Association of environmental risk factors and trachoma in Gashoho Health District, Burundi

A review of Musca sorbens (Diptera: Muscidae) and Musca domestica behavior and responses to chemical and visual cues

Musca flies (Diptera: Muscidae) have been found culpable in the mechanical transmission of several infectious agents, including viruses, bacteria, protozoans, and helminths, particularly in low-income settings in tropical regions. In large numbers, these flies can negatively impact the health of communities and their livestock through the transmission of pathogens. In some parts of the world, Musca sorbens is of particular importance because it has been linked with the transmission of trachoma, a leading cause of preventable and irreversible blindness or visual impairment caused by Chlamydia trachomatis, but the contribution these flies make to trachoma transmission has not been quantified and even less is known for other pathogens. Current tools for control and monitoring of house flies remain fairly rudimentary and have focused on the use of environmental management, insecticides, traps, and sticky papers. Given that the behaviors of flies are triggered by chemical cues from their environment, monitoring approaches may be improved by focusing on those activities that are associated with nuisance behaviors or with potential pathogen transmission, and there are opportunities to improve fly control by exploiting behaviors toward semiochemicals that act as attractants or repellents. We review current knowledge on the odor and visual cues that affect the behavior of M. sorbens and Musca domestica, with the aim of better understanding how these can be exploited to support disease monitoring and guide the development of more effective control strategies.

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 and circulant genotypes of Chlamydia trachomatis in university women from cities in the Brazilian Amazon

BACKGROUND

Approximately 80% of infected women infected by Chlamydia trachomatis are asymptomatic, although this infection can lead to serious complications in the female reproductive tract. Few data on Chlamydia infection and genotypes are available in Amazonian communities.

OBJECTIVES

To describe the prevalence of and associated factors and to identify the genotypes of sexual C. trachomatis infection in female university students in different urban centers (capital and interiors) in the Brazilian state of Pará, in the eastern Amazon region.

METHODS

A cross-sectional study was performed among young women attending public universities in four different urban centers in the eastern Amazon region. They were invited to participate in the studt and cervical secretions were collected for molecular diagnosis of C. trachomatis. We utilized amplification of the ompA gene by nested PCR. Positive samples were genotyped by nucleotide sequencing. Study participants completed a questionnaire on social, epidemiological, and reproductive health variables. A Qui-square and Binominal regression test were used to evaluate the degree of association of these variables with the infection.

RESULTS

A total of 686 female students was included in the study. The overall prevalence of C. trachomatis was 11.2% (77/686). The prevalence of this infection was higher in interiors (15.2% vs 9.5%/ p: 0.0443). Female university students who do not have a sexual partner (11.8%/p <0.008), who do not use a condom in their sexual relations (17.8%/p <0.0001) and who reported having suffered a miscarriage (32%/p <0.0001) have high chances of acquiring this sexual infection. The ompA gene was sequenced in only 33 (42.8%) samples, revealing the genotype J was the most frequent (27.2% [9/33]), followed by genotypes D (24.2% [8/33]), and then genotypes F (18.2% [6/33]), E (15.1% [5/33]) K (6.1% [2/33]), Ia (6.1% [2/33]), and G (3.1% [1/33]).

CONCLUSIONS

The high prevalence of sexual infection by C. trachomatis in the female university students from the interior of the state of Pará, individuals with no fixed sexual partner, those that had had a miscarriage, the students that do not use condoms in their sexual relations. The genotype J of C. trachomatis genotypes was the most frequent. These data are important to help defining the epidemiological effects of chlamydial infections in Amazonian populations.

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.

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.

Reproductive health issues, infections and non-communicable diseases

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