Prevalence of and Risk Factors for Trachoma in Oromia Regional State of Ethiopia: Results of 79 Population-Based Prevalence Surveys Conducted with the Global Trachoma Mapping Project.
To complete the baseline trachoma map in Oromia, Ethiopia, by determining prevalences of trichiasis and trachomatous inflammation - follicular (TF) at evaluation unit (EU) level, covering all districts (woredas) without current prevalence data or active control programs, and to identify factors associated with disease.



Using standardized methodologies and training developed for the Global Trachoma Mapping Project, we conducted cross-sectional community-based surveys from December 2012 to July 2014.



Teams visited 46,244 households in 2037 clusters from 252 woredas (79 EUs). A total of 127,357 individuals were examined. The overall age- and sex-adjusted prevalence of trichiasis in adults was 0.82% (95% confidence interval, CI, 0.70-0.94%), with 72 EUs covering 240 woredas having trichiasis prevalences above the elimination threshold of 0.2% in those aged ≥15 years. The overall age-adjusted TF prevalence in 1-9-year-olds was 23.4%, with 56 EUs covering 218 woredas shown to need implementation of the A, F and E components of the SAFE strategy (surgery, antibiotics, facial cleanliness and environmental improvement) for 3 years before impact surveys. Younger age, female sex, increased time to the main source of water for face-washing, household use of open defecation, low mean precipitation, low mean annual temperature, and lower altitude, were independently associated with TF in children. The 232 woredas in 64 EUs in which TF prevalence was ≥5% require implementation of the F and E components of the SAFE strategy.



Both active trachoma and trichiasis are highly prevalent in much of Oromia, constituting a significant public health problem for the region.
a The Fred Hollows Foundation Ethiopia , Addis Ababa , Ethiopia.
Berhanu
B
Bero
b Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.|c Sightsavers, Haywards Heath , UK.
Colin
C
Macleod
a The Fred Hollows Foundation Ethiopia , Addis Ababa , Ethiopia.|d Berhan Public Health and Eye Care Consultancy , Addis Ababa , Ethiopia.
Wondu
W
Alemayehu
e Oromia Regional Health Bureau , Addis Ababa , Ethiopia.
Solomon
S
Gadisa
a The Fred Hollows Foundation Ethiopia , Addis Ababa , Ethiopia.
Ahmed
A
Abajobir
f Department of Ophthalmology, Faculty of Medicine , Addis Ababa University , Addis Ababa , Ethiopia.
Yilikal
Y
Adamu
g Task Force for Global Health , Addis Ababa , Ethiopia.
Menbere
M
Alemu
h Lig Eye Care and Public Health Research , Addis Ababa , Ethiopia.
Liknaw
L
Adamu
i Michael Dejene Public Health Consultancy Services , Addis Ababa , Ethiopia.
Michael
M
Dejene
e Oromia Regional Health Bureau , Addis Ababa , Ethiopia.
Addis
A
Mekasha
e Oromia Regional Health Bureau , Addis Ababa , Ethiopia.
Zelalem
Z
Habtamu Jemal
e Oromia Regional Health Bureau , Addis Ababa , Ethiopia.
Damtew
D
Yadeta
j Federal Ministry of Health , Addis Ababa , Ethiopia.
Oumer
O
Shafi
j Federal Ministry of Health , Addis Ababa , Ethiopia.
Genet
G
Kiflu
k Task Force for Global Health , Decatur , GA , USA.
Rebecca
R
Willis
k Task Force for Global Health , Decatur , GA , USA.
Rebecca M
RM
Flueckiger
k Task Force for Global Health , Decatur , GA , USA.
Brian K
BK
Chu
k Task Force for Global Health , Decatur , GA , USA.
Alexandre L
AL
Pavluck
b Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.
Anthony W
AW
Solomon
D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D014943:Global Health; D006306:Health Surveys; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D014141:Trachoma / Q000453:epidemiology*; D058457:Trichiasis / Q000453:epidemiology*
Ethiopia; Global Trachoma Mapping Project; Oromia; prevalence; risk factors; trachoma; trichiasis