Twelve-Year Longitudinal Trends in Trachoma Prevalence among Children Aged 1–9 Years in Amhara, Ethiopia, 2007–2019 (original) (raw)
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The American Journal of Tropical Medicine and Hygiene, 2019
At baseline in 2006, Amhara National Regional State, Ethiopia, was the most trachoma-endemic region in the country. Trachoma impact surveys (TIS) were conducted in all districts between 2010 and 2015, following 3-5 years of intervention with the WHO-recommended SAFE (surgery, antibiotics, facial cleanliness, and environmental improvement) strategy. A multistage cluster random sampling design was used to estimate the district-level prevalence of trachoma. In total, 1,887 clusters in 152 districts were surveyed, from which 208,265 individuals from 66,089 households were examined for clinical signs of trachoma. The regional prevalence of trachomatous inflammation-follicular (TF) and trachomatous inflammation-intense among children aged 1-9 years was 25.9% (95% CI: 24.9-26.9) and 5.5% (95% CI: 5.2-6.0), respectively. The prevalence of trachomatous scarring and trachomatous trichiasis among adults aged ³ 15 years was 12.9% (95% CI: 12.2-13.6) and 3.9% (95% CI: 3.7-4.1), respectively. Among children aged 1-9 years, 76.5% (95% CI: 75.3-77.7) presented with a clean face; 66.2% (95% CI: 64.1-68.2) of households had access to water within 30 minutes round-trip, 48.1% (95% CI: 45.5-50.6) used an improved water source, and 46.2% (95% CI: 44.8-47.5) had evidence of a used latrine. Nine districts had a prevalence of TF below the elimination threshold of 5%. In hyperendemic areas, 3-5 years of implementation of SAFE is insufficient to achieve trachoma elimination as a public health problem; additional years of SAFE and several rounds of TIS will be required before trachoma is eliminated.
BMC Ophthalmology, 2020
BackgroundTrachoma is a contagious infection of the eye. World Health Organization recommended three rounds of mass drug administration in districts where the prevalence of trachomatous follicular (TF) is ≥10% in children aged 1–9 years. Mass drug distribution was given to residents for three consecutive years with more than 90% coverage. However, the prevalence and associated factors of active trachoma in the study community after the intervention was not yet determined. Thus, this deals with the prevalence and associated factors of active trachoma among children aged 1–9 years.MethodsWe conducted a Community based cross-sectional study among 502 children aged 1–9 in March 2018 in Deguatemben. A multi-stage sampling technique was applied. Selected children were examined for trachoma using 2.5x binocular loupe and graded based on the WHO simplified grading system. Mothers were interviewed for factors associated with trachoma using a structured questionnaire. Data was entered on Epi-Info and exported to SPSS for analysis. Both descriptive and inferential analyses were done with 95% confidence intervals (CIs) at a p-value < 0.05 for the final model.ResultsThe prevalence of active trachoma was found 21.5% (95% CI: 17.8–25.1%). Being 1 to 4 years old [AOR (95% CI) = 6.81(2.00–23.11)], not washing face [AOR (95% CI) =9.31(1.13–77.66)], not using soap [AOR (95% CI) =5.84(1.87–18.21)], unclean face [AOR(95% CI) = 18.22(4.93–69.32)] and mother’s knowledge [AOR (95% CI) =0.06(0.02–0.19)] were found as independent predictors.ConclusionThe prevalence declined from the baseline, but it is still a public health problem in the district. Personal-related factors were found to be associated with the disease. Health education of “Facial cleanness” and related factors is recommended to increase knowledge of the mothers on their children’s care in addition to the provision of antibiotics.
Ophthalmic Epidemiology, 2018
Purpose: Ethiopia is highly trachoma endemic. Baseline mapping was needed in Ethiopia's Somali Region to guide elimination efforts. Methods: Cross-sectional community-based surveys were conducted in 34 suspected trachomaendemic woredas, grouped as 14 evaluation units (EUs), using a standardised mapping methodology developed for the Global Trachoma Mapping Project. Results: In total, 53,467 individuals were enumerated. A total of 48,058 (89.9%) were present at the time of survey teams' visits and consented to examination. The prevalence of trachomatous inflammation-follicular (TF) among children aged 1-9 years ranged from 4.1% in the EU covering Danot, Boh, and Geladin woredas in Doolo Subzone to 38.1% in the EU covering Kebribeyah and Hareshen woredas in Fafan Subzone (East). The trichiasis prevalence among adults aged over 15 years varied from 0.1% in the EU covering Afder, Bare, and Dolobay woredas in Afder Subzone (West) to 1.2% in the EU covering Awbere in Fafan Subzone (West). Conclusion: Mass drug administration (MDA) with azithromycin is needed in 13 EUs (population 2,845,818). Two EUs (population 667,599) had TF prevalences in 1-9-year-olds of ≥30% and will require at least 5 years of MDA; 5 EUs (population 1,1193,032) had TF prevalences of 10-29.9% and need at least three years of MDA; 6 EUs (population 985,187) had TF prevalences of 5-9.9% and need at least one round of azithromycin distribution before re-survey. In all 13 of these EUs, implementation of facial cleanliness and environmental improvement measures is also needed. Surveys are still needed in the remaining 34 unmapped woredas of Somali Region.
Infectious Diseases of Poverty, 2017
Background: Trachoma 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. Methods: This 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. Results: The 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. Conclusions: There 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.
Clinical Ophthalmology, 2016
Background: Trachoma is the leading cause of preventable blindness worldwide. It is common in areas where people are socioeconomically deprived. Globally, approximately 1.2 billion people live in trachoma-endemic areas, in which, 40.6 million individuals have active trachoma and 8.2 million have trichiasis. According to the World Health Organization's 2007 report, globally close to 1.3 million people are blind due to trachoma, while approximately 84 million suffer from active trachoma. The National Survey (2007) of Ethiopia showed a prevalence of 40.1% active trachoma among children aged 1-9 years. Trachoma is still endemic in most parts of Ethiopia. Objective: To assess prevalence of trachoma and factors associated with it among children aged 1-9 years in Zala district, Gamo Gofa Zone, Southern Nations, Nationalities, and Peoples' Region. Methods: A community-based cross-sectional study was conducted in Zala district from February 28 to March 26, 2014. A total of 611 children were examined for trachoma based on the simplified World Health Organization 1983 classification. A multistage stratified sampling technique with a systematic random sampling technique was used to select study participants. Data were collected by using a semistructured pretested questionnaire and clinical eye examination. The data were entered using EpiData version 3.1 and analyzed using SPSS version 16. Multivariable logistic regression analysis was used to identify independently associated factors. Results: The overall prevalence of active trachoma cases was 224 (36.7%) consisting of 207 (92.4%) trachomatous follicles, eight (3.6%) trachomatous intense, and nine (4.0%) combination of trachomatous follicle and trachomatous intense. Inadequate knowledge of family head about trachoma (adjusted odds ratio [AOR] =2.8 [95% CI: 1.9, 4.2]); #10 m latrine distance (AOR =1.6 [95% confidence interval {CI}: 1.09, 2.4]); presence of above two preschool children (AOR =2.2 [95% CI: 1.3, 3.7]), flies on the face (AOR =6.3 [95% CI: 2.7, 14.7]), and unclean face (AOR =2.4 [95% CI: 1.5, 3.9]) were found to be independently associated with trachoma. Conclusion: Trachoma among children in Zala district is a disease of public health importance. Factors like inadequate knowledge about trachoma by the head of the family, #10 m latrine distance, presence of above two preschool children, flies on the face, and an unclean face were independently associated with trachoma among children. So strengthening of antibiotic use, face washing, and environmental improvement strategy implementation is mandatory.
BMC Infectious Diseases, 2019
Background: Trachoma, caused by Chlamydia trachomatis is the leading infectious cause of blindness. It is transmitted via personal contact with infected ocular and nasal secretions by hands, fomites and eye-seeking flies. Active trachoma is more common among children aged 1 to 9 years. The objective of this study was determining the prevalence of active trachoma and associated factors among children aged 1 to 9 years in rural community of Lemo district. Methods: Community-based cross-sectional study was conducted from March to April, 2018 in rural community of Lemo district. Multistage sampling technique was used to select 589 study participants. Data were collected by using structured pre-tested questionnaire, physical examination and observation. Binocular loupe was used to identify active trachoma cases. The data were entered by using EPi-data version 3.1 and analyzed by SPSS. Binary logistic regression was used to assess factors associated with active trachoma. Variables with p-value < 0.05 in the multivariable analysis were used to declare significance of association. Result: Eighty seven (15.2%) children were positive for active trachoma. Absence of solid waste disposal pit (AOR = 2.20, 95% CI (1.12-4.37), do not use latrine as reported by respondent (AOR = 7.53, 95% CI (2.86-19.84), do not use soap for face washing as reported by respondent (AOR =2.3, 95% CI (1.32-4.12), washing face frequency as reported by respondent (AOR = 1.86, 95% CI (1.06-3.26), and family size greater than five (AOR = 1.96, 95% CI (1.06-3.67) were significantly associated with active trachoma. Conclusion: Active trachoma among children aged 1 to 9 years is high. Do not use latrine, do not use soap for face washing, and face washing frequency in a day as reported by respondents and family size were associated with active trachoma. Access to adequate water and sanitation can be important components in working towards eliminating trachoma as a public health problem. Therefore, prompt measures must be taken by concerned bodies to increase access to adequate water and sanitation facilities.
2016
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,...
Background: Trachoma 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. Methods: A 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. Results: Among 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). Conclusion: There 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 of Rural South Gonder, Ethiopia
2004
Background Trachoma is a neglected eye problem and primary cause of preventable corneal blindness. In endemic areas, initial infection occurs in early childhood, and recurrent infection progress to scarring and blindness. In the past four decades, GET2020 initiative eliminated Trachoma from developed countries through enhancements of hygiene and sanitation but still a problem of developing countries. Studies and reports also indicated the presence of high prevalence of Trachoma in Ethiopia and in the study area. Thus, the purpose of this study is to assess the prevalence and risk factors of active trachoma among rural preschool children in Wadla district, Ethiopia. Methods: A community based crosssectional study design was considered to gather data from 583 children using sample size determination, but 596 children were screened for signs of active trachoma because of the sampling procedure nature, cluster sampling technique. Wadla district has 150 rural villages, which are similar in topography and socio-demographic status. Based on rule of thumb 30 villages (clusters) were included for the data collection. An interview on socio-demographic data were collected by health informatics professionals using structured interview questioners, which were prepared through reviewing previous literatures and
2019
Background፡ Trachoma is a neglected eye problem and primary cause of preventable corneal blindness. In endemic areas, initial infection occurs in early childhood, and recurrent infection progress to scarring and blindness. In the past four decades, GET2020 initiative eliminated Trachoma from developed countries through enhancements of hygiene and sanitation but still a problem of developing countries. Studies and reports also indicated the presence of high prevalence of Trachoma in Ethiopia and in the study area. Thus, the purpose of this study is to assess the prevalence and risk factors of active trachoma among rural preschool children in Wadla district, Ethiopia. Methods: A community based cross-sectional study design was considered to gather data from 583 children using sample size determination, but 596 children were screened for signs of active trachoma because of the sampling procedure nature, cluster sampling technique. Wadla district has 150 rural villages, which are simila...