAFE (Surgery, Antibiotics, Facial cleanliness, Environmental improvement) strategy was recommended for the effective prevention and control of trachoma in the study area since the prevalence of active trachoma, 10.3% was higher than the WHO recommended thresholds (>10% prevalence).

Prevalence and Associated Risk Factors of Active Trachoma Among Primary School Children at Atayetown, Efratanagidim Woreda, North Shoa Zone, Ethiopia, 2019

Prevalence and Associated Risk Factors of Active Trachoma Among Primary School Children at Atayetown, Efratanagidim Woreda, North Shoa Zone, Ethiopia, 2019

Application of Ordinal Logistic Regression Analysis in Determining Risk Factors of Active Trachoma among Rural Children of Aged 1-9 Years Old in Kaffa Zone, South West Ethiopia

Application of Ordinal Logistic Regression Analysis in Determining Risk Factors of Active Trachoma among Rural Children of Aged 1-9 Years Old in Kaffa Zone, South West Ethiopia

The burden of and risk factors for active trachoma in the North and South Wollo Zones of Amhara Region, Ethiopia: a cross-sectional study

BackgroundTrachoma is a disease of the eye, caused by the bacteria Chlamydia trachomatis, which can lead to blindness if left untreated. Ethiopia is one of the most trachoma-affected countries in the world. The objective of this study was to determine the prevalence of and associated risk factors for active trachoma among children in selected woredas of North and South Wollo Zones in Amhara Region, Ethiopia.MethodsThis study was a community-based, cross-sectional study, which was conducted from October to December 2014 among children aged 1–8. A four-stage random cluster sampling technique was employed to select the study areas and participants. From each selected household, one child was clinically assessed for active trachoma. A structured questionnaire was used to collect sociodemographic, behavioral, and clinical data. Multivariate logistic regression analysis was used to analyze the association between predictor variables and active trachoma.ResultsThe overall prevalence of active trachoma among 1358 children was found to be 21.6% (95% CI: 19.4–23.8%). When analyzed by the presence or absence of individual WHO simplified system signs of active trachoma, trachomatous inflammation-follicular cases constituted18% (95% CI: 15.9–20.2%), while 4.7% (95% CI: 3.6–5.8%) were trachomatous inflammation-intense cases. Ocular discharge (aOR = 5.2; 95% CI: 3.3–8.2), nasal discharge (aOR = 1.8; 95% CI: 1.2–2.7), time taken to fetch water (aOR = 0.02; 95% CI: 0.01–0.05), frequency of hand and face washing (aOR = 4.4; 95% CI: 1.1–17.8), and access to a latrine (aOR = 0.006; 95% CI: 0.001–0.030) were found to be independently associated with the presence of active trachoma.ConclusionsThere is a high burden of active trachoma among children in the study areas. Lack of personal hygiene and limited access to a safe water supply and latrines were associated with increased prevalence of active trachoma. In order to reduce the burden of active trachoma, facial cleanliness and environmental improvement components of the SAFE strategy should be upgraded in the study areas.

Prevalence of active trachoma and associated risk factors among children in Gazegibela district of Wagehemra Zone, Amhara region, Ethiopia: community-based cross-sectional study.

BackgroundTrachoma continues to be hyperendemic in many rural areas of Ethiopia. The aim of this study was to determine the prevalence and associated risk factors of active trachoma among children in Gazegibela district, Ethiopia.MethodsA community-based cross-sectional study was conducted in April 2015 among children aged 1–9 years. Data were collected through an interview and eye examinations. Descriptive and logistic regression analyses were performed.ResultsAmong 601 children, 315 (52.4 %) were positive for active trachoma. Of these cases, 49.1 % were trachomatous inflammation-follicular and 3.3 % were trachomatous inflammation-intense. Children from households using rivers and ponds as their source of drinking water were more likely to develop active trachoma compared to those from households using water from springs or hand-dug wells (aOR = 2.9, 95 % CI: 1.70–4.81). Children from farming households were more likely to develop active trachoma (AOR = 3.3, 95 % CI: 1.02–10.65), as were children from housholds that lacked a latrine (aOR = 12.9, 95 % CI: 5.96–28.29). Children who washed their face only once a day were more likely to have active trachoma compared to those who washed for two and more times a day (aOR = 2.6, 95 % CI: 1.43–4.72).ConclusionThere is a high prevalence of trachoma among children from Gazegibela district. Trachoma remains a public health challenge in this region, requiring intervention from the government and other stakeholders.

Prevalence and Risk Factors of Active Trachoma among Children in Gondar Zuria District North Gondar, Ethiopia

The aim of this study was to investigate prevalence and potential risk factors of active trachoma in Gondar zuria district. Methods: Community-based cross-sectional study was conducted in Gondar Zuria District from December 1 to December 30, 2014. Multi stage random cluster-sampling technique was employed and all children 1-9 years old from selected household were clinically assessed for trachoma based on simplified WHO 1983 classification. A total of 597 children were included in this study. Data were collected by using semi-structured interview, pre-tested questionnaire and observation. EpiInfo 3.5.3 was used for data entry and cleaning, while IBM SPSS Statistics 20 was used for data analysis. A P-value <0.05 was considered statistically significant throughout this study. Result: The overall prevalence of active trachoma in this study was found to be 12.1%. The risk factors identified were age 1-5 years, low monthly income, poor perceived economy, infrequent face washing habit, not using soap during washing, absence of clean face, not using latrine, absence of waste disposal, and higher house hold fly density. On the other hand going to school was the only preventive factor identified in this study. Conclusion: The study result has shown the magnitude of active trachoma dropped from 76.5% to 12.1%, by 8 folds. This is dramatic decrement taking in to consideration the very large magnitude of the problem as of the base line data. WHO has leveled a cut of point for active trachoma to decide it is or not major public health problem. Based on this criterion, active trachoma is still a public health problem in the study woreda. So the woreda community at large and other responsible bodies should integrate each other to mobilize AFE strategy interventions by large.

Risk factors for active trachoma among children aged 1-9 years in Maksegnit town, Gondar Zuria District, Northwest Ethiopia

Background: Trachoma is a leading preventable infectious eye disease caused by repeated infection with eye strains of the bacteria Chlamydia trachomatis . Developing countries that have poor environmental sanitation, inadequate water supply, and poor socioeconomic status are highly exposed with the disease. Aims of the study: The aim of the research was to assess the risk factors of active trachoma among children 1-9 years old in Maksegnit town. Settings and Design: Cross-sectional community based study was conducted in April 2012; in Maksegnit town located at Gondar Zuria District, North Gondar, northwest Ethiopia. Materials and Methods: A total of 420 children (age 1-9-years-old) from 420 households were included in the study. All children were examined for trachoma by optometrists and ophthalmic officers using the World Health Organization (WHO) simplified clinical grading system. Interviews and observations were used to assess risk factors. Descriptive statistics was carried out for variables in the study and odds ratio (OR) with 95% confidence interval (CI) were used to assess the association between the potential risk factors and active trachoma. Result: The prevalence of active trachoma was found to be 100 (23.8 %). Unclean face (adjusted odds ratio (AOR) = 4.12; 95% CI = 1.92-8.81), flies on face (AOR = 2.310; 95% CI = 1.32-4.05), and using wood and animal dung as a source of energy for cooking (AOR = 2.190; 95% CI = 1.152-4.163) were independent predictors of active trachoma. Conclusion: Trachoma is still a major public health problem in the study area. Trachoma prevention programs that include smoke-free household energy, fly control, sanitation, and hygiene are recommended to lower the burden of trachoma in Maksegnit town.

Coming National Program of Epidemiological Survey for Trachoma in China: Prevalence of Trachoma in Northern China

Purpose: To assess the prevalence of and risk factors for trachoma among primary school children in three north districts of China. Methods: The survey was carried out in three north districts of China (Wuqiang county of Hebei province, Yinchuan city of Ningxia Huizu province, and Datong city of Shanxi province). Chester sampling survey was employed in this study. The general state of health and case history of those children were recorded. Sanitation status and habits of both respondent and household, knowledge of health-related issues and the condition of inhabitancy were also questioned. Trachoma was clinically diagnosed according to the simplified classification for trachoma proposed by the World Health Organization (WHO). At the same time, Chlamydia trachomatis (C. trachomatis) was detected by polymerase chain reaction (PCR) when the child was clinically diagnosed as trachoma. Results: In Wuqiang county, out of 1622 primary school children, 333 children were clinically diagnosed as trachoma and the prevalence of trachoma was 20.5% (95%CI 18.5% to 22.5%). In Yinchuan city, out of 1883 primary school children, 577 children were diagnosed as trachoma and the prevalence was 30.6% (95% CI 28.6% to 32.7%). Out of 1236 primary school children in Datong city, 135 person of trachoma were found, the prevalence of trachoma was 10.9% (95%CI 9.2%-12.6%). The prevalence of trachoma in primary school children from countryside is higher than that in cities (P<0.01). The positive rate of PCR for C. trachomatis was 64.9% (in 333), 48.9% (in 577), and 63.7% (in 135) in the 3 districts respectively. Narrow living condition, short of clean water and poor personal sanitation habits, and poor knowledge of trachoma were the independent risk factors for active trachoma. Conclusions: Trachoma is still now a remarkable eye health problem in north China. It is necessary to have a nationwide survey for the prevalence of whole country and evaluate mass interventions, both medical and educational, in the community.

Prevalence of and Risk Factors for Trachoma in Kano State, Nigeria

BackgroundIn northern Nigeria, trachoma is an important public health problem, but there are currently few population-based data on prevalence of disease and no formal trachoma control programs.Methodology / Principal FindingsIn Kano state, Nigeria, we conducted a population-based cross-sectional survey using multistage cluster random sampling, combining examination for clinical signs of trachoma and application of questionnaires assessing potential household-level risk factors. A total of 4491 people were examined in 40 clusters, of whom 1572 were aged 1–9 years, and 2407 (53.6%) were female. In 1–9 year-olds, the prevalence of trachomatous inflammation–follicular (TF) was 17.5% (95% CI: 15.7–19.5%). In a multivariate model, independent risk factors for active trachoma were the presence of flies on the face (OR 1.98, 95% CI 1.30–3.02); a dirty face (OR 2.45, 95% CI 1.85–3.25) and presence of animal dung within the compound of residence (OR 3.46, 95% CI 1.62–7.41). The prevalence of trachomatous trichiasis in persons aged ≥15years was 10.9% (95% CI: 9.7–12.2%). Trichiasis was significantly more common in adult females than in adult males.Conclusion/SignificanceThere is an urgent need for a trachoma control program in Kano state, with emphasis given to provision of good quality trichiasis surgery. Particular effort will need to be made to identify women with trichiasis and engage them with appropriate services while also taking steps to secure azithromycin for mass treatment and ensuring personal and environmental hygiene.

Trachoma Prevalence and Associated Risk Factors in The Gambia and Tanzania: Baseline Results of a Cluster Randomised Controlled Trial

BackgroundBlinding trachoma, caused by ocular infection with Chlamydia trachomatis, is targeted for global elimination by 2020. Knowledge of risk factors can help target control interventions.Methodology/Principal FindingsAs part of a cluster randomised controlled trial, we assessed the baseline prevalence of, and risk factors for, active trachoma and ocular C. trachomatis infection in randomly selected children aged 0–5 years from 48 Gambian and 36 Tanzanian communities. Both children's eyes were examined according to the World Health Organization (WHO) simplified grading system, and an ocular swab was taken from each child's right eye and processed by Amplicor polymerase chain reaction to test for the presence of C. trachomatis DNA. Prevalence of active trachoma was 6.7% (335/5033) in The Gambia and 32.3% (1008/3122) in Tanzania. The countries' corresponding Amplicor positive prevalences were 0.8% and 21.9%. After adjustment, risk factors for follicular trachoma (TF) in both countries were ocular or nasal discharge, a low level of household head education, and being aged ≥1 year. Additional risk factors in Tanzania were flies on the child's face, being Amplicor positive, and crowding (the number of children per household). The risk factors for being Amplicor positive in Tanzania were similar to those for TF, with the exclusion of flies and crowding. In The Gambia, only ocular discharge was associated with being Amplicor positive.Conclusions/SignificanceThese results indicate that although the prevalence of active trachoma and Amplicor positives were very different between the two countries, the risk factors for active trachoma were similar but those for being Amplicor positive were different. The lack of an association between being Amplicor positive and TF in The Gambia highlights the poor correlation between the presence of trachoma clinical signs and evidence of C. trachomatis infection in this setting. Only ocular discharge was associated with evidence of C. trachomatis DNA in The Gambia, suggesting that at this low endemicity, this may be the most important risk factor.Trial RegistrationClinicalTrials.gov NCT00792922

Personal and environmental risk factors for active trachoma in children in Yobe state, north‐eastern Nigeria

To determine the personal and environmental risk factors associated with trachoma in pre-school children in Yobe state, Nigeria. Total of 639 children aged 1-5 from 27 villages were examined in their households for clinical signs of trachoma. Personal and environmental risk factors were independently determined by an observer while clinical examination was being performed. The prevalence of active trachoma was 35.7% (95% CI; 32.0-39.6) with prevalence of disease in boys being similar to girls. The highest prevalence was in children 2-3 years of age. The presence of flies on the face (OR 4.14; CI 2.72-6.29) and lack of a toilet in the compound (OR 2.11; CI 1.38-3.23) were independent risk factors for trachoma. The prevalence of trachoma is high. Provision and use of toilets, education on personal and environmental hygiene improvements need to be emphasized as part of the Surgery Antibiotics Facial cleanliness and Environmental improvement strategy.

Access to Water Source, Latrine Facilities and Other Risk Factors of Active Trachoma in Ankober, Ethiopia

ObjectiveThis study aims to determine the prevalence and correlates of active trachoma in Ankober, Ethiopia.MethodsA cross-sectional community-based study was conducted during July 2007. A total of 507 children (ages 1–9 years), from 232 households were included in the study. All children were examined for trachoma by ophthalmic nurses using the WHO simplified clinical grading system. Interviews and observations were used to assess risk factors. Logistic regression procedures were used to determine associations between potential risk factors and signs of active trachoma.ResultsOverall, the prevalence of active trachoma was found to be 53.9% (95%CI 49.6%–58.2%). Presence of fly-eye (fly contact with the eyelid margin during eye examination) (Odds Ratio (OR) = 4.03 95% CI 1.40–11.59), absence of facial cleanliness (OR = 7.59; 95%CI 4.60–12.52), an illiterate mother (OR = 5.88; 95%CI 2.10–15.95), lack of access to piped water (OR = 2.19; 95%CI 1.14–6.08), and lack of access to latrine facilities (OR = 4.36; 95%CI 1.49–12.74) were statistically significantly associated with increased risk of active trachoma.ConclusionActive trachoma among children 1–9 years of age in Ankober is highly prevalent and significantly associated with a number of risk factors including access to water and latrine facilities. Trachoma prevention programs that include improved access to water and sanitation, active fly control, and hygiene education are recommended to lower the burden of trachoma in Ankober, Ethiopia.

Risk factors for active trachoma in The Gambia

Trachoma has been endemic in The Gambia for decades but national surveys indicate that the prevalence is falling. Risk factor data can help guide trachoma control efforts. This study investigated risk factors for active trachoma and ocular Chlamydia trachomatis infection in children aged below 10 years in two Gambian regions. The overall prevalence of C. trachomatis infection was only 0.3% (3/950) compared with 10.4% (311/2990) for active trachoma, therefore analyses were only performed for active trachoma. After adjustment, increased risk of trachoma was associated with being aged 1-2 years (odds ratio (OR) 2.20, 95% CI 1.07-4.52) and 3-5 years (OR 3.62, 95% CI 1.80-7.25) compared with <1 year, nasal discharge (OR 2.07, 95% CI 1.53-2.81), ocular discharge (OR 2.68, 95% CI 1.76-4.09) and there being at least one other child in the household with active trachoma (OR 11.28, 95% CI 8.31-15.31). Compared with other occupations, children of traders had reduced risk (OR 0.53, 95% CI 0.30-0.94). At the household level, only the presence of another child in the household with active trachoma was associated with increased risk of active trachoma, suggesting that current trachoma control interventions are effective at this level. In contrast, child-level factors were associated with increased risk after adjustment, indicating a need to increase control efforts at the child level.

Risk factors for active trachoma in children and trichiasis in adults: a household survey in Amhara Regional State, Ethiopia

Identification of risk factors is essential for planning and implementing effective trachoma control programmes. We aimed to investigate risk factors for active trachoma and trichiasis in Amhara Regional State, Ethiopia. A survey was undertaken and eligible participants (children aged 1-9 years and adults aged 15 years and above) examined for trachoma. Risk factors were assessed through interviews and observations. Using ordinal logistic regression, associations between signs of active trachoma in children and potential risk factors were explored. Associations between trichiasis in adults and potential risk factors were investigated using conventional logistic regression. A total of 5427 children from 2845 households and 9098 adults from 4039 households were included in the analysis. Ocular discharge [odds ratio (OR)=5.9; 95% CI 4.8-7.2], nasal discharge (OR=1.6; 95% CI 1.3-1.9), thatch roof in household (OR=1.3; 95% CI 1.0-1.5), no electricity in household (OR=2.4; 95% CI 1.3-4.3) and increasing altitude (Ptrend<0.001) were independently associated with severity of active trachoma. Trichiasis was associated with increasing age (ORper 5 year increase=1.5; 95% CI 1.4-1.7), female gender (OR=4.5; 95% CI 3.5-5.8), increasing prevalence of active trachoma in children (Ptrend=0.003) and increasing altitude (Ptrend=0.015).

Risk factors for active trachoma and Chlamydia trachomatis infection in rural Ethiopia after mass treatment with azithromycin

To investigate risk factors for ocular Chlamydia trachomatis infection and active trachoma, comparing communities receiving or not receiving an intervention programme of community-wide azithromycin treatment and health education. In a 3-year post-intervention follow-up survey, 1722 children aged 3-9 years, from randomly selected households in 37 communities, were examined for signs of active trachoma and had samples taken to test for ocular C. trachomatis by polymerase chain reaction. Multivariate random effects logistic regression analyses considered interventions at community level, adjusting for other independent risk factors as appropriate. Younger age, ocular discharge and flies on eyes were risk factors for active trachoma in communities with and without antibiotic treatment. After azithromycin treatment, odds of active trachoma were lower in children aged 6-9 years than in children aged 3-5 years (OR 0.48, 95% CI: 0.36-0.66) and higher for children with ocular discharge (OR 4.5, 95% CI: 2.6-7.7) or flies on their eyes (OR 2.5, 95% CI: 1.6-3.7). Odds of C. trachomatis infection were lower in children aged 6-9 years than in younger children (OR 0.47, 95% CI: 0.23-0.96); and in children who received 2 or 3 doses rather than 1 (OR 0.26, 95% CI: 0.08-0.88). In communities that received or did not receive the mass antibiotic treatment, the same risk factors for C. trachomatis and active trachoma were identified. Education and environmental improvements need to supplement antibiotic campaigns in order to positively impact on these remaining child level risk factors.

Prevalence of Trachoma in a Population of the Upper Rio Negro Basin and Risk Factors for Active Disease

Purpose: To determine the prevalence of trachoma in São Gabriel da Cachoeira (SGC), the only urban community of the upper Rio Negro Basin of the Amazon state in Brazil, near the Colombian border, and to investigate the risk factors associated with the active forms of the disease. Methods: A total of 1702 people (440 children up to 9 years and 1069 adults aged 15 years and above) were examined. The sample was selected from a probabilistic household sampling procedure based on census data and a previous study of trachoma prevalence in São Gabriel da Cachoeira. A two-stage probabilistic household cluster sample was drawn. Household units were randomly selected within each cluster. A variety of socioeconomic and hygiene variables were studied in order to determine the risk factors for active trachoma in a household. Results: The total prevalence of trachoma was 8.9%. Prevalence of active trachoma (TF and/or TI) in children aged 1–9 years was 11.1% and trachomatous trichiasis in adults aged 15 years and above was 0.19%. Trachomatous scarring reached a peak of 22.4% for subjects between 50 to 60 years of age. Corneal opacity occurred in subjects aged 50 years and older with a prevalence of 2.0%. No sex effect was found on the overall prevalence of trachoma in SGC. Risk factors associated with active trachoma were mainly related to poor socioeconomic indicators. Conclusions: Despite the ubiquitous presence of water, the analysis of the risk factors associated with the active forms of the disease supports the idea that a low personal standard of hygiene and not water availability per se, is the key factor associated with trachoma.

Blinding Trachoma in Katsina State, Nigeria: Population-Based Prevalence Survey in Ten Local Government Areas

Purpose: To assess the prevalence of trachomatous inflammation follicular (TF) in children aged 1–9 years and trachomatous trichiasis (TT) in adults aged 15 years or more in Katsina State, Nigeria. Methods: Cross sectional population-based trachoma prevalence surveys were conducted using multistage cluster random sampling methodology and the WHO simplified grading system for trachoma in ten local government areas (LGAs). Individual and household risk factors were recorded using a standard questionnaire. Results: A total of 11,407 children and 8,901 adults from 2,244 households were surveyed. Prevalence of TF in children aged 1–9 years ranged from 5.0 to 24.0%. Five LGAs exceeded the 10% threshold for intervention and a further three exceeded 10% in the 95% confidence limits. The prevalence of TT in adults aged 15 years or more ranged from 2.3 to 8.0%: all ten LGAs exceeded the 1% intervention threshold. Analysis of risk factors for active trachoma (TF and/or TI) in children showed the following significant independent associations: Presence of ocular discharge OR = 2.34 (95%CI 1.81–3.03); presence of nasal discharge OR = 1.44 (1.22–1.70); reported frequency of face washing once versus at least twice per day OR = 1.27 (1.02–1.58); disposal of trash inside the compound OR = 1.23 (1.02–1.48); and the absence of a household latrine OR = 1.43 (1.15–1.78). Conclusions: A trachoma control program is warranted in Katsina. Surgical interventions to correct TT are needed immediately in all LGAs surveyed and the full SAFE strategy is justified for five of the ten LGAs, and possibly for another three.

Distance to water source and altitude in relation to active trachoma in Rombo district, Tanzania.

To investigate the relationship between distance to water source, altitude and active trachoma in children in Rombo district, Tanzania. In each of Rombo's 64 villages, 10 balozis (groups of 8-40 households) were selected at random and all resident children aged 1-9 years were examined for clinical signs of active trachoma. The households of these children and village water sources were mapped using differentially corrected global positioning system data to determine each household's altitude and distance to the nearest water supply. We examined 12 415 children and diagnosed 1171 cases of active trachoma (weighted prevalence=9.1%, 95% CI: 8.0, 10.2%). Active trachoma prevalence ranged from 0% to 33.7% across villages. Increasing distance to the nearest water source was significantly associated with rising trachoma prevalence (age-adjusted odds ratio for infection (OR) for highest quartile compared to lowest=3.56, 95% CI 2.47, 5.14, P for trend <0.0001). Altitude was significantly inversely associated with trachoma prevalence (age-adjusted OR for highest quartile compared to lowest=0.55, 95% CI 0.41, 0.75, P for trend <0.0001). These associations remained significant after adjustment in multivariate analysis. Trachoma is endemic in Rombo district, although the prevalence varies considerably between villages. Spatial mapping is a useful method for analysing risk factors for active trachoma.