A community-based trachoma survey: Prevalence and risk factors in the tigray region of northern Ethiopia

Aim: Trachoma is a public health problem in Ethiopia accounting for 35 - 50% of cases of blindness. This study aims to determine the prevalence of trachoma in Tigray and to evaluate whether common risk factors are also risk factors in this region. Method: A cross sectional community-based survey was conducted. From six districts, a total of 48 villages were selected by a multistage cluster random sampling technique. A total of 3900 people who were selected randomly from 1200 households were assessed for signs of trachoma. Ophthalmic nurses used a simplified clinical grading system to assess stages of trachoma while environmentalists assessed risk factors for trachoma. Results: Of the 3900 people examined, 13% had trachomatous follicles (TF), 27% intense trachomatous inflammation (TI), 17.7% trachomatous scarring (TS), 3.4% trachomatous trichiasis ( TT) and 0.3% had corneal opacity ( CO). The presence of a kitchen with chimney had a protective effect on TS ( Adjusted Odds Ratio [AOR] = 0.82; 95% Confidence Interval [CI]: 0.65 - 0.96) and TT ( AOR = 0.80; 95% CI: 0.53; 0.97). Active trachoma was more prevalent among children (AOR = 0.97; 95% CI: 0.96 - 0.97), illiterates (AOR = 1.38; 95% CI: 1.13 - 1.69) and those who infrequently wash their face (AOR = 1.35; 95% CI: 1.18 - 1.54). Conclusions: Trachoma is hyperendemic in the Tigray region. Mass chemotherapy, the expansion of primary eye care services, and promotion of a regular face washing habit are recommended. We recommend further investigations on the effect of domestic use of biomass energy on trachoma.