article · Ophthalmic Epidemiology
Extensive population-based surveys conducted across 252 woredas in the Oromia Regional State of Ethiopia have completed the baseline trachoma map for the region. Examining over 127,000 individuals across 46,244 households, the study established prevalence rates for trachomatous inflammation follicular in children and trichiasis in adults. The findings show that active trachoma and trichiasis are widespread public health concerns across the region. The overall adult trichiasis prevalence exceeded the elimination threshold in 240 woredas, while active follicular trachoma affected nearly a quarter of children aged one to nine. Key risk factors associated with active trachoma in children included younger age, female sex, longer travel time to water sources for face-washing, open defecation, lower altitude, low annual rainfall, and low mean temperatures. Consequently, most surveyed districts urgently require comprehensive implementation of the SAFE strategy components to manage and eliminate the disease.
Trachoma remains a primary cause of preventable infectious blindness. By providing granular, district-level data across previously unmapped areas of Oromia, these findings identify the specific communities most vulnerable to disease transmission. This evidence enables public health organisations and policymakers to target antibiotic distribution, surgical outreach, and water and sanitation investments directly to the communities where disease burdens remain substantially above global elimination targets.
The abstract outlines epidemiological survey data rather than a commercial product or technical invention. While the findings provide actionable evidence directly ready for use by public health authorities, nongovernmental organisations, and healthcare programmes to allocate pharmaceutical supplies and surgical resources, the abstract does not indicate a commercialisation pathway.
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PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: Both active trachoma and trichiasis are highly prevalent in much of Oromia, constituting a significant public health problem for the region.
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DOI: 10.1080/09286586.2016.1243717
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