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Asmare ZA, Seifu BL, Mare KU, Asgedom YS, Kase BF, Shibeshi AH, Tebeje TM, Lombebo AA, Sabo KG, Fente BM, Teshale AB, Asebe HA. Prevalence and associated factors of active trachoma among 1-9 years of age children in Andabet district, northwest Ethiopia, 2023: A multi-level mixed-effect analysis. PLoS Negl Trop Dis 2023; 17:e0011573. [PMID: 37590321 PMCID: PMC10464999 DOI: 10.1371/journal.pntd.0011573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/29/2023] [Accepted: 08/05/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Trachoma is the chief cause of preventable blindness worldwide and has been earmarked for elimination as a public health problem by 2030. Despite the five-year Surgery, Antibiotics, Facial cleanliness, and Environmental improvement (SAFE)-based interventions in the Andabet district, the prevalence of trachomatous follicular (TF) was 37%. With such a high prevalence of TF, the determinant factors were not revealed. Besides, there were no reports on the overall prevalence of active trachoma (i.e.TF and or trachomatous intense (TI)). OBJECTIVE To determine the prevalence and associated factors of active trachoma among 1-9 years of age children in the Andabet district. METHOD A community-based cross-sectional study was conducted among children aged under nine years from March 1-30, 2023 in Andabet district, Northwest Ethiopia. Multi-stage systematic random sampling was employed to reach 540 children. A multilevel mixed-effect logistic regression analysis was employed to assess factors associated with active trachoma. We fitted both random effect and fixed effect analysis. Finally, variables with p<0.05 in the multivariable multilevel analysis were claimed to be significantly associated with active trachoma. RESULT In this study, the overall prevalence of active trachoma was 35.37% (95% CI: 31.32%, 39.41%). The prevalence of TF and TI was 31.3% and 4.07% respectively. In the multilevel logistic regression analysis ocular discharge, fly-eye contact, latrine utilization, and source of water were significantly associated with the prevalence of active trachoma. CONCLUSION In this study, the prevalence of active trachoma was much higher than the World Health Organization (WHO) threshold prevalence. Ocular discharge, fly-eye contact, latrine utilization, and source of water were independent determinants of active trachoma among children (1-9 years). Therefore, paying special attention to these high-risk groups could decrease the prevalence of a neglected hyperendemic disease, active trachoma.
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Affiliation(s)
- Zufan Alamrie Asmare
- Department of Ophthalmology, School of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Beminate Lemma Seifu
- Department of Public Health, Collage of Medicine and Health Science, Samara University, Afar, Ethiopia
| | - Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Afar, Ethiopia
| | - Yordanos Sisay Asgedom
- Department of Epidemiology and Biostatics, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Bizunesh Fantahun Kase
- Department of Public Health, Collage of Medicine and Health Science, Samara University, Afar, Ethiopia
| | - Abdu Hailu Shibeshi
- Department of Statistics, College of Natural and Computational Science, Samara University, Afar, Ethiopia
| | - Tsion Mulat Tebeje
- School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Afework Alemu Lombebo
- School of Medicine, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kebede Gemeda Sabo
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Afar, Ethiopia
| | - Bezawit Melak Fente
- Department of General Midwifery, School of Midwifery, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hiwot Altaye Asebe
- Department of Public Health, Collage of Medicine and Health Science, Samara University, Afar, Ethiopia
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Asmare ZA, Assefa NL, Abebe D, Nigatu SG, Alimaw YA. Trachoma prevention practice and associated factors among mothers having children aged under nine years in Andabet district, northwest Ethiopia, 2022: A multi-level analysis. PLoS Negl Trop Dis 2023; 17:e0011433. [PMID: 37390045 DOI: 10.1371/journal.pntd.0011433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 06/02/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND The world health organization (WHO) adopted the Surgery, Antibiotic, facial cleanliness, and environmental improvement (SAFE) strategy for the prevention of trachoma, and different prevention strategies have been employed in Andabet district. Trachoma still has a high prevalence despite these efforts. So, it is imperative to assess ground trachoma prevention practice (TPP) since there are insufficient studies in the study area. OBJECTIVE To determine the magnitude and factors associated with TPP among mothers having children aged under nine years in Andabet district, Northwest Ethiopia. METHOD A community-based cross-sectional study involving 624 participants was conducted June 1-30, 2022. Systematic random sampling was carried out to select study participants. Multi-level binary logistic regression analysis was used to identify factors associated with poor TPP. Descriptive and summary statistics were performed and variables with p-value < 0.05 in the best-fitted model were declared to be significantly associated with poor TPP. RESULTS In this study, the proportion of poor TPP was found to be 50.16% (95%CI = 46.23, 54.08). In the multi-variable multi-level logistic regression; having no formal education (AOR = 2.95; 95%CI: 1.41,6.15) and primary education (AOR = 2.33; 95%CI:1.04, 5.24), being a farmer (AOR = 3.02; 95%CI:1.73,5.28), and merchant (AOR = 2.63; 95%CI:1.20, 5.75), time taken to water point >30 minutes (AOR = 4.60,95CI:1.30,16.26) and didn't receive health education about trachoma (AOR = 2.36;95CI:1.16,4.79) were significantly associated with poor TPP. CONCLUSION The proportion of poor TPP was high relative to other studies. Level of education, occupation, time taken to the water point, and health education were significantly associated with poor TPP. Therefore, taking special attention to these high-risk groups could decrease the poor TPP.
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Affiliation(s)
- Zufan Alamrie Asmare
- Department of Ophthalmology, School of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Lakachew Assefa
- Department of Optometry, School of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Abebe
- Department of Ophthalmology, School of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Solomon Gedlu Nigatu
- Department of Epidemiology & Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yezinash Addis Alimaw
- Department of Optometry, School of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Lee L, Moo E, Angelopoulos T, Yashadhana A. Integrated people-centered eye care: A scoping review on engaging communities in eye care in low- and middle-income settings. PLoS One 2023; 18:e0278969. [PMID: 36656849 PMCID: PMC9851534 DOI: 10.1371/journal.pone.0278969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/24/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Community engagement has been endorsed as a key strategy to achieving integrated people-centered eye care that enables people and communities to receive a full spectrum of eye care across their life-course. Understanding the ways communities are engaged in eye care, to what degree participation is achieved, and the factors associated with intervention implementation is currently limited. OBJECTIVE The scoping review aimed to assess how community engagement is approached and implemented in eye care interventions in low- and middle-income countries, and to identify the barriers and facilitators associated with intervention implementation. METHODS Searches were conducted across five databases for peer-reviewed research on eye care interventions engaging communities published in the last ten years (January 2011 to September 2021). Studies were screened, reviewed and appraised according to Cochrane Rapid Reviews methodology. A hybrid deductive-inductive iterative analysis approach was used. RESULTS Of 4315 potential studies screened, 73 were included in the review. Studies were conducted across 28 countries and 55 targeted populations across more than one life-course stage. A variety of community actors were engaged in implementation, in four main domains of eye care: health promotion and education; drug and supplement distribution and immunization campaigns; surveillance, screening and detection activities; and referral and pathway navigation. With the approaches and level of participation, the majority of studies were community-based and at best, involved communities, respectively. Involving community actors alone does not guarantee community trust and therefore can impact eye care uptake. Community actors can be integrated into eye care programs, although with varying success. Using volunteers highlighted sustainability issues with maintaining motivation and involvement when resources are limited. CONCLUSION This scoping review provides researchers and policy makers contextual evidence on the breadth of eye care interventions and the factors to be considered when engaging and empowering communities in integrated people-centered eye care programs.
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Affiliation(s)
- Ling Lee
- International Programs Division, The Fred Hollows Foundation Australia, Melbourne, Australia
- School of Optometry and Vision Science, The University of New South Wales, Sydney Australia
- Department of Pediatrics, The University of Melbourne, Melbourne, Australia
- * E-mail:
| | - Elise Moo
- International Programs Division, The Fred Hollows Foundation Australia, Melbourne, Australia
| | - Tiffany Angelopoulos
- International Programs Division, The Fred Hollows Foundation Australia, Melbourne, Australia
| | - Aryati Yashadhana
- International Programs Division, The Fred Hollows Foundation Australia, Melbourne, Australia
- Centre for Primary Health Care and Equity, The University of New South Wales, Sydney, Australia
- School of Population Health, The University of New South Wales, Sydney, Australia
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Shobiso MG, Hussen MS, Munaw MB, Tilahun MM. Trachoma Prevention Practice and Associated Factors in Rural Lemo District, Southern Ethiopia, 2021. Ethiop J Health Sci 2023; 33:123-132. [PMID: 36890944 PMCID: PMC9987275 DOI: 10.4314/ejhs.v33i1.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/01/2022] [Indexed: 03/10/2023] Open
Abstract
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.
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Genet A, Dagnew Z, Melkie G, Keleb A, Motbainor A, Mebrat A, Leshargie CT. Prevalence of active trachoma and its associated factors among 1–9 years of age children from model and non-model kebeles in Dangila district, northwest Ethiopia. PLoS One 2022; 17:e0268441. [PMID: 35704657 PMCID: PMC9200339 DOI: 10.1371/journal.pone.0268441] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 04/30/2022] [Indexed: 11/20/2022] Open
Abstract
Background Trachoma is the leading infectious disease that leads to blindness worldwide, especially in developing countries. Though Ethiopia had targeted a trachoma elimination program by 2020, the problem worsens, particularly in the Amhara Region. Even though sustained intervention measures are undertaken across the region, it is unclear why trachoma is still a significant public health problem. So, this study assessed the prevalence of active trachoma and associated factors among 1–9 years of age children from model and non-model kebeles in Dangila district Amhara Region, Northwest Ethiopia. Methods A community-based comparative cross-sectional study was conducted from 20th September 2019 to 29th October 2019. A multistage stratified random sampling technique was used to reach 704 children from model and non-model kebeles. Samples were allocated proportionally to model and non-model kebeles. A structured and pretested data collection tool and observational checklist was used to manage the necessary data. Data were coded and entered in Epidata version 4.6, and further analysis was done using SPSS version 20 software. Bivariable and multivariable logistic regression analysis was employed to identify factors associated with active trachoma. Adjusted Odds Ratios (AOR), p-value, and respected Confidence Interval (CI) were used to report the findings. Results Seven hundred four children were included in this study, with a response rate of 97.8%. The overall prevalence of active trachoma was 6% (95% CI: 4.5, 8.1). The prevalence of active trachoma among non-model and model Kebele was not significantly different. Still, the prevalence of active trachoma among children from model Kebele were [4.5%, (95% CI: 2.4%, 7.1%)] relatively lower compared with non-model kebeles, [7.6%, 95% CI: (4.9%, 10.9%)]. Moreover, not using latrine (AOR = 4.29, 95% CI: 1.96, 9.34), fly-eye contact (AOR = 2.59, 95% CI: 1.11, 6.03), presence of sleep in eyes (AOR = 2.46, 95% CI: 1.10, 5.47), presence of ocular discharge (AOR = 2.79, 95% CI: 1.30, 6.00), presence of nasal discharges (AOR = 2.67, 95% CI: 1.21, 5.90) and washing faces with soap (AOR = 0.22, 95% CI: 0.07, 0.69) were found significantly associated with the prevalence of active trachoma among children 1–9 years old. Conclusions The prevalence of active trachoma in the model and non-model kebeles was high and did not show a statistical difference. Attention to be given to latrine utilization, washing face with soap, and other personal hygiene activities.
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Affiliation(s)
- Almaw Genet
- Awi Zone, Dangila Woreda Health Office, Dangila, Ethiopia
| | - Zewdu Dagnew
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Gashaw Melkie
- Department of Environmental Health, School of Public Health, Teda Health Science College, Gondar, Ethiopia
| | - Awoke Keleb
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Achenef Motbainor
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amare Mebrat
- School of Public Health, College of Medicine and Health Science, Wolldia University, Woldia, Ethiopia
| | - Cheru Tesema Leshargie
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- * E-mail:
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Shimelash A, Alemayehu M, Dagne H, Mihiretie G, Lamore Y, Tegegne E, Kumlachew L. Prevalence of active trachoma and associated factors among school age children in Debre Tabor Town, Northwest Ethiopia, 2019: a community based cross-sectional study. Ital J Pediatr 2022; 48:61. [PMID: 35505439 PMCID: PMC9066785 DOI: 10.1186/s13052-022-01258-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/01/2022] [Indexed: 11/20/2022] Open
Abstract
Background Trachoma is an infectious eye disease caused by Chlamydial trachomatis. It is a major health problem in poor nations, notably in Sub-Saharan Africa. Despite the severity of the problem, there was a scarcity of data on trachoma prevalence and associated factors among school-aged children in Debre Tabor town following SAFE and MDA. Objectives The goal of this study was to determine the prevalence of active trachoma and its associated factors among school-aged children in Debre Tabor, Northwest Ethiopia, in 2019. Methods A community-based cross-sectional study was used among school-aged children. Structured interview questionnaires, an observational checklist, and a physical examination were used to collect data from study participants who were chosen using a systematic random sampling procedure. IBM SPSS 20 was used to enter data, which was then transferred to IBM SPSS 20 for bivariate and multivariable logistic regression analysis. Result A total of 394 children aged 5–15 had been screened and took part in the study, with 9.9% (95% CI: 6.9, 12.7) testing positive for active trachoma. Having an unimproved larine type (AOR = 5.18; 95%CI: 1.96, 13.69), improper solid waste disposal (AOR = 3.026; 95%CI: 1.17, 7.8), family size greater than four (AOR = 3.4; 95%CI: 1.22, 9.49), not using soap for face washing (AOR = 4.48; 95%CI: 1.46, 13.72) and an unclean face of the child during examination (AOR = 23.93; 95%CI: 8.25, 69.38) were found to be significant predictors of active trachoma. Conclusion Active trachoma among school-age children was high compared to the WHO’s definition of trachoma as a public health problem. A family size of four, poor solid waste management, an unimproved type of latrine, an unclean child's face, and not using soap when washing one's face were all significant predictors of active trachoma. Promotion of behavioral determinants through health education programs like keeping facial cleanliness by washing their child’s face with soap, managing solid waste properly, and installing improved latrines to reduce active trachoma needs to be in place.
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Affiliation(s)
- Alebachew Shimelash
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Mekuriaw Alemayehu
- Institutes of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Henok Dagne
- Institutes of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getenet Mihiretie
- Department of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yonas Lamore
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Eniyew Tegegne
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
| | - Lake Kumlachew
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Naqvi FA, Das JK, Salam RA, Raza SF, Lassi ZS, Bhutta ZA. Interventions for Neglected Tropical Diseases Among Children and Adolescents: A Meta-analysis. Pediatrics 2022; 149:186947. [PMID: 35503336 DOI: 10.1542/peds.2021-053852e] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) are a group of communicable diseases affecting the poorest populations around the world. OBJECTIVE To assess the effectiveness of interventions, including mass drug administration (MDA), water, sanitation, and hygiene (WASH), vector control, health education, and micronutrients supplementation, for NTDs among children and adolescents. METHODS We conducted a literature search on the Cochrane Controlled Trials Register, Medline, and other databases until December 2020. We included randomized controlled trials and quasi-experimental studies conducted among children and adolescents. Two authors independently screened studies for relevance. Two authors independently extracted data, assessed the risk of bias, performed metaanalysis, and rated the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation. RESULTS We included 155 studies (231 articles) involving 262 299 participants. For soil-transmitted helminthiasis, MDA may reduce the prevalence of Ascaris, Trichuris, and hookworm by 58%, 36%, and 57%, respectively. We are uncertain of the effect of health education, WASH, and iron supplementation on soil-transmitted helminthiasis prevalence. For Schistosomiasis, health education probably reduces the intensity and prevalence of S. mansoni, whereas micronutrient supplementation may reduce anemia prevalence and the infection intensity of S. hematobium compared with no supplementation. We are uncertain of the effect of MDA and vector control on Schistosomiasis outcomes. For trachoma, health education probably reduces the prevalence of active Trachoma, whereas we are uncertain of the effect of MDA, WASH, and vector control on Trachoma outcomes. There is limited data on the effectiveness of interventions for NTDs targeting children and adolescents. CONCLUSION Future studies are needed to evaluate the relative effectiveness and cost-effectiveness of various interventions specifically targeting children and adolescents.
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Affiliation(s)
- Fatima Abbas Naqvi
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Rehana A Salam
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Syeda Fatima Raza
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Zohra S Lassi
- Robinson Research Institute, the University of Adelaide, Adelaide, Australia.,Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Zulfiqar A Bhutta
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan.,Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
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Chirgwin H, Cairncross S, Zehra D, Sharma Waddington H. Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low- and middle-income countries: An evidence and gap map of effectiveness studies. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1194. [PMID: 36951806 PMCID: PMC8988822 DOI: 10.1002/cl2.1194] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Background Lack of access to and use of water, sanitation and hygiene (WASH) cause 1.6 million deaths every year, of which 1.2 million are due to gastrointestinal illnesses like diarrhoea and acute respiratory infections like pneumonia. Poor WASH access and use also diminish nutrition and educational attainment, and cause danger and stress for vulnerable populations, especially for women and girls. The hardest hit regions are sub-Saharan Africa and South Asia. Sustainable Development Goal (SDG) 6 calls for the end of open defecation, and universal access to safely managed water and sanitation facilities, and basic hand hygiene, by 2030. WASH access and use also underpin progress in other areas such as SDG1 poverty targets, SDG3 health and SDG4 education targets. Meeting the SDG equity agenda to "leave none behind" will require WASH providers prioritise the hardest to reach including those living remotely and people who are disadvantaged. Objectives Decision makers need access to high-quality evidence on what works in WASH promotion in different contexts, and for different groups of people, to reach the most disadvantaged populations and thereby achieve universal targets. The WASH evidence map is envisioned as a tool for commissioners and researchers to identify existing studies to fill synthesis gaps, as well as helping to prioritise new studies where there are gaps in knowledge. It also supports policymakers and practitioners to navigate the evidence base, including presenting critically appraised findings from existing systematic reviews. Methods This evidence map presents impact evaluations and systematic reviews from the WASH sector, organised according to the types of intervention mechanisms, WASH technologies promoted, and outcomes measured. It is based on a framework of intervention mechanisms (e.g., behaviour change triggering or microloans) and outcomes along the causal pathway, specifically behavioural outcomes (e.g., handwashing and food hygiene practices), ill-health outcomes (e.g., diarrhoeal morbidity and mortality), nutrition and socioeconomic outcomes (e.g., school absenteeism and household income). The map also provides filters to examine the evidence for a particular WASH technology (e.g., latrines), place of use (e.g., home, school or health facility), location (e.g., global region, country, rural and urban) and group (e.g., people living with disability). Systematic searches for published and unpublished literature and trial registries were conducted of studies in low- and middle-income countries (LMICs). Searches were conducted in March 2018, and searches for completed trials were done in May 2020. Coding of information for the map was done by two authors working independently. Impact evaluations were critically appraised according to methods of conduct and reporting. Systematic reviews were critically appraised using a new approach to assess theory-based, mixed-methods evidence synthesis. Results There has been an enormous growth in impact evaluations and systematic reviews of WASH interventions since the International Year of Sanitation, 2008. There are now at least 367 completed or ongoing rigorous impact evaluations in LMICs, nearly three-quarters of which have been conducted since 2008, plus 43 systematic reviews. Studies have been done in 83 LMICs, with a high concentration in Bangladesh, India, and Kenya. WASH sector programming has increasingly shifted in focus from what technology to supply (e.g., a handwashing station or child's potty), to the best way in which to do so to promote demand. Research also covers a broader set of intervention mechanisms. For example, there has been increased interest in behaviour change communication using psychosocial "triggering", such as social marketing and community-led total sanitation. These studies report primarily on behavioural outcomes. With the advent of large-scale funding, in particular by the Bill & Melinda Gates Foundation, there has been a substantial increase in the number of studies on sanitation technologies, particularly latrines. Sustaining behaviour is fundamental for sustaining health and other quality of life improvements. However, few studies have been done of intervention mechanisms for, or measuring outcomes on sustained adoption of latrines to stop open defaecation. There has also been some increase in the number of studies looking at outcomes and interventions that disproportionately affect women and girls, who quite literally carry most of the burden of poor water and sanitation access. However, most studies do not report sex disaggregated outcomes, let alone integrate gender analysis into their framework. Other vulnerable populations are even less addressed; no studies eligible for inclusion in the map were done of interventions targeting, or reporting on outcomes for, people living with disabilities. We were only able to find a single controlled evaluation of WASH interventions in a health care facility, in spite of the importance of WASH in health facilities in global policy debates. The quality of impact evaluations has improved, such as the use of controlled designs as standard, attention to addressing reporting biases, and adequate cluster sample size. However, there remain important concerns about quality of reporting. The quality and usefulness of systematic reviews for policy is also improving, which draw clearer distinctions between intervention mechanisms and synthesise the evidence on outcomes along the causal pathway. Adopting mixed-methods approaches also provides information for programmes on barriers and enablers affecting implementation. Conclusion Ensuring everyone has access to appropriate water, sanitation, and hygiene facilities is one of the most fundamental of challenges for poverty elimination. Researchers and funders need to consider carefully where there is the need for new primary evidence, and new syntheses of that evidence. This study suggests the following priority areas:Impact evaluations incorporating understudied outcomes, such as sustainability and slippage, of WASH provision in understudied places of use, such as health care facilities, and of interventions targeting, or presenting disaggregated data for, vulnerable populations, particularly over the life-course and for people living with a disability;Improved reporting in impact evaluations, including presentation of participant flow diagrams; andSynthesis studies and updates in areas with sufficient existing and planned impact evaluations, such as for diarrhoea mortality, ARIs, WASH in schools and decentralisation. These studies will preferably be conducted as mixed-methods systematic reviews that are able to answer questions about programme targeting, implementation, effectiveness and cost-effectiveness, and compare alternative intervention mechanisms to achieve and sustain outcomes in particular contexts, preferably using network meta-analysis.
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Affiliation(s)
- Hannah Chirgwin
- International Initiative for Impact Evaluation (3ie)London International Development CentreLondonUK
| | | | | | - Hugh Sharma Waddington
- London School of Hygiene and Tropical Medicine and International Initiative for Impact Evaluation (3ie)London International Development CentreLondonUK
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Belsti Y, Fekadu SA, Assem AS. Active trachoma prevalence and its associated factors among children aged 1-9 years in rural residents of Lare District, Southwest Ethiopia. Int J Ophthalmol 2021; 14:1756-1764. [PMID: 34804867 DOI: 10.18240/ijo.2021.11.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/30/2021] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Yitayeh Belsti
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar 196, Ethiopia
| | - Sofonias Addis Fekadu
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar 196, Ethiopia
| | - Abel Sinshaw Assem
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar 196, Ethiopia
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Brito CMGD, Medeiros ZMD, Barbosa CC, Montarroyos UR, Ferraz C, Vieira MDT, Lopes MDFC, Gouveia GC. Prevalence of trachoma in Pernambuco State, Brazil (2014-2015). Rev Inst Med Trop Sao Paulo 2021; 63:e29. [PMID: 33852712 PMCID: PMC8046508 DOI: 10.1590/s1678-9946202163029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/12/2021] [Indexed: 08/30/2023] Open
Abstract
To estimate the prevalence of cases of trachoma in the population at social risk
aged 1-9 years in Pernambuco State and its mesoregions. This was a
cross-sectional study in which secondary data from the National Household Survey
on Trachoma (2014-2015) were analyzed. The study covered 96 census tracts
distributed across the mesoregions of Pernambuco State (Metropolitan Region of
Recife, Zona da Mata, Agreste, Sertao do Sao Francisco and Sertao Pernambucano).
The study included all homes with children aged 1-9 years, and all of them were
examined for trachoma, using the WHO criteria. Among the total of 7,423 children
aged 1-9 years who participated in this survey, 446 presented with active
trachoma. Thus, the prevalence of trachoma in Pernambuco State, in children
between 1-9 years old was 6.65%, and it was higher among children aged 5-9 years
(7.12%) and among girls (7.23%). This result was seen in the majority of the
mesoregions studied, except in the Zona da Mata and Sertao do Sao Francisco,
where there were higher prevalences in the age group of 1-4 years (5.55%) and
among boys (5.90%). A tendency towards a higher prevalence between 1 and 6 years
of age was observed. The follicular trachoma continues to be an important public
health problem in Pernambuco State. It particularly affects poor people,
including those living in urban areas of the State.
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Affiliation(s)
- Cintia Michele Gondim de Brito
- Universidade de Pernambuco, Recife, Pernambuco, Brazil.,Secretaria de Saúde, I Região de Saúde, Departamento da Vigilância em Saúde, Recife, Pernambuco, Brazil
| | - Zulma Maria de Medeiros
- Universidade de Pernambuco, Recife, Pernambuco, Brazil.,Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Recife, Pernambuco, Brazil
| | - Celivane Cavalcanti Barbosa
- Secretaria de Saúde, I Região de Saúde, Departamento da Vigilância em Saúde, Recife, Pernambuco, Brazil.,Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Recife, Pernambuco, Brazil
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Eshetu D, Kifle T, Hirigo AT. Knowledge, Attitudes, and Practices of Hand Washing among Aderash Primary Schoolchildren in Yirgalem Town, Southern Ethiopia. J Multidiscip Healthc 2020; 13:759-768. [PMID: 32821113 PMCID: PMC7423343 DOI: 10.2147/jmdh.s257034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 06/24/2020] [Indexed: 11/23/2022] Open
Abstract
Background Hand washing is a simple, convenient, and cost-effective means to limit the transmission of communicable diseases. Improving the practice of hand washing is vital to decrease hygiene-related morbidity and mortality, particularly in developing countries. As such, this study aimed to assess knowledge, attitudes, and practices of hand washing among schoolchildren in Aderash primary school, Yirgalem town. Methods A cross-sectional study was conducted on 279 schoolchildren from March to May 2019. A pretested structured questionnaire was applied to collect all relevant information using simple random sampling. Data entry and clearance was done with Epi-Info version 7 and exported to SPSS version 20 for analysis. Adjusted ORs with 95% CI were used to assess statistically significant variables (p<0.05). Results Overall, 62.7% of schoolchildren had adequate knowledge of hand washing, 61.3% exhibited positive attitudes toward hand washing and 39.1% had good hand-washing practices. Over three quarters (89%) of them had good knowledge of washing hands with soap. About 24%, 56.6%, 9.3%, 6.5%, and 3.6% of children reported washing hands after defecation, before meals, after meals, after work, and after play, respectively. In addition, 73.8% of them reported washing hands with soap if their hands looked dirty or smelled bad. Urban dwelling increased knowledge of hand washing of 1.3-fold (95% CI 1.2–2.85). Conclusion Even though >60% of children had adequate knowledge and exhibited positive attitudes toward hand washing, proper hand-washing practices was <40%. Therefore, much effort should be directed toward improving children’s understanding of the benefits of proper hand washing in schools.
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Affiliation(s)
- Daniel Eshetu
- Department of Microbiology, Yirgalem Hospital Medical College, Yirgalem, Ethiopia
| | - Tigist Kifle
- College of Medicine and Health Science, Comprehensive Specialized Hospital, Hematology Unit, Hawassa University, Hawassa, Ethiopia
| | - Agete Tadewos Hirigo
- College of Medicine and Health Science, School of Medical Laboratory Sciences, Hawassa University, Hawassa, Ethiopia
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Reda G, Yemane D, Gebreyesus A. Prevalence and associated factors of active trachoma among 1-9 years old children in Deguatemben, Tigray, Ethiopia, 2018: community cross-sectional study. BMC Ophthalmol 2020; 20:144. [PMID: 32293359 PMCID: PMC7161230 DOI: 10.1186/s12886-020-01394-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Trachoma 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. METHODS We 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. RESULTS The 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. CONCLUSION The 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.
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Affiliation(s)
| | - Dejen Yemane
- College of Health Sciences, Mekelle University, P.O.BOX:1871, Mekelle, Tigray, Ethiopia
| | - Aregawi Gebreyesus
- College of Health Sciences, Mekelle University, P.O.BOX:1871, Mekelle, Tigray, Ethiopia.
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de Brito CMG, Barbosa CC, de Andrade SMC, de Oliveira ALS, Montarroyos UR, Ferraz C, Vieira MDT, Lopes MDFC, Gouveia GC, de Medeiros ZM. Household Survey of Trachoma among Children Living in Pernambuco, Brazil. Pathogens 2019; 8:pathogens8040263. [PMID: 31775360 PMCID: PMC6963545 DOI: 10.3390/pathogens8040263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 09/28/2019] [Accepted: 10/10/2019] [Indexed: 11/18/2022] Open
Abstract
This study analyzed the association between individual and household factors and the incidence of trachoma among a population aged between 1 and 9 years in the state of Pernambuco. This was a population-based household study conducted using a population-based sample of residents from 96 census sectors of the 1778 sectors considered to be at social risk in the state. The estimated odds ratio of the univariate analysis presented a confidence interval of 95%. Weights and clusters were adjusted through the Generalized Linear and Latent Mixed Model (GLLAM) method. Trachoma cases were the dependent variable in the multivariate analysis. The independent variables were selected through the stepwise forward method, with an input criterion of 20% (p < 0.20) and an output criterion of 10% (p < 0.10). The prevalence was 6.65%. Trachoma was associated with a female sex, age of 5–9 years, either the absence of use or infrequent use of soap to wash the hands and face, the presence of nasal secretion, a lack of piped water from a public supply system, a greater number of rooms used for sleeping, a greater number of people living in the same household, and a family income of up to one minimum monthly wage. The prevalence of follicular trachoma in Pernambuco was higher than what is recommended by the World Health Organization (WHO).
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Affiliation(s)
- Cintia Michele Gondim de Brito
- University of Pernambuco, Recife 50100130, Pernambuco, Brazil; (U.R.M.)
- Department of Epidemiological Surveillance, First Healthcare Region of the Health Department of the State of Pernambuco, Recife 50050911, Pernambuco, Brazil;
- Correspondence: ; Tel.: +55-(81)-991388298
| | - Celivane Cavalcanti Barbosa
- Department of Epidemiological Surveillance, First Healthcare Region of the Health Department of the State of Pernambuco, Recife 50050911, Pernambuco, Brazil;
- Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (FIOCRUZ), Recife 50740465, Pernambuco, Brazil; (S.M.C.d.A.); (A.L.S.d.O.); (G.C.G.)
| | - Sérgio Murilo Coelho de Andrade
- Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (FIOCRUZ), Recife 50740465, Pernambuco, Brazil; (S.M.C.d.A.); (A.L.S.d.O.); (G.C.G.)
| | - André Luiz Sá de Oliveira
- Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (FIOCRUZ), Recife 50740465, Pernambuco, Brazil; (S.M.C.d.A.); (A.L.S.d.O.); (G.C.G.)
| | | | - Cristiano Ferraz
- Federal University of Pernambuco, Recife 50670901 Pernambuco, Brazil;
| | | | | | - Giselle Campozana Gouveia
- Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (FIOCRUZ), Recife 50740465, Pernambuco, Brazil; (S.M.C.d.A.); (A.L.S.d.O.); (G.C.G.)
| | - Zulma Maria de Medeiros
- University of Pernambuco, Recife 50100130, Pernambuco, Brazil; (U.R.M.)
- Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (FIOCRUZ), Recife 50740465, Pernambuco, Brazil; (S.M.C.d.A.); (A.L.S.d.O.); (G.C.G.)
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Knowledge, Attitude, and Practice on Hygiene and Morbidity Status among Tertiary Students: The Case of Kotebe Metropolitan University, Addis Ababa, Ethiopia. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2018; 2018:2094621. [PMID: 30228823 PMCID: PMC6136465 DOI: 10.1155/2018/2094621] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/14/2018] [Accepted: 07/30/2018] [Indexed: 01/17/2023]
Abstract
Considerable fractions of the world's diseases are communicable, of which over 60% are infectious. Knowledge, attitude, and practice of hygiene are very important to decrease these disease burdens especially in places like higher education institutions. This study is aimed at revealing the status and gaps on knowledge, attitude, and practice of hygiene among Kotebe Metropolitan University students. Alongside, morbidity records of the students' clinic are reviewed. Sampled regular students who are boarding and who serve the students' canteen are studied. The investigation applied a cross-sectional study design. A structured questionnaire is administered following a pretest, and the data collected are analyzed using “SPSS v.20.” The review on morbidity record showed that the leading infections so far are respiratory (47%), gastrointestinal (amoebiasis, giardiasis, and typhoid) (34%), and eye and skin infections (16%). Regarding the responses to the knowledge questions, 1451 (60.8%) were correct while 934 (39.2%) were incorrect. Concerning handwashing as knowledge question, significant difference (p ≈ 0.00) existed between genders. Over 50% of the respondents do think parasitic infections typically amoeba is acquired not due to the contaminated vegetables, but rather they assume that such vegetables trigger those parasites already lodging in their gut. Above 60% of the respondents agreed that sharing drinking cups as a sign of affection as unfavorable attitude. In relation to that, the students' attitude highly varies by gender. However, the responses on hygiene practice enquiries appear to be promising. Further, the students do some practice while not having the desired level of knowledge on hygiene. Generally, there is a considerable gap in the knowledge, attitude, and practice of hygiene among students.
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Webb C, Cabada MM. A Review on Prevention Interventions to Decrease Diarrheal Diseases’ Burden in Children. CURRENT TROPICAL MEDICINE REPORTS 2018. [DOI: 10.1007/s40475-018-0134-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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