Prevalence of Trachoma from 66 Impact Surveys in 52 Woredas of Southern Nations, Nationalities and Peoples’ and Sidama Regions of Ethiopia, 2017–2019

ABSTRACT

Purpose

Trachoma is endemic in Southern Nations, Nationalities and Peoples’ (SNNP) and Sidama regions of Ethiopia. We aimed to measure the prevalence of trachomatous inflammation—follicular (TF) among children aged 1 – 9 years and the prevalence of trachomatous trichiasis (TT) unknown to the health system among people aged ≥15 years following interventions for trachoma in 52 woredas of SNNP and Sidama regions.

Methods

From 2017 – 2019, 66 two-stage cluster sampling cross-sectional population-based surveys were carried out in 52 woredas (third-level administrative divisions) using a standardized World Health Organization-recommended survey methodology. This included one impact survey in 40 woredas, two consecutive impact surveys in 10 woredas and three consecutive impact surveys in two woredas. Water, sanitation and Hygiene (WASH) access was assessed using a modified version of the United Nations Children’s Fund/WHO Joint Monitoring Programme questionnaire.

Results

By the end of this survey series, 15 (23%) of the woredas had met the active trachoma elimination threshold (TF prevalence <5%) and 12 (18%) had met the TT threshold (TT ≤ 0.2%). Regarding WASH coverage, 20% of households had access to an improved drinking water source within a 30-min journey and 3% had an improved latrine. There was strong evidence that TF was less common in 4 – 6-year-olds and 7 – 9-year-olds than 1 – 3-year-olds.

Conclusion

Based on the findings, further antibiotic mass drug administration is required in 37 woredas and active TT case finding is needed in 40 woredas. In these surveys, access to WASH facilities was very low; WASH improvements are required.

KEYWORDS:

• Ethiopia
• trachoma
• trichiasis
• Southern Nations
• Nationalities and Peoples’ Region
• Sidama Region

Acknowledgments

We are very grateful to thank all survey participants, recorders, graders, and field supervisors for their time and hard work.

Disclosure statement

AB, RW, and SB were employed by the International Trachoma Initiative at The Task Force for Global Health, which receives an operating budget and research funds from Pfizer Inc., the manufacturers of Zithromax® (azithromycin). EMHE receives salary support from the International Trachoma Initiative.

Disclaimer

The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated, USAID or the United States Government.

Additional information

Funding

This study was funded by Orbis International Ethiopia under their trachoma elimination program. Core Tropical Data funding was provided by the International Trachoma Initiative; Sightsavers; and RTI International through the United States Agency for International Development (USAID) Act to End NTDs | East program. RB’s salary was funded by the Fred Hollows Foundation. AWS is a staff member of the World Health Organization.