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. 2023 Dec;30(6):655-662.
doi: 10.1080/09286586.2022.2119258. Epub 2022 Dec 15.

Prevalence of Trachoma in Pre-validation Surveillance Surveys in 11 Evaluation Units (Covering 12 Districts) in Oromia Regional State, Ethiopia: Results from 2018-2020

Hirpa Miecha  1 , Michael Dejene  2 , Dereje Adugna  1 , Ageru Kebede  3 , Damtew Yadeta  1 , Addisu Alemayehu  4 , Aemero Abateneh  5 , Mihiret Dayessa  6 , Muhammed Shafi  7 , Emawayish Taye  3 , Leta Balcha  3 , Nebiyu Negussu  2 , Belete Mengistu  4 , Rebecca Willis  8 , Cristina Jimenez  9 , Ana Bakhtiari  8 , Sarah Boyd  8 , Biruk Kebede  2 , Fantahun Tadesse  2 , Ayele Mamo  1 , Mengistu Bekele  1 , Zelalem Sinke  1 , Anthony W Solomon  10 , Emma M Harding-Esch  11
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Prevalence of Trachoma in Pre-validation Surveillance Surveys in 11 Evaluation Units (Covering 12 Districts) in Oromia Regional State, Ethiopia: Results from 2018-2020

Hirpa Miecha et al. Ophthalmic Epidemiol. 2023 Dec.

Abstract

Purpose: Interventions to reduce the prevalence of trachoma and transmission of ocular Chlamydia trachomatis have been implemented in Oromia Region, Ethiopia. Following an impact survey in which the trachomatous inflammation-follicular (TF) prevalence in 1-9-year-olds is <5%, a surveillance survey is recommended 2 years later, without additional antibiotic treatment. We report results of surveillance surveys in 11 evaluation units (EUs) covering 12 districts in Oromia Region, to plan whether future interventions are needed.

Method: We use a two-stage cluster-sampling cross-sectional survey design. In each EU, 26 clusters (villages) were systematically selected with probability proportional to size; from each cluster, 30 households were selected using compact segment sampling. Water, sanitation and hygiene (WASH) access was assessed in all selected households. All residents of selected households aged ≥1 year were examined for TF and trachomatous trichiasis (TT) by certified graders.

Result: Of 31,991 individuals enumerated, 29,230 (91% of) individuals were examined. Eight EUs had an age-adjusted TF prevalence in 1-9-year-olds of ≥5% and seven had a TT prevalence unknown to the health system among adults aged ≥15 years of ≥0.2%. About one-third of visited households had access to an improved water source for drinking, and 5% had access to an improved latrine.

Conclusion: Despite TF reductions to <5% at impact survey, prevalence recrudesced to ≥5% in all but three of the 11 EUs. Operational research is needed to understand transmission dynamics and epidemiology, in order to optimise elimination strategies in high-transmission settings like these.

Keywords: epidemiology; recrudescence; trachoma; trichiasis.

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Conflict of interest statement

RW, AB and SB were employees of the International Trachoma Initiative, which receives an operating budget andresearch funds from Pfizer Inc., the manufacturer of Zithromax (azithromycin). EMHE receives salary support from the International Trachoma Initiative. No potential conflict of interest was reported by the other authors

Figures

Figure 1.
Figure 1.
Trachomatous inflammation—follicular (TF) prevalence in 1–9-year-olds over time, 11 evaluation units, Oromia Region, Ethiopia. (Methodologies and results of baseline and impact surveys are published elsewhere.),
See this image and copyright information in PMC

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