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. 2025 Jan 2;25(1):5.
doi: 10.1186/s12879-024-10410-3.

Impact of trachoma elimination efforts in afar regional state, Ethiopia: survey findings from 26 evaluation units

Getachew Gebreselassie  1 , Kasahun Negash  2 , Dawit Woga  2 , Misrak Makonnen  2 , Baye Deneke  2 , Muluken Desalegn  2 , Seada Ali  3 , Colin L Beckwith  4 , Fentahun Tadesse  4   5 , Fikre Seife  6 , Genet Kiflu  6 , Fikreab Kebede  6
Affiliations

Impact of trachoma elimination efforts in afar regional state, Ethiopia: survey findings from 26 evaluation units

Getachew Gebreselassie et al. BMC Infect Dis. .

Abstract

Background: Following interventions to eliminate trachoma in the Afar region of Ethiopia, our goal was to reassess the prevalence of trachomatous trichiasis (TT) and trachomatous inflammation-follicular (TF) at the woreda level, and to identify factors associated with the disease.

Methods: Cross-sectional community-based surveys were conducted in 26 trachoma-endemic woredas, employing a standardized approach. Households were selected as the secondary sampling unit. Surveys involved interviews with household heads, direct assessment of water, sanitation, and hygiene (WASH) access, and clinical examination of eligible household members for trachomatous trichiasis (TT) and trachomatous inflammation-follicular (TF).

Result: Overall, 18 out of the 26 woredas (69%) achieved the World Health Organization-recommended threshold for active trachoma elimination, with a prevalence of trachomatous inflammation-follicular (TF) below 5% in children aged 1-9 years. Additionally, 14 woredas (54%) met the threshold for trachomatous trichiasis (TT) elimination, with a prevalence of TT cases unknown to the health system below 0.2% in adults aged 15 years and older. However, access to improved drinking water sources within a 30-minute trip was limited to only 17% of households, and merely 9% had access to improved latrines. Addressing these WASH (Water, Sanitation, and Hygiene) challenges remains critical for sustaining progress in trachoma control and achieving long-term public health improvements in the Afar region.

Conclusion: In seven woredas, further rounds of antibiotic mass drug administration are required, complemented by initiatives to promote facial cleanliness and improve environmental conditions. Additionally, surgical campaigns for trachomatous trichiasis (TT) are needed in 12 woredas. There is a critical need to enhance access to improved Water, Sanitation, and Hygiene (WASH) facilities across all surveyed woredas to consolidate gains in trachoma control and achieve sustained public health improvements.

Keywords: Afar region; Elimination; Ethiopia; Survey; Trachoma.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the principles outlined in the Declaration of Helsinki. Ethical approval was obtained from Afar Regional Health Bureau Ethical Clearance Committee and the London School of Hygiene & Tropical Medicine, and Before participation, each individual was informed about the objectives of the survey and provided verbal informed consent. For children, verbal informed consent was obtained from parents or guardians. Informed consent was recorded using an Android smartphone. All procedures involving human participants were carried out in compliance with appropriate national and international ethical guidelines. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Prevalence of trachomatous inflammation—follicular (TF) in 1–9-year-olds, in trachoma impact surveys, Afar region, Ethiopia, 2020–2023. The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the authors, or the institutions with which they are affiliated, concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries
Fig. 2
Fig. 2
Prevalence of trachomatous trichiasis (TT) in ≥ 15-year-olds, in trachoma impact surveys, Afar region, Ethiopia, 2020–2023. The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the authors, or the institutions with which they are affiliated, concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries
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