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Prevalence and associations of active trachoma among rural preschool children in Wadla district, northern Ethiopia.

ABSTRACT: BACKGROUND:Trachoma is a neglected eye disease and an important cause of preventable corneal blindness. In endemic areas, initial infection can occur in early childhood and following a recurrent episodes, it progresses to scarring and visual impairment. Trachoma disappeared from high income countries through enhancements of hygiene and sanitation but the disease is still a challenge in developing countries. In Ethiopia, data indicate that Amhara is the region with the highest prevalence of active trachoma. The aim of this study was to assess the prevalence and associations of active trachoma among rural preschool children in Wadla district, Amhara region, Ethiopia. METHODS:In this study, 596 children were screened for signs of active trachoma by using cluster-sampling technique. Following pre-testing of the survey instrument in a different district, questions about socio-demographic status were delivered for heads of households. Integrated eye care workers, previously trained to undertake trachoma screening for one month, performed eye examination. The logistic regression model was used to look for associations of active trachoma. RESULTS:The prevalence of active trachoma among rural preschool children in Wadla district was 22%. Low economic status (adjusted odds ratio [AOR]3.8 (95%CI 1.3-11.4), being 37-48?months old (4.2;1.5-12.0), living in a house with thatched roof (4.4;1.4-13.6), presence of flies in a home (4.6;2.1-9.9), once-weekly face-washing frequency (8.6;2.5-29.3), having a face that had not been washed for longer than a week (10.6;2.9-37.7), and not using soap (4.5;1.8-11.3) had association to active trachoma. CONCLUSION:The prevalence of active trachoma among rural pre-school children in Wadla district was high. This indicates that Trachoma is still a public health problem in the district. This high prevalence calls for further interventions to prevent future trachomatis blindness.

SUBMITTER: Kassaw MW

PROVIDER: S-EPMC7449018 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Prevalence and associations of active trachoma among rural preschool children in Wadla district, northern Ethiopia.

Kassaw Mesfin Wudu MW Abebe Ayele Mamo AM Tegegne Kirubel Dagnaw KD Getu Mikiyas Amare MA Bihonegn Woldemichael Tadesse WT

BMC ophthalmology 20200826 1

<h4>Background</h4>Trachoma is a neglected eye disease and an important cause of preventable corneal blindness. In endemic areas, initial infection can occur in early childhood and following a recurrent episodes, it progresses to scarring and visual impairment. Trachoma disappeared from high income countries through enhancements of hygiene and sanitation but the disease is still a challenge in developing countries. In Ethiopia, data indicate that Amhara is the region with the highest prevalence ...[more]

PMID: 32842993

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Project description: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.

Project description:BackgroundIn developing countries particularly in sub-Saharan Africa trachoma is still a public health concern. Ethiopia is the most affected of all and bears the highest burden of active trachoma. In spite of this, the prevalence of active trachoma among the pastoralist population in Ethiopia not yet disclosed. The aim of this study was to determine the prevalence of active trachoma and associated risk factors among children in a pastoralist population in Madda Walabu rural district, Ethiopia.MethodsA community-based cross-sectional study was conducted among children in a pastoralist population in Madda Walabu rural district, from May 1 to 30, 2017. A systematic sampling technique was employed to select 409 children's. Simplified WHO classification scheme was used to assess trachoma. Descriptive and logistic regression analyses were performed.ResultsA total of 406 children aged 1-9 years have participated, 89 (22%) [95%CI: 18.0-25.6%] were positive for active trachoma. Of these cases, 75(84%) had TI alone in one or both eyes, 14(16%) had TF alone in one or both eyes, and none of the children had both TI and TF. The odds of having active trachoma among children from households using river/ponds, unprotected well/spring and rainwater as their source of drinking water were higher than those from households using water from piped or public tap water (AOR:13,95%CI: 2.9, 58.2), (AOR: 6.1, 95%CI:1.0,36.5) and (AOR: 4.8, 95%CI:1.3,17.8) respectively. Children's from households that lacked a latrine (AOR: 2.5, 95% CI: 1.8, 5.3), children who did not wash their face by using soap (AOR: 4.3, 95% CI: 1.8, 10.6) and children from households within 16-30 min of water source (AOR: 8.7, 95% CI: 2.20, 34.2) were higher odds of having active trachoma.ConclusionsThe findings of this study revealed that close to one-quarter of the total children screened for trachoma were positive for the disease. The finding implies that trachoma is still a major concern among children of the pastoralist community which demands further attention of the district health office. Again, intervention with the A, F and E components of SAFE strategy is strongly recommended.

Project description:BackgroundTrachoma is the commonest infectious cause of blindness. It is prevalent in areas where personal and community hygiene is poor, and it mainly affects deprived and marginalized communities most importantly in Ethiopia. Hence, the aim of this study was to determine the prevalence and associated factors of active trachoma among children in Ethiopia.MethodA systematic review and meta-analysis was employed to determine the prevalence of active trachoma and associated factors among children in Ethiopia. We searched databases, including PubMed, Google Scholar, Science Direct, EMBASE and Cochrane Library. To estimate the prevalence, studies reporting the prevalence of active trachoma and its associated factors were included. Data were extracted using a standardized data extraction format prepared in Microsoft excel and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistics and I2 test were used. Since the included studies revealed considerable heterogeneity, a random effect meta- analysis model was used to estimate the pooled prevalence of active trachoma. Moreover, the association between factors and active trachoma were examined.ResultsThe result of 30 eligible studies showed that the overall prevalence of active trachoma among children in Ethiopia was 26.9% (95% CI: 22.7, 31.0%). In the subgroup analysis, while the highest prevalence was reported in SNNP (35.8%; 95% CI: 22.7, 48.8), the lowest prevalence was reported in Oromia region (20.2%; 95% CI: 12.2, 28.2). Absence of latrine: OR 6.0 (95% CI 2.0, 17.5), the unclean faces of children: OR 5.5 (95% CI 2.8, 10.9), and no reported use of soap for washing: OR 3.3 (95% CI 1.8, 6.0) have shown a positive association with active trachoma among children.ConclusionFrom this review, it has been concluded that active trachoma among children is still a public health problem in different districts of Ethiopia. The prevalence of almost all studies are significantly higher than WHO target for elimination. Absence of latrine, unclean faces of children, no reported use of soap for washing are the important factors associated with active trachoma among children.

Project description:BackgroundTo eliminate blinding trachoma, the World Health Organization emphasizes implementing the SAFE strategy, which includes annual mass drug administration (MDA) with azithromycin to the whole population of endemic districts. Prevalence surveys to assess impact at the district level are recommended after at least 3 years of intervention. The decision to stop MDA is based on a prevalence of trachomatous inflammation follicular (TF) among children aged 1-9 years below 5% at the sub-district level, as determined by an additional round of surveys limited within districts where TF prevalence is below 10%. We conducted impact surveys powered to estimate prevalence simultaneously at the sub-district and district in two zones of Amhara, Ethiopia to determine whether MDA could be stopped.MethodologySeventy-two separate population-based, sub-district surveys were conducted in 25 districts. In each survey all residents from 10 randomly selected clusters were screened for clinical signs of trachoma. Data were weighted according to selection probabilities and adjusted for correlation due to clustering.Principal findingsOverall, 89,735 residents were registered from 21,327 households of whom 72,452 people (80.7%) were examined. The prevalence of TF in children aged 1-9 years was below 5% in six sub-districts and two districts. Sub-district level prevalence of TF in children aged 1-9 years ranged from 0.9-76.9% and district-level from 0.9-67.0%. In only one district was the prevalence of trichiasis below 0.1%.Conclusions/significanceThe experience from these zones in Ethiopia demonstrates that impact assessments designed to give a prevalence estimate of TF at sub-district level are possible, although the scale of the work was challenging. Given the assessed district-level prevalence of TF, sub-district-level surveys would have been warranted in only five districts. Interpretation was not as simple as stopping MDA in sub-districts below 5% given programmatic challenges of exempting sub-districts from a highly regarded program and the proximity of hyper-endemic sub-districts.

Project description:Over 80% of morbidity due to soil-transmitted helminthiasis (STH) occurs in low-income countries. Children under 5 account for 20-30% of the burden in endemic areas. This study assessed the prevalence, intensity and factors associated with STH infections among preschool-age children (PSAC) in Hoima district, Uganda. The PSAC are particularly vulnerable because the chronicity of this condition usually affects their physical and mental growth and development.A cross-sectional study was carried out among 562 PSAC (1-5 years old) in 6 counties of Hoima district using Expanded Program on Immunization (EPI) method. Stool samples from children were examined using the formol ether concentration technique for STH egg detection. Egg counts were represented as egg per gram (EPG). A structured questionnaire was used to collect information on factors associated with STH infection. Generalized linear models were used to analyze relationships between STH infection and associated factors.Overall STH prevalence was 26.5%. Hookworm infection was the most prevalent (18.5%), followed by A.lumbricoides (9.8%) and T.trichiura (0.5%). Prevalence of STH infection was significantly higher in children aged 5 years (Pearson chi-square test, p?=?0.009) than in children aged 1 year. The general geometric mean (GM) counts for Hookworm infection was (696.1 EPG; range (530.3-913.8)) with girls having a higher GM (789.8 EPG; range (120-13,200)) than boys. Eating uncooked or unwashed vegetables (adj. Prevalence Ratio (PR)?=?1.9, 95% CI: 1.3-2.7) and fruits (adj.PR?=?1.8, 95% CI: 1.1-2.8), indiscriminate disposal of young children's faeces (adj.PR?=?1.5, 95% CI: 1.1-2.0); not washing hands after defecation (adj.PR?=?2.6, 95% CI: 1.9-3.6); and not deworming children regularly (adj.PR?=?1.4, 95% CI: 1.1-1.8) were significantly associated with STH infection.The prevalence of Soil transmitted helminths infection among preschool-age children in Hoima district significantly increased with age. Poor hygiene, inadequate sanitation and irregular deworming were associated with STH infections among PSAC in the study area. Intense health education on the importance of hygienic practices, improved sanitation and regular deworming of PSAC should be integrated into prevention and control programs.

Dataset Information

Prevalence and associations of active trachoma among rural preschool children in Wadla district, northern Ethiopia.

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Prevalence and associations of active trachoma among rural preschool children in Wadla district, northern Ethiopia.

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