Background Although 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. Methods Comparative 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. Result From 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. Conclusion Significant 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.

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Background: Development of a national ophthalmology review course for the education of residents and use of a standardized international exam as a metric of resident knowledge and education.Methods: A 3 day review course for all Ethiopian ophthalmology residents, taught by visiting and local faculty, in preparation for the International Council of Ophthalmology (ICO) exam. The ICO exam serves as an external and standardizing measurement of residency curriculum and preparedness for clinical practice. The course and exam was provided free of cost to residents. Baseline knowledge was assessed with the ICO exam in 2017 and results compared with performance each year after the introduction of the review course. Results: Over 2 years of implementation, the resident passage rates of the basic sciences and optics and refraction exams increased by 10% and 28% and a 15% improvement in passage rate of the clinical sciences exam. These scores were significantly higher than international averages. Additionally, increasing numbers of residents were able to sit for the advanced exam with a passage rate of 67% in 2019 compared to the international passage rate of 56%.Conclusions: The implementation of a national review course is feasible and effective in enhacing the education of ophthalmology residents in Ethiopia. The review course and ICO exam serves as a key metric in the education of Ethiopian residents and their knowledge as it compares to their peers in other countries.