Prevalence and associated factors of active trachoma among children aged 1-9 years old in mass drug administration graduated and non-graduated districts in Northwest Amhara region, Ethiopia: A comparative cross-sectional study

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.

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.

One size does not fit all: an application of stochastic modeling to estimating primary healthcare needs in Ethiopia at the sub-national level

BACKGROUND

Primary healthcare systems require adequate staffing to meet the needs of their local population. Guidelines typically use population ratio targets for healthcare workers, such as Ethiopia's goal of two health extension workers for every five thousand people. However, fixed ratios do not reflect local demographics, fertility rates, disease burden (e.g., malaria endemicity), or trends in these values. Recognizing this, we set out to estimate the clinical workload to meet the primary healthcare needs in Ethiopia by region.

METHODS

We utilize the open-source R package PACE-HRH for our analysis, which is a stochastic Monte Carlo simulation model that estimates workload for a specified service package and population. Assumptions and data inputs for region-specific fertility, mortality, disease burden were drawn from literature, DHS, and WorldPop. We project workload until 2035 for seven regions and two charted cities of Ethiopia.

RESULTS

All regions and charted cities are expected to experience increased workload between 2021 and 2035 for a starting catchment of five thousand people. The expected (mean) annual clinical workload varied from 2,930 h (Addis) to 3,752 h (Gambela) and increased by 19-28% over fifteen years. This results from a decline in per capita workload (due to declines in fertility and infectious diseases), overpowered by total population growth. Pregnancy, non-communicable diseases, sick child care, and nutrition remain the largest service categories, but their priority shifts substantially in some regions by 2035. Sensitivity analysis shows that fertility assumptions have major implications for workload. We incorporate seasonality and estimate monthly variation of up to 8.9% (Somali), though most services with high variability are declining.

CONCLUSIONS

Regional variation in demographics, fertility, seasonality, and disease trends all affect the workload estimates. This results in differences in expected clinical workload, the level of uncertainty in those estimates, and relative priorities between service categories. By showing these differences, we demonstrate the inadequacy of a fixed population ratio for staffing allocation. Policy-makers and regulators need to consider these factors in designing their healthcare systems, or they risk sub-optimally allocating workforce and creating inequitable access to care.

Burden of neglected tropical diseases and access to medicine and diagnostics in Ethiopia: a scoping review

BACKGROUND

More than 1.7 billion people are affected by neglected tropical diseases (NTDs) worldwide. Forty percent of the NTD-affected people live in Africa with the poorest, most vulnerable, and hard to reach geographical areas. The NTDs cause significant social and economic burden and deepen marginalization and stigmatization. The World Health Organization's current roadmap for NTD aims to prevent, control, eliminate, or eradicate 20 tropical diseases. Ethiopia experiences a high burden of these diseases, but current access to diagnostics, medicine, and/or care has been little explored to inform the country's NTD strategic plan. The overall purpose of the scoping review was to map and characterize the burden of NTDs and challenges in access to diagnostics, medicine, and/or care in Ethiopia.

METHODS

A systematic search of evidence was conducted in PubMed, Cochrane Library, and Google Scholar from January 2000 until May 2022, without restrictions of language or study design. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review was followed for screening of studies. Key findings were extracted and narrated qualitatively.

RESULTS

The search resulted in 4532 articles, of which 105 met the inclusion criteria and were included in the scoping review under three themes: burden of NTDs, access to diagnostics, medicine and/or care, and key barriers. Although gains have been made in the prevention and control of NTDs in Ethiopia, the burden remains high, and progress in access to diagnostics, medicine/drugs, and/or care is very slow. Poverty, poor quality of life, and underfunding of NTD programs decelerate the process of NTD elimination program in the country.

CONCLUSIONS

The scoping review identified a considerable number of studies on the burden of NTDs in Ethiopia and strategies for diagnosis, treatment, and/or care; however, there is a paucity of evidence on the suitability and potential benefits of novel diagnostic technologies and medicines in the country. A regular review and analysis of such country-level evidence is important to inform the country NTDs roadmap and local implementation strategies.

Prevalence of active trachoma and associated factors among children 1-9 years old at Arsi Negele Town, West Arsi Zone, Oromia Regional State, Southern Ethiopia

BACKGROUND

Trachoma is a public health issue in more than 50 nations worldwide, mainly in Sub-Saharan Africa, where hundreds of millions of people are considered blind. Ethiopia is projected to have 30% of the global active trachoma burden. The frequency of Trachoma Folliculitis in children aged 1 to 9 years old is 30% in the Oromia Region. Therefore, the aim of this study was to assess the prevalence of active trachoma and associated variables among children aged 1 to 9 years old in Arsi Negele Town, West Arsi Zone, Oromia Regional State, Southern Ethiopia, December 24-26, 2019.

METHODS

A community-based cross-sectional study was conducted in the Arsi Negele town community on December 24-26, 2019. A total of 178 study volunteers were recruited using a single population proportion formula and assigned to families in the town's three kebeles in proportion. A simple random selection procedure was used to choose study participants from the identified households. Madda Walabu University provided ethical approval, and different government structures provided letters of permission. Pre-tested structured questionnaires and binocular loupes X 2.5 were used to collect data from either mothers or fathers of eligible children for eye examination; torches with bottles of alcohol were used to gather data from either mothers or fathers of eligible children for eye examination. For analysis, data was entered into (IBM, SPSS) version 22. To assess factors associated with active trachoma, bivariate and multivariable logistic regressions were used. The crude and adjusted odds ratios with 95% confidence intervals were calculated to investigate the degree of association between the independent variables and active trachoma. Multivariate logistic regression was used to find connections between dependent and independent variables with a p≤ 0.05 confidence levels and a 95% confidence interval.

RESULT

The prevalence of active trachoma was determined to be 21.91% TF among 178 children aged 1 to 9 years. Flies on children's faces (AOR = 3.427; 95 percent CI: 1.432-8.171), unclean children's faces (AOR = 3.99; 95 percent CI: 1.427-11.158), face washing habits (AOR = 3.064; 95 percent CI: 1.273-7.373), and not using soap while face washing (AOR = 4.564; 95 percent CI 1.561-13.342) were found to be statistically significant associated factors with the prevalence of active trachoma.

CONCLUSION

The prevalence of active trachoma was found to be relatively high. Face washing practices and the lack of soap use while washing faces were found as associated factors requiring optimal interventions to prevent trachoma infection among children aged 1-9 years in Arsi Negele town.

Serological Evidence of Infectious Laryngotracheitis Infection and Associated Risk Factors in Chickens in Northwestern Ethiopia

Infectious laryngotracheitis (ILT) is a disease of high economic consequence to the poultry sector. Gallid herpesvirus 1 (GaHV-1), a.k.a infectious laryngotracheitis virus (ILTV), under the genus Iltovirus, and the family Herpesviridae, is the agent responsible for the disease. Despite the clinical signs on the field suggestive of ILT, it has long been considered nonexistent and a disease of no concern in Ethiopia. A cross-sectional study was conducted from November 2020 to June 2021 in three selected zones of the Amhara region (Central Gondar, South Gondar, and West Gojjam zones), Ethiopia, with the objective of estimating the seroprevalence of ILTV in chickens and identifying and quantifying associated risk factors. A total of 768 serum samples were collected using multistage cluster sampling and assayed for anti-ILTV antibodies using indirect ELISA. A questionnaire survey was used to identify the potential risk factors. Of the 768 samples, 454 (59.1%, 95% CI: 0.56–0.63) tested positive for anti-ILTV antibodies. Mixed-effect logistic regression analysis of potential risk factors showed that local breeds of chicken were less likely to be seropositive than exotic breeds (OR: 0.38, 95% CI: 0.24–0.61). In addition, factors such as using local feed source (OR: 6.53, 95% CI: 1.77–24.04), rearing chickens extensively (OR: 1.97, 95% CI: 0.78–5.02), mixing of different batches of chicken (OR: 14.51, 95% CI: 3.35–62.77), careless disposal of litter (OR: 1.62, 95% CI: 0.49–4.37), lack of house disinfection (OR: 11.05, 95% CI: 4.09–47.95), lack of farm protective footwear and clothing (OR: 20.85, 95% CI: 5.40–80.45), and careless disposal of dead chicken bodies had all been associated with increased seropositivity to ILTV. Therefore, implementation of biosecurity measures is highly recommended to control and prevent the spread of ILTV. Furthermore, molecular confirmation and characterization of the virus from ILT suggestive cases should be considered to justify the use of ILT vaccines.