Prevalence of and Risk Factors for Trachoma in Southern Nations, Nationalities, and Peoples’ Region, Ethiopia: Results of 40 Population-Based Prevalence Surveys Carried Out with the Global Trachoma Mapping Project

Abstract

Purpose: We sought to estimate the prevalence of trachoma at sufficiently fine resolution to allow elimination interventions to begin, where required, in the Southern Nations, Nationalities, and Peoples’ Region (SNNPR) of Ethiopia. Methods: We carried out cross-sectional population-based surveys in 14 rural zones. A 2-stage cluster randomized sampling technique was used. A total of 40 evaluation units (EUs) covering 110 districts (“woredas”) were surveyed from February 2013 to May 2014 as part of the Global Trachoma Mapping Project (GTMP), using the standardized GTMP training package and methodology. Results: A total of 30,187 households were visited in 1047 kebeles (clusters). A total of 131,926 people were enumerated, with 121,397 (92.0%) consenting to examination. Of these, 65,903 (54.3%) were female. In 38 EUs (108 woredas), TF prevalence was above the 10% threshold at which the World Health Organization recommends mass drug administration with azithromycin annually for at least 3 years. The region-level age- and sex-adjusted trichiasis prevalence was 1.5%, with the highest prevalence of 6.1% found in Cheha woreda in Gurage zone. The region-level age-adjusted TF prevalence was 25.9%. The highest TF prevalence found was 48.5% in Amaro and Burji woredas. In children aged 1–9 years, TF was associated with being a younger child, living at an altitude <2500m, living in an area where the annual mean temperature was >15°C, and the use of open defecation by household members. Conclusion: Active trachoma and trichiasis are significant public health problems in SNNPR, requiring full implementation of the SAFE strategy (surgery, antibiotics, facial cleanliness, and environmental improvement).

Prevalence of trachoma in Yemen: results of population-based prevalence surveys of 42 evaluation units in nine governorates

“…We found that younger children had lower odds of TF. This finding contrasts with that of many other studies, 19,21,26,27 where the burden of TF is typically found in pre-school childrenthe age group shown to harbor the bulk of the ocular C. trachomatis reservoir in environments in which this has been studied in detail. 28,29 A shift of the burden of TF to higher age groups has been noted in areas where trachoma has lower overall prevalence, presumably because intensity of transmission (and age of first exposure) is lower in these areas.…”

“…The exception to this is the trichiasis prevalence estimate for Ma'rib, which we have not reported here because (due to the fact that an unexpectedly large proportion of adults were working outside the governorate) only 25 adults were examined in the EU as a whole. In the remainder, relatively low prevalences of TF (compared to those recorded in many parts of Ethiopia, [19][20][21] for example) were matched by low prevalences of trichiasis. Only eight EUs had TF prevalences in 1-9-year-olds ≥5%, and only five had trichiasis prevalence in ≥15-year-olds ≥0.2%, indicating a need for public health-level action.…”

“…In our data, reported open defecation by adults was associated with higher odds of active trachoma in children in the same household, as also seen in previous studies. 19,21 This is thought to relate to the fact that eyeseeking Musca sp. flies lay their eggs on surface-exposed human faeces.…”

Prevalence and associated factors of active trachoma among 1–9 years old children in Deguatemben, Tigray, Ethiopia, 2018: community cross-sectional study

“…Active trachoma was five times more likely to happen among children from 1 to 4 years old than children 5 to 9. This finding is in line with the findings of the study conducted in Ankober and southern nations and nationalities people (SNNP) [24,28]. This may be due to young children may not able to care about themselves and play in dirty places than older children.…”

Prevalence of Trachoma in Gambella Region, Ethiopia: Results of Three Population-Based Prevalence Surveys Conducted with the Global Trachoma Mapping Project

“…16 In the global context, the TF prevalences recorded here are high, particularly when compared to the WHO 5% TF elimination threshold, but they are noticeably lower than TF prevalences in adjacent areas of SNNPR 19 and Oromia. 20 TF prevalences above 10% mandate full implementation of the A, F and E components of the SAFE strategy.…”