Prevalence and associated factors of active trachoma among children in Ethiopia: a systematic review and meta-analysis

Magnitude of Active Trachoma Among Host and Refugee Children in Gambella Regional State, Ethiopia

Background

Trachoma is a serious public health concern and cause of blindness globally. Despite its vulnerability to all ages, children are more vulnerable to its adverse outcomes and devastating complications. This study assessed the magnitude of trachoma among children in host and refugee communities in Gambella, Ethiopia.

Methods

A community-based comparative survey was done among 743 participants. Multistage sampling technique was used to select participants. Selected children were examined for trachoma using a 2.5x binocular loupe and graded using the World Health Organization (WHO) simplified grading system. A standardized, structured, and pretested tool was used to collect the data. Data were collected through interviews and observation. Bivariable and multivariable logistic regression analyses were done to identify the associated factors. Variable with a p-value <0.05 was considered statistically significant.

Results

The magnitude of active trachoma was 119 (16.5%; 95% CI: 13.5, 21.4) with 36 (14.5%; 95% CI: 11.9, 18.8) and 83 (17.5%; 95% CI: 14.3, 22.7) from refugees and host communities, respectively. Poor knowledge of caregiver about trachoma [AOR = 3.55, 95% CI: (1.48, 8.85)], presence of human feces near the house [AOR = 4.57, 95% CI: (1.84, 11.34)], presence of garbage near the house [AOR = 4.07, 95% CI: (1.34, 12.36)], and the presence of flies on the face of the child [AOR = 3.42, 95% CI: (1.32, 8.84)] were significantly associated factors with active trachoma.

Conclusion

Overall, one-sixth of children had experienced active trachoma. The magnitude of trachoma was higher in the host community compared to the refugees. Proper waste disposal and personal hygiene measures are important measures that should be addressed to tackle the problem.

Prevalence of trachomatous inflammation-follicular and associated factors among children aged 1-9 years in northeastern Ethiopia

BACKGROUND

Trachoma is the most prevalent eye disease in Ethiopia, especially among children aged 1-9 years and continues to be a public health concern. Nevertheless, in Ethiopia's rural Jamma district in South Wollo Zone of Amhara Regional State, factors associated with trachomatous inflammation-follicular (TF) among children aged 1-9 years have not yet been studied.

METHODS

A community-based cross-sectional study was conducted among 616 children aged 1-9 years in rural Jamma district in Ethiopia from January-March, 2019. Data were collected using a pre-tested structured questionnaire, an observation checklist and clinical examination of study participants for active trachoma. The presence of TF and trachomatous inflammation-intense (TI) was clinically assessed by integrated eye care workers using the World Health Organization simplified grading system. Data were analysed using SPSS (Statistical Package for Social Sciences) Version 25.0. A logistic regression model with 95% CI was used. From the multivariable analysis, variables with p-value < 0.05 were declared as associated factors of TF.

RESULT

The prevalence of TF was 10.9% (95% CI [8.6 - 13.6%]) among the rural children aged 1-9 years. The mean family size was 5.5 ± 1.9 persons. About one-fifth (20.6%) of households kept domestic animals overnight in the same room as family. Almost one-sixth (17.5%) of the children involved in this study had an ocular discharge. Two-thirds of the children (68.8%) washed their hands once per day and just over half (55.8%) washed their faces once per day. From multivariable analysis, we found that the presence of domestic animals kept overnight in the same room as the family (adjusted odds ratio [AOR] = 4.32; 95%CI [2.49-9.52]), mother's/caregiver's illiteracy (AOR = 2.01; 95%CI [1.11-4.67]), household size (> 7 persons) (AOR = 3.50; 95%CI [1.66-8.50]), washing of children's hands and face without soap (AOR = 2.41; 95%CI [1.29-5.18]), feces observed in the compound (AOR = 5.10; 95%CI [2.01-10.14]), presence of ocular discharge (AOR = 7.23, 95%CI [4.10-12.51]) and nasal discharge (AOR = 4.54, 95%CI [1.95-9.26]) were significantly associated with TF.

CONCLUSION

The prevalence of TF among rural children aged 1-9 years in this study was almost two times higher than the WHO-recommended threshold (TF < 5%) for trachoma elimination and beyond the trachoma control target (TF < 10%). Presence of domestic animals kept overnight in the same room as the family, mother's/caregiver's illiteracy, household size (> 7 persons), washing of children's hands and face without soap, feces observed in the compound, presence of ocular and nasal discharge were significantly associated with TF. We recommended interventions that will help household income to be improved to enable families to be able to construct separate rooms in which to keep animals overnight. Furthermore, we also recommend to policy makers to design mechanisms for enhancement of behavioural change among householders to keep household compounds clean and creating awareness among mothers/caregivers about prevention of trachoma.

Motivating school communities towards behavior change and local ownership: a gamification intervention to prevent trachoma at primary schools in southern Ethiopia

BACKGROUND

Ethiopia alone carries 49% of the global burden of trachoma, associated with a lack of safe water, sanitation and hygiene (WASH) and poor health practices. The aim of this study was to examine whether gamification among schoolchildren and promotion of local ownership of school WASH is associated with healthy behaviors and WASH infrastructure improvements.

METHODS

Application of the Accelerate gamification intervention for elimination of trachoma, with an emphasis on gamification among schoolchildren and community involvement in motivating face-washing, handwashing and functional use of latrines, was undertaken.

RESULTS

The study was conducted over 9 mo in 223 rural schools from six districts within the intervention area, reaching 93 518 schoolchildren. At baseline, students were observed washing their hands after using latrines in 23 (10.3%) schools. This increased to 132 (59%) schools (p≤0.001) at follow-up. The number of latrines increased from 585 at baseline to 594 at follow-up (p=0.031). The availability of handwashing stations in schools increased from 31 (13.9%) with water access (8%) and soap (5%) to 155 (69.5%) schools with handwashing stations with water access in 153 (98.7%) (p<0.001) and soap in 121 (78%) (p<0.001).

CONCLUSIONS

Motivational strategies such as gamification among schoolchildren and promotion of local ownership of school WASH may be associated with healthy behaviors and WASH infrastructure improvements.

High prevalence of active trachoma and associated factors among school-aged children in Southwest Ethiopia

BACKGROUND

Active trachoma is a highly contagious ongoing stage of trachoma that predominantly occurs during childhood in an endemic area. This study assessed the prevalence and factors associated with active trachoma among school-aged children.

METHODOLOGY/PRINCIPAL FINDINGS

A community-based analytical cross-sectional study was done from March 1st to June 30th, 2021, in Southwest Ethiopia's people's regional state. A total of 1292 school-aged children were surveyed. The quantitative data were collected using a pre-tested, structured interview-based questionnaire and observation check list. The World health organization (WHO) simplified trachoma grading system was used to assess stages of trachoma. In this study, the prevalence of active trachoma was 570(44.1%), 95% CI (41.4, 46.9). Also, age group 6-10; being female; flies at household (HH), flies on child's face, improved water source, improved sanitation, presence of ocular discharge, presence of nasal discharge, and unclean faces of the child were significantly associated with active trachoma.

CONCLUSIONS/SIGNIFICANCE

The very high prevalence of active trachoma in the study area is significantly associated with; age group 6-10, female gender, presence of flies in household and on child's face, presence of ocular and nasal discharge, unclean faces, improved water source, improved sanitation in the household. Thus, environmental sanitation and facial cleans trachoma elimination strategy should be intensified in the study area.

Exploring multi-level risk factors and post-war burdens of trachomatous trichiasis among displaced population in Raya Kobo districts, implication for urgent action

AIM

To estimate post-war burdens of trachomatous trichiasis (TT) and multi-level risk factors among displaced population in Raya Kobo districts, implication for urgent action.

METHODS

A community-based cross-sectional study was conducted among 603 participants from randomly selected 14 displaced slums in the Raya Kobo district. The data was collected from February 16th to March 30th, 2023. Study participants were selected using the multistage sampling technique. A structured questionnaire and ophthalmic loupe with ×2.5 magnificence were used to collect from participants. Multi-level binary logistic regression was used to determine associated factors with TT infection. Adjusted odds ratio (AOR) with 95% confidence interval (CI) were claimed for the strength of association at P<0.05.

RESULTS

We recruited 602 (99.9%) participants for the final analysis. From the total, 126 (20.9%) and 98 (16.3%, 95%CI: 13.5%-19.4%) participants were diagnosed with active trachoma & TT infection, respectively. Being age ≥45y (AOR=7.9, 95%CI: 2.4-25.3), having multiple eye infections (AOR=2.73, 95%CI: 1.47-5.29), poor wealth index (AOR=9.2; 95%CI: 2.7-23.7) and twice face washing per day (AOR=0.082, 95%CI: 0.03-0.21) has identified as individual as factors for TT infection. Whereas, distance between clean water source ≥10 km (AOR=6.5, 95%CI: 3.9-31.3), and latrine availability (AOR=0.35, 95%CI: 0.21-0.58) were the two community-level factors associated with TT infections.

CONCLUSION

The high prevalence of TT infection post-war throughout the study districts indicates a need for urgent clinical intervention in addition to rapid scaling up surgery, antibiotics, facial cleanliness, and environmental improvement (SAFE) strategies, strategy for high-risk population. Age≥45y, distance from the clean water source, poor wealth indexes, and eye infection are identified to be risk factors for TT infection. Furthermore, community-level preventative factors for TT infection are found as latrine availability and face washing practice.

Prevalence of active trachoma infection and associated factors post-war resettled population in raya kobo districts, North East Ethiopia: A community-based cross-sectional study in 2022

Background

Active trachoma infection poses a serious threat to public health, particularly for those who live in an unprivileged area and has practiced open-field defecation. This study aimed to estimate the prevalence of active trachoma infection and associated factors in the post-war resettled population in Raya Kobo district, North East Ethiopia: a community-based cross-sectional study in 2022.

Methods

A community-based cross-sectional study was conducted among 602 participants randomly selected in 14 slum villages in Raya Kobo from February 16th to March 30th, 2023. After the data was collected using a semi-structured questionnaire and entered into Epi-data version 3.2. The study participants were chosen using a two-stage sampling process. Binary logistic regression was used to identify factors for active trachoma infection. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were claimed for the strength of association at p < 0.05.

Results

Overall, 602 (99.9%) study participants were included in the final analysis. At the end of the study period, 126 (20.9) participants developed active trachoma infection. On multivariable analysis, were aged ≥45 years (AOR = 7.9, 95% CI = 2.4-25.3), history of eye infection (AOR = 3.7, 95% CI = 2.4-10.4, p = 0.001), were poor wealth index (AOR = 9.2, 95% CI = 2.7-23.7), having separated kitchen (AOR = 4.05, 95% CI = 1.86-8.86), living with animals (AOR = 5.92, 95% CI = 2.31-14.7) and having got administration of mass-drug (AOR = 8.9, 95% CI = 2.36-33.6) were significant risk factors for active trachoma infection. Whereas, face washing practice regularly (AOR = 0.23, 95% CI = 0.127-0.43), and toilet availability (AOR = 0.35, 95% CI = 0.20-0.97) were preventive factors for active trachoma infection.

Conclusion

A significant prevalence of active trachoma infection was reported in the area as compared with previous findings and urgent clinical intervention, and the WHO critical SAFE strategies (surgery, antibiotics, facial cleanliness, and environmental improvement) implementation is highly needed in the area. In addition, healthcare providers should focus on information dissemination on proper latrine utilization, and washing the face regularly to prevent active trachoma infection is highly recommended.

Assessment of the status of improved F&E trachoma control practices among children of agro-pastoralists in Southern Ethiopia: a mixed design survey using theory of triadic influences

BACKGROUND

Ethiopia is one of the countries with heavy trachoma burdens states globally. More than 75 million people in Ethiopia live in the trachoma endemic zones. Most populations with neglected tropical diseases (NTDs) live in hard-to-reach residences because of landscape and socio-cultural variances. This survey assessed the status of improved Face hygiene and Environmental cleanliness (F&E) trachoma control practices in children 1-9 years of age.

METHODS

A mixed-method study design was applied concurrently. Enumeration was done through interviews using the standard tool and observational technique. Focus Group discussions (FGDs) and Key informant Interviews (KIIs) were used to conduct the qualitative arm. Confounders were controlled by modeling with multivariable logistic regression.

RESULTS

For the Quantitative survey: The response rate was 99.8% of participants. The proportion with improved practice was 8%. About 13.9% of a child washed their faces and were visibly clean. About 15.2% of the households had an observable clean environment. High Wealth index, Perceived ability, knowledge about trachoma transmission from person to person, and stance toward preventive behavior were associated with improved practices. The odds of having improved F&E practice were 67% lower for those who reported positive normative preventive behavior than negatives. Qualitative arm: Some key informants reported village dwellers' shortage of basic knowledge; attitude and behavioral change for improved hygienic practices are the challenges. Inhabitants, including elder children, are aware of the hygiene issue though they do not practice it or have no intention to practice it.

CONCLUSIONS

Improved F&E practices were much lower in the study region than the regional plan to achieve.

Active Trachoma Prevalence and Related Variables among Children in a Pastoralist Community in Southern Ethiopia in 2021: A Community-Based Cross-Sectional Study

An estimated 30% of trachoma burden is borne by Ethiopia. Data on the prevalence of active trachoma and related factors in a pastoralist population are currently lacking. Additionally, no research has been conducted in the Oromia, Guji Zone of the Liben District. A community-based cross-sectional study was conducted among 538 children 1-9 years old in the pastoralist community of the Liben District from March 1 to April 30, 2021. A multistage systematic sampling method was applied to choose the sample. A structured questionnaire and WHO's trachoma grading scheme were used to identify active trachoma. Bivariate and multivariable logistic regression models were fitted to determine associated factors. An adjusted odds ratio with 95% confidence interval was calculated to decide the level of significance: 157 (29.2%) (95% CI: 24.9, 33.1) of children had clinical signs of active trachoma, 103 (66%) had trachomatous follicles, 41 (26%) had trachomatous intense, and 13 (8%) had both. There was an independent relationship between active trachoma and open defecation (adjusted odds ratio [AOR]: 2.75; 95% CI: 1.24, 6.09), defecating outside close to a house (AOR: 2.5; 95% CI: 1.07, 6.08), not having a latrine (AOR: 3.70; 95% CI: 1.60, 8.60), children who did not wash their faces with soap (AOR: 1.85; 95% CI: 1.10, 3.07), and being in a widowed household (AOR: 3.26; 95% CI: 1.57, 6.63). The study's findings revealed that about one-third of the children had clinical signs of trachoma. Research indicates that trachoma is a major concern for children in rural communities. Therefore, attention to trachoma control with antibiotics, facial hygiene, and environmental sanitation is strongly encouraged.

Trachoma Prevention Practice and Associated Factors in Rural Lemo District, Southern Ethiopia, 2021

Background

Trachoma is a leading cause of preventable blindness. It is more prevalent in areas where there is poor personal and environmental sanitation. Implementing a SAFE strategy will reduce the incidence of trachoma. The purpose of this study was to look into trachoma prevention practices and associated factors in rural Lemo, South Ethiopian communities.

Methods

We conducted a community-based cross-sectional study in the rural Lemo district of south Ethiopia, covering 552 households, from July 1 - July 30, 2021. We used a multistage sampling technique. Seven Kebeles were selected using a simple random sampling method. Then, a systematic random sampling procedure with a five-interval size was applied to select the households.Our study assessed the association between the outcome variable and explanatory variables using binary and multivariate logistic regressions. The adjusted odds ratio was calculated, and variables with a p-value below 0.05 at the 95% confidence interval (CI) were considered statistically significant.

Results

The study found that 59.6% (95% CI: 55.5%-63.7%) of participants had good trachoma prevention practices. Having a favorable attitude (odds ratio [AOR]: 1.91, 95% CI: 1.26-2.89), receiving health education (AOR: 2.16, 95% CI: 1.46-3.21), and obtaining water from a public pipe (AOR: 2.48, 95% CI: 1.09-5.66) were significantly associated with good trachoma prevention practice.

Conclusions

Fifty-nine percent of the participants had good prevention practices for trachoma. Health education, a favorable attitude, and a water source from public pipes were variables associated with good trachoma prevention practice. Improving water sources and disseminating health information are vital to increasing trachoma prevention practices.

Determinants of Trachomatous Inflammation-Follicular Among Children Aged 1 to 9 Years Old in a Rural Area of Gozamn District, Northwestern Ethiopia: A Matched Case-Control Study

Background

Approximately 1.9 million people worldwide are blind or visually impaired due to trachoma, and trachoma remains endemic in 44 countries. Amhara in Ethiopia has the highest burden of trachoma in the world. A key indicator of whether active trachoma requires public health intervention is the incidence of trachomatous inflammation-follicular in children aged 1 to 9 years. However, limited study has been conducted on the determinants in rural communities. This study therefore aimed to fill this gap by identifying determinants in the Gozamn district of northwestern Ethiopia.

Methods

A community-based case-control study was carried out between March 15 and April 30, 2021. Five or more follicles on the epitaxial conjunctivae that are larger than 0.5 mm were considered a case. Controls were free of any sign of trachoma. A semi-structured questionnaire and an observational checklist were used to gather the data, and STATA version 14 was used for the analysis. Using a 95% confidence interval, both bivariable and multivariable conditional logistic regression was performed.

Results

A total of 726 mothers/caregivers participated in this study, with a participation rate of 98.4%. Children from poor families (mAOR = 4.68; CI: 2.80-6.21), households where the water source is far from home (>30 minutes) (mAOR = 4.91; KI: 1.37-12.56), mean daily water consumption (<20 l/c/d) (mAOR = 4.42; CI:1.71-11.39), face washing frequency less than once a day (mAOR = 10.64; CI: 2.58-18.84), cloth washing frequency once a month or less (mAOR = 9.18; CI: 2.20-18.62), and mothers or caregivers with poor knowledge of active trachoma (mAOR = 3.88; CI: 1.47-10.22) were determinants of trachomatous inflammation-follicular.

Conclusions

We conclude that infrequent faces and clothes washing; unavailability of water, children in poor families, and poor knowledge of mothers/caregivers were risk factors. Health education initiatives about active trachoma, its prevention, and control methods focusing on personal hygiene are so required.

Prevalence of visual impairment and associated factors among children in Ethiopia: Systematic review and meta-analysis

Introduction

Visual impairment is a major public health problem in developing countries where there is no enough health-care service. It has a significant impact on the affected child’s psychological, educational and socioeconomic experiences, during childhood and beyond. Therefore, the aim of this review was to estimate the pooled prevalence of visual impairment and its associated factors among children in Ethiopia.

Method

This systematic review and meta-analysis was designed based on the PRISMA guidelines. Relevant published articles in Ethiopia from 2011–2021 were searched in PubMed/Medline, HINARI, Google scholar, and conference paper and thesis or research final reports were accessed from Ethiopian Universities’ repositories. Data was extracted in Microsoft excel by using JBI data extraction checklist. The pooled prevalence and odds ratio of associated factors with their 95% CI was computed by using STATA 14/SE software. A fixed effect meta-analysis model was employed for a Cochrane Q test statistic and I² test showed there was no heterogeneity in the included studies.

Result

A total of 7,647 children from nine studies were included in this study. The overall prevalence of visual impairment among children in Ethiopia was 7% (95% CI: 6, 7%). The pooled prevalence of visual impairment by region was almost similar in Ethiopia. However, there was no significant association between the identified factors and visual impairment among children. But the result showed that being males (AOR 0.642, 95% CI: 0.357–1.156), Children in the age of 10–13 years (AOR 0.224, 95% CI: 0.046–1.102) and 14–18 years (AOR 0.508, 95% CI: 0.102–2.534) were found to be less likely to have visual impairment. On the other hand, children of parents with visual impairment (AOR 1.820, 95% CI: 0.381–8.698) more likely to have visual impairment.

Conclusion

Visual impairment among children in Ethiopia is still a public health problem one year later to VISION 2020, a global initiative aimed to eliminate avoidable blindness. All most one out of fourteen children in Ethiopia had visual impairment. Therefore, the government of Ethiopia should focus on effective, efficient, comprehensive eye health care services by integrating with the national health system to prevent avoidable visual impairment among children.

Active trachoma prevalence and its associated factors among children aged 1-9 years in rural residents of Lare District, Southwest Ethiopia

AIM

To determine the prevalence of active trachoma and its associated factors among children in Lare District, Southwest Ethiopia, 2019.

METHODS

A community-based cross-sectional study was conducted. A total of 620 participants were recruited using a multi-stage sampling technique. A structured questionnaire, torch, and magnifying loupes were used for data collection. The data was entered into epidemiological information and exported to statistical package for social science version 20 for analysis. The bi-variable and multivariable Logistic regression analysis model was fitted to identify factors associated with active trachoma. Odds ratio with a 95%CI was used to show the direction and strength of association between independent and outcome variables.

RESULTS

A total of 610 children participated in this study with a response rate of 98.39%. The prevalence of active trachoma was 132 (21.60%; 95%CI: 18.40-24.70). Family size being 6-9 (AOR=2.34; 95%CI: 1.14-5.02), presence of more than two preschool children in a house (AOR=2.04; 95%CI: 1.12-3.70), open field waste disposal system (AOR=2.62; 95%CI: 1.00-6.80) and type of latrine being uncovered (AOR=4.12; 95%CI: 2.00-8.51) were positively associated with active trachoma. On the other side, water consumption being 40-60 liters per day was a protective factor for active trachoma.

CONCLUSION

The prevalence of active trachoma is high among children aged 1-9y in Lare District. Uncovered latrine, open field waste disposal system, family sizes of 6-9, and the presence of more than two preschool children in a house are associated with the occurrence of active trachoma. On the other side, water consumption of 40-60 liters is a protective factor.

Status of active trachoma infection among school children who live in villages of open field defecation: a comparative cross-sectional study

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.

The impact of access to water supply and sanitation on the prevalence of active trachoma in Ethiopia: A systematic review and meta-analysis

Background

Trachoma is a worldwide infectious disease causing blindness. Trachoma continued as a public health problem in Ethiopia due to a lack of sanitation and inadequate prevention strategies. This study aimed to identify the impact of water supply and sanitation intervention on preventing active trachoma among children.

Methods

Systematic literature searches were performed from 4 international databases. The search involved articles published from January 1995 up to March 2019. The Cochran Q and I² statistical tests were used to check heterogeneity among the studies. A random-effect meta-analysis was employed to determine the pooled estimates with a 95% confidence interval (CI). Data analysis was performed using the CMA V.3 and RevMan 5 software program, and the result of the systematic review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Findings

Out of 211 studies screened for the analysis, only 29 studies were finally included in this systematic review and meta-analysis. The result revealed factors that are significantly associated with increased odds of active trachoma. Accordingly, households with no access to toilet facilities (odds ratio [OR]: 2.04, 95% CI: 1.75–2.38), no access to improved water (OR: 1.58, 95% CI: 1.27–1.96), and do not practice regular face washing for children (OR: 4.19, 95% CI: 3.02–5.81) have shown increased odds of active trachoma. Besides, the results show a higher prevalence of active trachoma among children who did not wash their faces with soap and frequently.

Conclusions

The study found strong evidence that lack of access to water, sanitation, and hygiene (WASH) was associated with increased prevalence of active trachoma among children. Therefore, a comprehensive and partnership-oriented program is needed to tackle the problem, but further study will be required to strengthen its implementation.

Impact of the COVID-19 Pandemic on the Mental Health of College Students: A Systematic Review and Meta-Analysis

Background

The coronavirus disease (COVID-19) pandemic has been spreading and brought unprecedented psychological pressure on people across the entire globe since December 2019.

Objectives

To synthesize the existing evidence of the prevalence of mental health status during the epidemic and provide the basis for mental health education.

Materials and methods

The literature search was conducted in nine databases from December 2019 to October 2020. The risk of bias for each study was assessed, and the random-effects meta-analysis was used to estimate the prevalence of specific mental health problems. The review protocol was registered in PROSPERO with the registration number CRD42020208619.

Results

About 27 studies were included in the analysis with a total of 706,415 participants combined, and 14 mental health problems were gathered. Meta-analysis showed that the prevalence of depression was 39% (95% CI: 27–51%) and that of anxiety was 36% (95% CI: 26–46%). Subgroup analysis indicated that the prevalence of depression and anxiety varied among nations and due to the survey date. The prevalence of depression (60%, 95% CI: 46–74%) and anxiety (60%, 95% CI: 46–74%) in non-Chinese college students was higher than those in Chinese college students (26%, 95% CI: 21–30% and 20%, 95% CI: 14–26%). The proportion of depression (54%, 95% CI: 40–67%) and anxiety (37%, 95% CI: 26–48%) was higher after March 1 than before it (21%, 95% CI: 16–25% and 19%, 95% CI: 13–25%).

Conclusions

The meta-analysis results presented that the prevalence of depression (39%) or anxiety (36%) among college students greatly increased during the COVID-19 pandemic. In addition, the mental health of college students is affected by the nations and the survey date. It was necessary to take measures to reduce mental health risks during the pandemic.

Low prevalence of active trachoma and associated factors among children aged 1-9 years in rural communities of Metema District, Northwest Ethiopia: a community based cross-sectional study

BACKGROUND

Trachoma is an infectious disease of the eye caused by Chlamydia trachomatis and transmitted via contact with eye discharge from infected persons and leading to blindness worldwide. Children less than 9 years of age affected more seriously. The disease is common where access to water and sanitation are limited.

OBJECTIVE

To determine the prevalence of active trachoma and associated factors among children aged 1-9 years in rural communities of Metema District, West Gondar Zone, Northwest Ethiopia.

METHOD

A community based cross-sectional study design was used to collect data from 792 children aged 1-9 years old in Metema district from April to May 2018. Multistage sampling technique was used to select the study participants. Pretested interviewer-administered structured questionnaire and eye examination using binocular loupe to differentiate trachoma cases was the data collection methods and tools. The bivariable and multivariable binary logistic regression model was employed for analysis. P-value < 0.05 was considered to declare statistical significance.

RESULTS

A total of 752 children aged l-9 years were enrolled in this study with response rate of 94.9%. The overall prevalence of active trachoma among the study participants was 11.8% (95% CI, 9.5-13.9). Unprotected source of water (AOR = 4.7; 95% CI: 2.5-8.9), lower household water consumption (AOR = 2.8; 95% CI: 1.3-6.0), improper latrine utilization (AOR = 3.2; 95% CI: 1.5-6.7), and frequency of face washing once per day (AOR = 5.3; 95% CI: 1.2-26.6) were the factors significantly associated with active trachoma.

CONCLUSION

The current study revealed a lower overall prevalence of active trachoma (11.8%) than the WHO threshold prevalence (20%) used to declare it as a severe public health problem. All residents and health professional should collaborate on trachoma prevention by implementing the WHO SAFE strategy- surgery for trichiasis, antibiotics, facial cleanliness and environmental improvement for further trachoma elimination.

Effectiveness and safety of azithromycin 1.5% eye drops for mass treatment of active trachoma in a highly endemic district in Cameroon

Objective

To evaluate the effectiveness and safety of azithromycin 1.5% eye drops under field conditions to reduce active trachoma in a highly endemic district in Cameroon. This is a follow-up of an initial report published in 2010.

Methods and analysis

Three annual campaigns were performed in 2008, 2009 and 2010 to treat the population (~1 20 000 individuals) of the Kolofata Health District with topical azithromycin 1.5% (one drop in each eye, morning and evening for three consecutive days). The effectiveness of this intervention against active trachoma was assessed in children aged 1–9 years in cross-sectional studies prior to each mass treatment using a systematic sampling procedure (in 2008, 2009 and 2010) and then 1 year (2011) and 3 years (2013) after the last intervention among the villages with previously high active trachoma prevalence or never tested.

Results

The prevalence of trachomatous inflammation—follicular (TF) dropped from 24.0% (95% CI 20.7 to 27.5) before treatment to 2.8% (95% CI 2.2 to 3.7) 1 year after completion of the 3 year campaign. Trachomatous inflammation—intense was present in only 4 (0.2%) children 1 year after the third round of treatment. Three years after the last campaign, the surveillance survey among the most prevalent villages and villages never tested before showed a prevalence of 5.2% (95% CI 3.6 to 7.2) of active trachoma. Tolerance was excellent, with no report of treatment interruption, serious ocular or systemic adverse events.

Conclusion

Annual mass treatment with azithromycin eye drops was shown to be effective in reducing TF to a level ≤5% one year after a 3-round annual mass treatment in an endemic region at the district level.

High Prevalence of Clinically Active Trachoma and Its Associated Risk Factors Among Preschool-Aged Children in Arba Minch Health and Demographic Surveillance Site, Southern Ethiopia

Background

Trachoma is the leading infectious cause of irreversible blindness. In areas where trachoma is endemic, active trachoma is common among preschool-aged children, with varying magnitude. There is a dearth of information on the prevalence of active trachoma among preschool-aged children (the most affected segment of the population).

Purpose

The study aimed to assess the prevalence of clinically active trachoma and its associated risk factors among preschool-aged children in Arba Minch Health and Demographic surveillance site, Southern Ethiopia.

Patients and Methods

A community-based cross-sectional study was conducted among 831 preschool-aged children from May 01 to June 16, 2019. A pre-tested and structured interviewer-administered Open Data Kit survey tool was used to collect data. The study participants were selected using a simple random sampling technique by allocating a proportion to each kebeles. Both bivariable and multivariable logistic regression analyses were performed to identify associated factors. The level of statistical significance was set at a p-value of less than 0.05 in multivariable logistic regression.

Results

The overall prevalence of clinically active trachoma among preschool-aged children was 17.8% with 95% CI (15%, 20%). Time taken to obtain water for greater than thirty minutes (AOR=2.8,95% CI: 1.62, 5.09), presence of animal pens in the living compound (AOR=5.1, 95% CI: 3.15, 8.33), improper solid waste disposal (AOR=7.8,95% CI: 4.68,13.26), improper latrine utilization (AOR=2.5, 95% CI: 1.63,3.94), a child with unclean face (AOR=3.5, 95% CI: 2.12,5.97) had higher odds of active trachoma.

Conclusion

The prevalence of clinically active trachoma among pre-school aged children was high. "Facial cleanliness" and "Environmental improvement" components of the SAFE strategy are vital components in working towards the 2020 target of eliminating trachoma. Therefore, stakeholders at different hierarchies need to exert continuing efforts to integrate the trachoma prevention and control programs with other public health programs, with water sanitation and hygiene programs and with the education system.