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

Figures & data

Table 1. Woredas surveyed for trachoma, or in which interventions against trachoma had commenced, prior to the Global Trachoma Mapping Project (GTMP), Oromia, Ethiopia, 2012.

Zone	Woreda	Year of most recentsurvey^a	TF,^b %	Trichiasis,^c %	Remarks
Arsi	Ziway Dugda	2010	22.1	3
	Dodota	2010	16.9	2.5
East Shewa	Bora	2008	60	12
	Dugda	2008	60	7
	Adami Tullu, Jido Kombolcha	2008	23	7
	Lomie	2013	12.53	1.68
	Adama	2007	19	1.7	MDA stopped in 2011. An impact survey was not done. Re-surveyed with GTMP.
	Fentale	2010	10	1.7
	Bosset	2007	19	1.7	MDA stopped in 2011. An impact survey was not done. Re-surveyed with GTMP.
East Wollega	Sibu Sire	2007	24.5	3.5	No woreda-level baseline data; antibiotic distribution commenced using region-level prevalence data (shown).
	Sasiga	2010	9.6	0.7
	Diga	2010	14	2.5
Ilu Aba Bora	Gechi	2011	23.2	1.6
Jimma	Sokoru	2007	24.5	3.5	No woreda-level baseline data; antibiotic distribution commenced using region-level prevalence data (shown).
	Omonada	2011	12.8	2.8	No baseline data. Data shown are from an impact survey conducted after 3 years of antibiotic distribution.
North Shewa	Dera	2010	34.1	8.7
	Hidhebu Abote	2008	42.9	4.8
	Wore Jarso	2010	16	9.5
West Arsi	Arsi Negele	2009	39.6	6.9
West Shewa	Dendi	2010	27.4	0
	Gindeberet	2011	55.3	1.7
	Abune Gindeberet	2011	55.3	1.7
	Bako Tibe	2010	37	0.5

^aPopulation-based prevalence survey.

^bPopulation-level prevalence in those aged 1–9 years.

^cPopulation-level prevalence in those aged ≥15 years.

MDA, mass drug administration; TF, trachomatous inflammation – follicular.

Figure 1. Map of woredas with previous trachoma mapping, or in which interventions against trachoma had commenced prior to the Global Trachoma Mapping Project, Oromia, Ethiopia, 2012.

Figure 2. Prevalence of trachomatous inflammation – follicular (TF) in children aged 1–9 years by evaluation unit, Global Trachoma Mapping Project, Oromia, Ethiopia, 2012–2014.

Figure 3. Prevalence of trichiasis in adults aged ≥15 years, Global Trachoma Mapping Project, Oromia, Ethiopia, 2012–2014.

Table 2. Prevalence of trachomatous inflammation – follicular (TF) in children aged 1–9 years by evaluation unit, Global Trachoma Mapping Project, Oromia, Ethiopia, 2012–2014.

Zone	Evaluation unit	Children aged 1–9years examined, n	TF cases, n	Unadjusted TF, %	Adjusted TF, % (95% CI)
Arsi	Amigna, Bele Gasgar, Robe, Seru, Shirka	1091	307	28.1	29.6 (23.4–36.4)
	Aseko, Chole, Gololcha (Arsi), Guna, Merti	878	221	25.2	24.3 (17.1–31.8)
	Degeluna Tijo, Enkelo Wabe, Limuna Bilbilo, Lude Hitosa, Tena	1022	243	23.8	20.9 (14.2–27.4)
	Deksis, Dodota, Jeju, Sire, Sude	1036	315	30.4	30.1 (24.1–38.1)
	Hitosa, Munessa, Tiyo, Ziway Dugda	1017	274	26.9	23.6 (15.7–31.5)
Bale	Agarfa, Dinsho, Gasera, Goba, Sinana	1023	480	46.9	42.3 (35.7–51.0)
	Berbere, Dolo Mena, Gura Damole, Harena Buluk, Meda Welabu	1041	441	42.4	38.8 (32.5–45.5)
	Dawe Kachen, Dawe Serer, Ginir, Gololcha (Bale), Goro (Bale), Lege Hida, Rayitu, Seweyna	1008	432	42.9	40.4 (33.2–49.3)
Borena	Abaya, Bule Hora, Dugda Dawa, Gelana	1292	502	38.9	37.1 (30.2–43.7)
	Arero, Dehas, Dire, Miyo, Moyale, Teltele, Yabelo	882	272	30.8	29.2 (20.9–38.6)
	Dillo, Melka Soda	1073	485	45.2	43.5 (35.4–53.1)
East Harerge	Babile, Chinaksen, Gursum, Jarso	1076	487	45.3	42.3 (34.2–48.3)
	Bedeno, Deder, Malka Balo	993	354	35.6	30.9 (23.2–39.6)
	Fedis, Girawa, Golo Oda, Meyu, Midega Tola	1187	575	48.4	46.6 (37.9–54.1)
	Goro Gutu, Kersa, Meta	1120	394	35.2	34.6 (29.2–40.3)
	Haro Maya, Kombolcha, Kurfa Chele	1061	267	25.2	25.0 (18.8–30.5)
	Kumbi	1046	426	40.7	38.0 (32.2–43.2)
East Shewa	Ada’a, Gimbichu, Liben	758	297	39.2	37.8 (31.4–46.0)
	Adama	711	262	36.8	34.7 (24.1–37.8)
	Boset	891	303	34.0	31.2 (27.1–43.8)
East Wollega	Boneya Boshe, Jimma Arjo, Leka Dulecha, Nunu Kumba, Wama Hagalo, Wayu Tuka	840	177	21.1	19.8 (13.0–27.9)
	Diga, Gobu Seyo, Gudeya Bila, Guto Gida, Sasiga	845	184	21.8	18.4 (11.0–27.6)
	Gida Kiremu, Haro Limu, Ibantu, Kiramu, Limu	994	441	44.4	43.2 (34.3–51.3)
Guji	Adola, Hambela Wamena, Liben (Guji), Odo Shakiso, Wadera	1265	469	37.1	35.5 (29.2–42.7)
	Afele Kola (Dima), Ana Sora, Gora Dola, Saba Boru	1071	264	24.6	24.8 (18.1–33.0)
	Bore, Girja (Harenfema), Kercha, Uraga	1253	434	34.6	29.7 (21.3–37.4)
Horo Guduru	Ababo, Abay Chomen, Abe Dongoro, Amuru, Guduru, Horo (Horo Guduru), Jarte Jardega, Jimma Genete, Jimma Rare	967	488	50.5	48.7 (41.6–57.1)
Illu Aba bora	Ale	631	42	6.7	4.9 (1.5–8.7)
	Alge Sachi, Bilo Nopha, Metu Zuria	843	71	8.4	5.5 (2.1–10.2)
	Badele Zuria, Chora, Chwaka, Dabo Hana, Dega, Dorani, Meko	943	157	16.6	16.0 (10.0–23.4)
	Bicho, Borecha, Dedesa, Hurumu, Yayu	803	212	26.4	21.0 (14.1–28.3)
	Bure	694	73	10.5	8.8 (4.4–13.8)
	Darimu	954	95	10.0	7.3 (3.5–12.2)
	Didu	762	82	10.8	10.2 (6.6–14.6)
	Halu (Huka)	549	10	1.8	1.2 (0.4–1.9)
	Nono Sale	332	74	22.3	22.4 (15.0–30.1)
Jimma	Chora Botor, Limu Kosa, Limu Seka	933	215	23.0	20.5 (13.4–28.2)
	Dedo, Seka Chekorsa	1012	488	48.2	45.9 (38.8–52.2)
	Gera, Nono Benja, Setema, Sigmo	972	479	49.3	46.3 (37.7–53.5)
	Goma, Guma, Shebe Sambo	991	431	43.5	41.5 (32.9–50.2)
	Kersa (Jimma), Mena (Jimma), Tiro Afeta	1103	400	36.3	35.5 (27.3–44.4)
Kelem Wollega	Anfilo, Gidami, Sayo	879	29	3.3	3.2 (1.0–4.9)
	Dale Sadi, Gawo Kebe, Lalo Kile	937	89	9.5	8.6 (4.1–13.0)
	Dale Wabera	886	42	4.7	6.3 (2.7–10.9)
	Hawa Galan	1331	154	11.6	10.0 (4.6–16.0)
	Jimma Horo	1027	22	2.1	2.9 (1.0–5.6)
	Yama Logi Welel	931	41	4.4	4.2 (1.7–6.2)
North Shoa	Abichuna Gne’a, Aleltu, Jida, Kembibit	861	223	25.9	25.5 (18.2–33.6)
	Debre Libanos, Kuyu, Wuchale, Yaya Gulele	968	466	48.1	47.1 (40.0–55.9)
	Degem, Dera, Gerar Jarso, Wara Jarso	824	411	49.9	48.4 (40.3–58.0)
South West Shewa	Akaki, Bereh, Mulo, Sebeta Hewas, Sululta, Walmara	881	290	32.9	29.8 (21.2–38.5)
	Ameya, Goro, Waliso, Wenchi	1159	391	33.7	32.1 (22.6–41.8)
	Becho, Dawo, Ilu, Kersana Malima, Seden Sodo, Sodo Daci, Tole	1006	316	31.4	30.3 (23.2–37.6)
West Harerge	Anchar, Goba Koricha, Habro	1040	391	37.6	36.3 (28.7–45.8)
	Boke, Daro Lebu, Gemechis, Oda Bultum	1231	416	33.8	33.4 (27.3–41.2)
	Chiro Zuria, Hawi Gudina, Mieso	1047	304	29.0	28.3 (22.4–35.3)
	Doba, Burka Demtu, Mesela, Tulo	978	207	21.2	21.8 (14.4–30.4)
West Shewa	Adda Berga, Ejere (Addis Alem), Meta Robi	950	348	36.6	35.4 (27.3–43.4)
	Ambo Zuria, Jibat, Nono, Tikur Enchini, Toke Kutaye	1058	330	31.2	29.1 (22.9–37.2)
	Bako Tibe, Cheliya, Ilu Gelan, Dano, Mida Kegn	1100	438	39.8	39.8 (31.0–47.3)
	Dendi, Ifata, Jeldu	1084	190	17.5	17.0 (12.4–22.1)
West Arsi	Adaba, Kokosa, Nenesebo	1159	143	12.3	13.2 (7.5–18.6)
	Dodola, Gedeb Asasa, Kore	1381	317	23.0	21.9 (15.6–29.7)
	Shalla, Shashemene, Siraro	1327	620	46.7	45.8 (37.8–55.1)
	Wondo, Kofele	1497	383	25.6	27.3 (20.0–35.5)
West Wollega	Ayra, Guliso, Jarso, Nejo	714	28	3.9	3.9 (1.2–7.7)
	Babo	997	25	2.5	2.5 (1.0–4.8)
	Begi	1079	109	10.1	9.3 (6.5–12.8)
	Boji Chekorsa	778	20	2.6	2.8 (0.7–5.9)
	Boji Dirmeji	640	8	1.3	1.2 (0.3–2.1)
	Gaji	780	10	1.3	1.1 (0.3–2.2)
	Gimbi	713	20	2.8	1.8 (0.8–3.3)
	Gudetu Kondole	1197	174	14.5	14.3 (8.5–19.9)
	Haru	708	20	2.8	2.9 (1.2–4.6)
	Homa, Yubdo	742	53	7.1	5.7 (2.1–8.5)
	Kiltu Kara, Mana Sibu	949	82	8.6	8.0 (3.7–13.8)
	Lalo Asabi	705	18	2.6	2.9 (0.4–6.6)
	Nole Kaba	741	33	4.5	4.3 (1.2–7.2)
	Sayo Nole	789	25	3.2	2.1 (0.4–4.5)

CI, confidence interval.

Table 3. Prevalence of trichiasis in adults aged ≥15 years by evaluation unit, Global Trachoma Mapping Project, Oromia, Ethiopia, 2012–2014.

Zone	Evaluation Unit	Adults ≥15 years examined, n	Trichiasis cases, n	Unadjusted trichiasis, %	Adjusted trichiasis, % 95% CI
Arsi	Amigna, Bele Gasgar, Robe, Seru, Shirka	1371	10	0.7	0.3 (0.1–0.7)
	Aseko, Chole, Gololcha (Arsi), Guna, Merti	1280	21	1.6	0.9 (0.5–1.4)
	Degeluna Tijo, Enkelo Wabe, Limuna Bilbilo, Lude Hitosa, Tena	1332	15	1.1	0.8 (0.2–1.5)
	Deksis, Dodota, Jeju, Sire, Sude	1282	18	1.4	0.7 (0.4–1.2)
	Hitosa, Munessa, Tiyo, Ziway Dugda	1394	31	2.2	1.3 (0.7–2.0)
Bale	Agarfa, Dinsho, Gasera, Goba, Sinana	1514	7	0.5	0.3 (0.1–0.7)
	Berbere, Dolo Mena, Gura Damole, Harena Buluk, Meda Welabu	1137	12	1.1	0.7 (0.3–1.0)
	Dawe Kachen, Dawe Serer, Ginir, Gololcha (Bale), Goro (Bale), Lege Hida, Rayitu, Seweyna	1303	33	2.5	1.5 (0.9–2.1)
Borena	Abaya, Bule Hora, Dugda Dawa, Gelana	1283	14	1.1	0.7 (0.2–1.1)
	Arero, Dehas, Dire, Miyo, Moyale, Teltele, Yabelo	1275	29	2.3	0.9 (0.5–1.6)
	Dillo, Melka Soda	1170	12	1.0	0.6 (0.3–1.0)
East Harerge	Babile, Chinaksen, Gursum, Jarso	1364	30	2.2	1.1 (0.6–1.6)
	Bedeno, Deder, Malka Balo	1321	30	2.3	1.1 (0.6–1.6)
	Boke, Daro Lebu, Gemechis, Oda Bultum	1403	37	2.6	1.2 (0.7–1.7)
	Fedis, Girawa, Golo Oda, Meyu, Midega Tola	1586	49	3.1	1.7 (1.2–2.4)
	Goro Gutu, Kersa, Meta	1537	47	3.1	1.4 (0.8–2.2)
	Haro Maya, Kombolcha, Kurfa Chele	1478	42	2.8	1.4 (0.6–2.0)
	Kumbi	1096	30	2.7	1.0 (0.5–1.6)
East Shewa	Ada’a, Gimbichu, Liben	1235	42	3.4	1.5 (0.8–2.5)
	Adama	1318	31	2.4	1.2 (0.4–1.3)
	Boset	1580	32	2.0	0.9 (0.7–1.8)
East Wollega	Boneya Boshe, Jimma Arjo, Leka Dulecha, Nunu Kumba, Wama Hagalo, Wayu Tuka	1477	18	1.2	0.7 (0.3–1.1)
	Diga, Gobu Seyo, Gudeya Bila, Guto Gida, Sasiga	1470	14	1.0	0.5 (0.2–1.0)
	Gida Kiremu, Haro Limu, Ibantu, Kiramu, Limu	1453	29	2.0	1.1 (0.5–1.9)
Guji	Adola, Hambela Wamena, Liben (Guji), Odo Shakiso, Wadera	1354	19	1.4	0.9 (0.3–1.9)
	Afele Kola (Dima), Ana Sora, Gora Dola, Saba Boru	1163	1	0.1	0.0 (0.0–0.1)
	Bore, Girja (Harenfema), Kercha, Uraga	1314	9	0.7	0.3 (0.1–0.6)
Horo Guduru	Ababo, Abay Chomen, Abe Dongoro, Amuru, Guduru, Horo (Horo Guduru), Jarte Jardega, Jimma Genete, Jimma Rare	1458	32	2.2	1.5 (0.7–2.3)
Illu Aba bora	Ale	1612	7	0.4	0.3 (0.0–0.7)
	Alge Sachi, Bilo Nopha, Metu Zuria	1720	11	0.6	0.5 (0.1–1.1)
	Badele Zuria, Chora, Chwaka, Dabo Hana, Dega, Dorani, Meko	1593	25	1.6	1.1 (0.5–2.0)
	Bicho, Borecha, Dedesa, Hurumu, Yayu	1644	24	1.5	1.1 (0.6–1.8)
	Bure	1617	6	0.4	0.3 (0.0–0.7)
	Darimu	1695	10	0.6	0.3 (0.1–0.7)
	Didu	1582	3	0.2	0.1 (0.0–0.1)
	Halu (Huka)	1600	9	0.6	0.3 (0.1–0.6)
	Nono Sale	780	1	0.1	0.1 (0.0–0.3)
Jimma	Chora Botor, Limu Kosa, Limu Seka	1614	26	1.6	1.0 (0.4–1.6)
	Dedo, Seka Chekorsa	1511	49	3.2	2.3 (1.4–3.3)
	Gera, Nono Benja, Setema, Sigmo	1349	28	2.1	1.6 (0.7–2.8)
	Goma, Guma, Shebe Sambo	1634	35	2.1	0.9 (0.5–1.4)
	Kersa, Mena, Tiro Afeta	1523	63	4.1	2.5 (1.6–3.6)
Kelem Wollega	Anfilo, Gidami, Sayo	1630	8	0.5	0.4 (0.1–0.7)
	Dale Sadi, Gawo Kebe, Lalo Kile	1617	14	0.9	0.6 (0.2–0.9)
	Dale Wabera	1817	19	1.0	0.7 (0.3–1.1)
	Hawa Galan	1846	30	1.6	1.0 (0.5–1.3)
	Jimma Horo	1765	4	0.2	0.1 (0.0–0.2)
	Yama Logi Welel	1766	5	0.3	0.2 (0.0–0.5)
North Shoa	Abichuna Gne’a, Aleltu, Jida, Kembibit	1728	10	0.6	0.5 (0.1–1.0)
	Debre Libanos, Kuyu, Wuchale, Yaya Gulele	1682	23	1.4	0.6 (0.3–1.0)
	Degem, Dera, Gerar Jarso, Wara Jarso	1582	52	3.3	2.0 (1.3–2.9)
South West Shewa	Akaki, Bereh, Mulo, Sebeta Hewas, Sululta, Walmara	1553	19	1.2	0.7 (0.3–1.3)
	Ameya, Goro, Waliso, Wonchi	1716	55	3.2	1.7 (0.9–2.4)
	Becho, Dawo, Ilu, Kersana Malima, Seden Sodo, Sodo Daci, Tole	1508	25	1.7	0.8 (0.4–1.2)
West Arsi	Adaba, Kokosa, Nenesebo	1289	5	0.4	0.3 (0.1–0.6)
	Dodola, Gedeb Asasa, Kore	1368	4	0.3	0.1 (0.0–0.3)
	Shalla, Shashemene, Siraro	1416	35	2.5	1.7 (1.0–2.5)
	Wondo, Kofele	1659	16	1.0	0.7 (0.2–1.2)
West Harerge	Anchar, Goba Koricha, Habro	1527	49	3.2	1.6 (1.0–2.5)
	Chiro Zuria, Hawi Gudina, Mieso	1461	46	3.1	1.8 (1.1–2.3)
	Doba, Burka Demtu, Mesela, Tulo	1455	29	2.0	1.0 (0.5–1.3)
West Shewa	Adda Berga, Ejere (Addis Alem), Meta Robi	1555	28	1.8	1.0 (0.5–1.5)
	Ambo Zuria, Jibat, Nono, Tikur Enchini, Toke Kutaye	1457	15	1.0	0.4 (0.2–0.7)
	Bako Tibe, Cheliya, Ilu Gelan, Dano, Mida Kegn	1632	33	2.0	1.2 (0.7–1.8)
	Dendi, Ifata, Jeldu	1653	10	0.6	0.4 (0.1–0.9)
West Wollega	Ayra, Guliso, Jarso (West Wollega), Nejo	1689	12	0.7	0.4 (0.1–0.7)
	Babo	1782	14	0.8	0.4 (0.1–0.7)
	Begi	1795	21	1.2	1.0 (0.5–1.7)
	Boji Chekorsa	1783	13	0.7	0.4 (0.2–0.8)
	Boji Dirmeji	1801	15	0.8	0.6 (0.3–1.0)
	Gaji	1642	4	0.2	0.1 (0.0–0.2)
	Gimbi	1581	18	1.1	0.5 (0.3–0.9)
	Gudetu Kondole	1750	27	1.5	1.3 (0.7–2.0)
	Haru	1638	10	0.6	0.4 (0.1–0.8)
	Homa, Yubdo	1554	9	0.6	0.2 (0–0.4)
	Kiltu Kara, Mana Sibu	1582	18	1.1	1.1 (0.4–1.9)
	Lalo Asabi	1677	9	0.5	0.2 (0.1–0.4)
	Nole Kaba	1586	2	0.1	0.0 (0.0–0.1)
	Sayo Nole	1510	4	0.3	0.2 (0–0.5)

CI, confidence interval.

Table 4. Multilevel univariable analysis of factors related to trachomatous inflammation – follicular (TF) in children aged 1–9 years, Global Trachoma Mapping Project, Oromia, Ethiopia, 2012–2014.

Variable		n	TF, %	Univariable oddsratio (95% CI)^a	P-value^b
Individual
Age, years	1–4	17,092	28.6	2.36 (2.22–2.50)	<0.0001
	5–9	24,550	16.8	1
Sex	Male	20,679	21.4
	Female	20,963	21.8	1.05 (0.99–1.11)	<0.0001
Household
Children aged 1–9 years in household, n	1–3	36,822	22.6	1
	≥4	4820	14.6	1.12 (0.99–1.25)	0.1473
Inhabitants in household, n	1–5	30,507	25.4	1
	≥6	11,135	11.3	1.00 (0.91–1.11)	0.2879
Open defecation (no facilities, bush, or field)	Yes	15,576	30.7	1.18 (1.09–1.27)
	No	26,066	16.2	1
Drinking source surface water^c	Yes	7733	24.0	1.00 (0.87–1.15)	0.7583
	No	33,909	21.1	1
Time to main source of drinking water, minutes^d	<30	19,657	17.3	1
	≥30	21,985	25.6	1.11 (1.01–1.22)	0.0391
Washing source surface water^c	Yes	9081	22.7	0.99 (0.87–1.13)	0.1213
	No	33,949	20.5	1
Time to main source of water used for face-washing, minutes^d	<30	20,176	17.3	1	0.014
	≥30	21,436	25.7	1.14 (1.04–1.25)
	All washing at source	30	6.7	2.30 (0.34–15.55)
Cluster-level geoclimatic
Altitude^e, m above sea level	<2500	37,034	21.5	1
	≥2500	4,595	22.4	0.41 (0.33–0.50)	<0.0001
Maximum temperature of warmest month^f, °C	<25	5,606	25.8	1
	≥25	36,036	21.0	2.05 (1.64–2.59)
Mean annual precipitation^f, mm	<1000	9,319	37.7	8.53 (6.89–10.57)	<0.0001
	1000–1499	16,308	22.0	3.18 (2.61–3.87)
	≥1500	16,015	11.9	1

^aMultilevel univariable random effects regression accounting for clustering at evaluation unit and kebele (cluster) level.

^bWald’s test.

^cRiver, dam, lake, canal.

^dTime for round-trip estimated by household head.

^eFrom GPS coordinates of household collected at time of survey.

^fFrom estimates of mean kebele (cluster) coordinates extracted from Bioclim rasters (Worldclim.org).

CI, confidence interval.

Table 5. Multilevel multivariable analysis of factors related to trachomatous inflammation – follicular (TF) in children aged 1–9 years, Global Trachoma Mapping Project, Oromia, Ethiopia, 2012–2014.

Variable		Multivariable odds ratio^a	p-value^b
Individual
Age 1–4 years (reference 5–9 years)		2.36	<0.00001
Female sex		1.08	0.011
Household
Open defecation (no facilities, bush, or field)		1.16	<0.0001
Time to main source of water used for face-washing, minutes	<30	1.00	0.0391
	≥30	1.12
	All washing at source	2.43
Cluster-level geoclimatic
Altitude^c, m above sea level	≥2500	0.44	<0.0001
Mean annual precipitation^d, mm	<1000	2.03	0.0022
	1000–1499	1.59
	≥1500	1.00

^aMultilevel multivariable random effects logistic regression accounting for clustering at evaluation unit and kebele (cluster) level.

^bLikelihood ratio test of inclusion/exclusion of variable in final model.

^cFrom GPS coordinates of households.

^dMean kebele (cluster) coordinates extracted from Bioclim rasters (Worldclim.org).

Table 6. Multilevel univariable analysis of factors related to the presence of trichiasis in adults aged ≥15 years, Global Trachoma Mapping Project, Oromia, Ethiopia, 2012–2014.

Variable		n	Trichiasis, %	Univariable oddsratio (95% CI)^a	p-value^b
Individual
Age, years	15–24	19,622	0.1	1	<0.0001
	25–34	18,468	0.5	3.46 (2.20–5.30)
	35–44	13,122	1.0	6.73 (4.40–10.20)
	45–54	8204	2.1	14.34 (9.50–21.50)
	55–64	4913	3.3	24.32 (16.10–36.00)
	≥65	5152	4.8	37.90 (25.40–56.70)
Sex	M	30,706	0.5	1	<0.0001
	F	38,775	1.7	3.36 (2.82–4.00)
Household
Children aged 1–9 years in household, n	0	32,110	1.5	1.89 (1.15–3.08)	<0.0001
	1–3	34,809	0.9	1.15 (0.70–1.87)
	≥4	2562	0.7	1
Inhabitants in household^c, n	1	6643	2.6	2.59 (1.95–3.42)	<0.0001
	2–5	47,183	1.2	1.34 (1.06–1.68)
	≥6	15,655	0.7	1
Open defecation (no facilities, bush, or field)	Yes	22,722	1.7	1.45 (1.23–1.70)	<0.0001
	No	46,759	0.9	1
Drinking source surface water^d	Yes	11,786	1.4	1.21 (0.97–1.49)	0.08
	No	57,695	1.2	1
Time to main source of drinking water, minutes^e	≥30	35,285	1.3	1.00 (0.84–1.16)	0.931
	<30	34,196	1.1	1
Washing source surface water^d	Yes	13,892	1.3	1.14 (0.94–1.40)	0.1857
	No	55,589	1.2	1
Time to main source of washing water^e, minutes	≥30	34,367	1.3	2.14 (0.25–18.22)	0.7839
	<30	35,054	1.1	1
	All washing at source	60	1.7	1.00 (0.85–1.17)
Cluster-level geoclimatic
Altitude^f, m above sea level	<1500	8973	1.7	1	<0.0001
	1500–2499	54073	1.2	0.86 (0.65–1.12)
	≥2500	6419	0.7	0.34 (0.22–0.54)
Maximum temperature of warmest month^g, °C	<25	7714	0.7	1	<0.0001
	≥25	61767	1.3	2.35 (1.67–3.29)
Mean annual precipitation^g, mm	<1000	12409	2.2	2.92 (2.06–4.13)	<0.0001
	1000–1499	24357	1.3	1.83 (1.35–2.46)
	≥1500	32715	0.7	1

^aMultilevel univariable random effects regression accounting for clustering at evaluation unit and kebele (cluster) level.

^bWald’s test.

^cPresented as binary living alone/not living alone in the final model, but displayed in further categories here for illustrative purposes.

^dRiver, dam, lake, canal.

^eTime for round-trip estimated by household head.

^fFrom GPS coordinates of households collected at time of survey.

^gMean kebele (cluster) coordinates extracted from Bioclim rasters (Worldclim.org).

CI, confidence interval.

Table 7. Multilevel multivariable analysis of factors related to the presence of trichiasis in adults aged ≥15 years, Global Trachoma Mapping Project, Oromia, Ethiopia, 2012–2014.

Variable		Multivariable odds ratio^a	p-value^b
Individual
Age, years	15–24	1.00	<0.0001
	25–34	3.25
	35–44	7.20
	45–54	15.62
	55–64	24.98
	≥65	41.81
Female sex		3.96	<0.0001
Household
Living alone		1.30	<0.0001
Open defecation (no facilities, bush, or field)		1.26	0.006
Cluster-level geoclimatic
Altitude^c, m above sea level	<1500	1.00	<0.0001
	1500–2499	0.93
	≥2500	0.50
Maximum temperature of warmest month^d, °C	≥25	1.89	0.0017
Mean annual precipitation^d, mm	<1000	2.55	<0.0001
	1000–1499	2.06
	≥1500	1.00

^aMultilevel multivariable random effects logistic regression accounting for clustering at evaluation unit and kebele (cluster) level.

^bp-value from Likelihood ratio test of inclusion/exclusion of variable in final model.

^cEstimate from GPS coordinates of household.

^dEstimates mean kebele (cluster) coordinates extracted from Bioclim rasters (Worldclim.org).